Chronic superficial gastritis - Causes, Symptoms, Diagnosis and Treatment
Chronic superficial gastritis - A disease characterized by inflammation of the mucous layer of the stomach wall, in which the pathological process does not extend to deeper layers and does not affect the secretory function of the organ. The main symptoms are considered to discomfort and dull pain in the upper abdomen, which appear after a meal. Also, the disease may be accompanied by a nausea, belching and heartburn. A key role in the diagnosis plays esophagogastroscopy, endoscopic biopsies and breath test on helicobacter pylori. For the treatment of chronic superficial gastritis used antisecretory drugs, antacids, antibiotics. Forecast favorable with timely treatment.
Chronic superficial gastritis
gastritis is a long persistent disease, the pathogenesis of which is an inflammation of the gastric mucosa. This pathology is also called "non-atrophic gastritis" or "gastritis type B". Similarly, to assess the prevalence of the disease is difficult, because many people have a superficial gastritis are asymptomatic. According to statistics, this pathology occurs more than 50% of the world's population, regardless of age. Most often it is diagnosed in men. The clinical significance of chronic gastritis is not so much the disease prevalence, as in its progression and possible transition to an ulcer or gastric cancer. The study features the origin and development of disease, as well as the development of new diagnostic and treatment methods involved in gastroenterology.
Smoking, medications, and Helicobacter pylori infection. By the development of chronic superficial gastritis may cause irregular eating, insufficient chewing of food, cold food intake products, the use of rough or spicy foods, hot drinks. All of these factors affect the mucous membranes and may provoke acidification. Drinking alcohol inhibits the mucus, violates the regeneration of epithelial cells and reduces the microcirculation in the mucosa. Long experience of smoking can lead to the progression of the disease as a result of the deterioration of blood circulation in the stomach, strengthen the production of hydrochloric acid and impaired motor function.
The appearance of chronic superficial gastritis plays a role use of drugs such as nonsteroidal anti-inflammatory drugs, corticosteroids, some antibiotics, antituberculosis drugs, and so forth. Most often leads to the development of pathology NSAIDs that reduce the production of protective prostaglandins in the stomach.
The leading role in the progression of the disease plays an infection of Helicobacter pylori. This bacterium destroys mucous-bicarbonate barrier, increases the production of hydrochloric acid, violates the blood supply to the mucosa. Initially, it colonizes the antral region of the stomach, which is often affected in chronic superficial gastritis.
Because endogenous causes major role played by various diseases of internal organs. In particular, the development of superficial gastritis may cause adrenal insufficiency, anemia, hypovitaminosis, cardiac and pulmonary insufficiency. For all these diseases there is hypoxia, which leads to a violation of the mucous layer of the stomach function.
gastro). In this case the pains are similar to the ulcer nature, ie there may be an empty stomach and at night.
In chronic superficial gastritis pain is less intense than in gastric ulcer. It often has the character of discomfort. Also, patients often complain of heartburn, periodic nausea, regurgitation, or air, and the presence of constipation. In some cases, the disease can be asymptomatic and detected only during esophagogastroscopy. An objective study does not provide any substantive information and is used primarily to rule out other digestive diseases. In some cases, a small pain in the epigastric palpation may be observed.
esophagogastroduodenoscopy with biopsy of the mucosa. In this study show an increased secretion of mucus, congestion and swelling of the mucous membrane. Often these changes are in the duodenum. Sometimes it can be visualized in the stomach bile, which is a consequence of the duodeno-gastric reflux. For the final confirmation of the diagnosis using endoscopic biopsy, in which in histological material surface show signs of inflammation in the form of lymph plazmotsitarnoy mucosal infiltration. According to current recommendations of the biopsy sample taken from the antrum and fundus of the stomach. In chronic superficial gastritis pathological process is most often localized in the antrum.
For the diagnosis of the disease can be applied with a stomach X-ray double contrast. The images revealed signs of hypersecretion, increase the thickness of the mucous layer folds and violation of the motor-evacuation function. However, to date, stomach radiography inferior fibrogastroscopy on descriptiveness. An important role in the diagnosis of chronic superficial gastritis plays a study of the level of secretion of hydrochloric acid, determined by means of a daily intragastric pH-metry. pH monitoring can be carried out using a single or multi-channel probes or special radiopill. A superficial gastritis, atrophic unlike, there is normal or elevated levels of acidity. For the evaluation function shown gastric glands determination of pepsinogen I and II in the blood, the level of which in this condition remains normal.
All patients with a diagnosis of chronic superficial gastritis should be carried out a survey for the presence of H. pylori infection. For this purpose, it may be used determination of H. pylori in the stool by ELISA, Helicobacter breath test or determination in the blood of antibodies to Helicobacter. From the presence or absence of an infectious agent depends largely on the treatment strategy.
Chronic superficial gastritis differentiate from gastric ulcer, esophagitis, functional dyspepsia, pancreatitis, cholecystitis, enteritis, gastric cancer, and others. For the differential diagnosis of these diseases can be used methods such as esophagoscopy, esophageal manometry, ultrasound of the abdomen, fecal occult blood.
gastroenterologist. In the treatment of this disease is important to consider the main etiological factors, the nature of morphological changes in the mucous and acidity level. Treatment of the disease is designated primarily as an outpatient. Hospitalization may be recommended in severe exacerbations or the need to conduct a comprehensive survey. When stored acidity shows the assignment of anti-ulcer diet, which provides chemical, thermal and mechanical sparing. Eat small portions, it is desirable for at least five times a day. From clean diet foods that stimulate acid secretion and damaging the mucosa: strong broth, spices, coffee, soft drinks, fried foods, and so on.
For drug treatment used antisecretory drugs, such as omeprazole, ranitidine, famotidine, and pantoprazole, reducing the production of hydrochloric acid. Appointed antacid and enveloping means that neutralize the acid and protect the mucosa from adverse effects. These include Almagelum, Aluminium phosphate gel, magnesium hydroxide and bismuth citrate. Cytoprotective properties against stomach cells has sucralfate. In the presence of infection Helicobacter pylori eradication therapy is shown, which can be triple or quadruple. The ternary diagram includes antisecretory drug omeprazole or pantoprazole, and two antibiotics - clarithromycin and amoxicillin. Quadruple therapy includes antisecretory agent, metronidazole, tetracycline and bismuth citrate.
Disease prevention is aimed at the normalization of diet, elimination of uncontrolled receiving anti-inflammatory drugs and prompt treatment of Helicobacter pylori infection. Prediction of chronic superficial gastritis favorable for life, but to achieve a full recovery can be difficult.