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Atrophic gastritis


Atrophic gastritis Atrophic gastritis is a pathological process in the stomach, characterized by the development of atrophic changes in the structure of the mucous membrane, a decrease in the production of enzymes and hydrochloric acid, and degeneration of the digestive glands.

Why does atrophic gastritis develop?

The atrophic form of inflammation of the gastric mucosa develops as a result of non-treated superficial gastritis. Often the symptoms of the initial stage of inflammation are ignored by the patient and not in a hurry to seek medical help. Such an attitude to their health leads to the transition of acute gastritis to the chronic stage, and then to the atrophic form of gastritis.

The inflamed gastric mucosa is constantly exposed to various stimuli that aggravate the course of gastritis and cause severe dystrophic changes in the stomach over time.

With the development of atrophic gastritis, the patient's condition is increasingly aggravated: the gastric mucosa rather sharply reacts to the gastric juice and ingested food. As a result, the mucous layer of the body becomes thinner, the glands that produce gastric juice and enzymes atrophy.

Atrophic gastritis is dangerous because the treatment no longer guarantees a complete recovery and recovery. Gastroenterologists regard this form of gastritis as a precancerous condition. Atrophy of the mucous membrane and glands of the internal secretion of the stomach seriously weakens the immune system as a whole. The body begins to produce an insufficient amount of immunoglobulin, and antibodies, which must fight against foreign microorganisms, begin to "kill" their cells. Against this background, the patient develops an autoimmune disease.

Eating negatively affects the state of the stomach, as food becomes an additional source of irritation of the damaged mucous membrane. The deformed gastric mucosa cannot withstand the ravages of food and the reactions of the immune system.

As a rule, the atrophic process in the stomach no longer has a returnable form. This means that it is impossible to completely cure the disease, however, timely initiated treatment can stop the pathological process.

Causes and predisposing factors

At risk for the development of this disease are:

  • people older than 35-40 years;
  • people who are forced to work in hazardous industries and inhale vapors of toxic substances;
  • people who are forced to take certain medications for a long time (especially non-steroidal anti-inflammatory, chloramphenicol, antibiotics);
  • people who are subject to frequent stress and psychological stress;
  • individuals with an asocial lifestyle - alcohol abusers who do not adhere to the diet;
  • people abusing spicy dishes, spices, pickles, strong coffee and black tea;
  • people who conducted diagnostic studies of the mucous membrane of the stomach and duodenum.

Hereditary predisposition to gastritis is also of great importance. If both parents suffer from diseases of the digestive tract, then it is likely that their child will sooner or later have problems with the stomach.

Symptoms of atrophic gastritis

The symptoms of the atrophic form of gastritis are in many ways similar to the manifestations of acute inflammation of the gastric mucosa. The patient has the following clinical symptoms:

  • Pain - as a rule, any violations in the work of the digestive system are accompanied by the appearance of discomfort or pain in the epigastric region. In its intensity, pain can be aching, weak, strong, cramping and sharp. Unpleasant sensations in the epigastric region may be present all the time or occur occasionally, under the influence of certain stimuli. The main distinguishing feature of atrophic gastritis is the absence of acute paroxysmal pain. Most often the pain is dull and sporadic.
  • Dyspeptic symptoms - heartburn, nausea, excessive salivation, feeling of heaviness in the stomach, aggravated after meals, diarrhea and constipation, flatulence, rumbling in the stomach.
  • Atrophic gastritis is accompanied by belching. The patient needs to pay special attention to the taste in the mouth after belching: a sour taste characterizes atrophic gastritis with high acidity.
  • With a pronounced atrophic process, the patient's condition is deteriorating. Due to damage to the gastric mucosa, enzymes and nutrients cannot be fully absorbed, and this leads to disruption of metabolic processes, the development of beriberi and iron deficiency anemia.
  • Against the background of vitamin B12 deficiency and iron, the patient appears weak, short of breath, heart palpitations.
  • When examining the tongue atrophy of the papillae is clearly visible - the tongue looks "polished".

At first, all these signs are hardly noticeable, but as the pathological process progresses, complete exhaustion of the body develops quite quickly.

Diagnosis of atrophic gastritis

Diagnosis of the atrophic form of gastritis is based on the obtained laboratory data, the clinical manifestations of the disease and the patient's complaints, endoscopic and histological data.

Functional diagnosis of atrophic gastritis includes:

  • pH measurement of metry, with which you can determine the secretory ability of parietal cells;
  • study of the activity of gastric enzymes and the total proteolytic activity of gastric juice;
  • diagnosis of motor function of the digestive tract, based on the results of gastrography.

Measurement of daily pH metrics is the main method for the diagnosis of atrophic forms of gastritis. This study allows to determine the treatment tactics for the patient, as well as to know the prognosis and effectiveness of the prescribed therapy. Most often, atrophic gastritis is accompanied by low acidity of the stomach. On average, the daily pH ranges from 3 to 6.

A mandatory study for any form of gastritis is the determination of the presence on the mucosa of the bacterium Helicobacter pylori. This study allows us to determine the cause of the lesion of the mucous membrane of the organ, as in most cases the current Helicobacter infection is a predisposing factor in the development of atrophic gastritis.

Treatment of atrophic gastritis

First of all, the treatment of atrophic gastritis is aimed at eliminating the causes of the development of the pathological process. If gastritis is caused by the Helicobacter pylori bacterium, the patient is prescribed eradication therapy - an enhanced course of antibiotics to which the bacterium is sensitive.

When the autoimmune cause of the development of the atrophic process, the patient is prescribed a course of hormonal therapy and vitamin B12.

Pathogenetic therapy

  • Replacement therapy includes the appointment of the patient drugs based on hydrochloric acid and enzymes of gastric juice. Sometimes patients are prescribed natural gastric juice before meals.
  • Be sure to prescribe drugs that contain gastric enzymes in order to facilitate the process of digestion and obstruction of congestive processes in the stomach.
  • When a patient is diagnosed with iron deficiency anemia and vitamin B12 deficiency in the body, B12 drugs are prescribed parenterally.
  • Drugs that stimulate the production of hydrochloric acid in the body.
  • During the period of subsidence of the acute process, it is advisable to use medicinal mineral waters - Essentuki 4 and 17, Mirgorodskaya, Borjomi, Narzan.
  • To stimulate the production of gastric juice, the patient on an empty stomach shows reception of broth hips, cabbage juice, tomato juice, lemon diluted in half with water.
  • To protect the gastric mucosa from the ravages of food and other irritants, preparations are prescribed that have an enveloping effect. Gels and syrups based on aluminum and bismuth have such properties.

Folk treatment of atrophic gastritis

It is possible to increase the secretion of gastric juice in atrophic gastritis with low acidity with the help of folk treatment methods:

  • Increase the level of acidity will help St. John’s wort - 2 tablespoons of crushed flowers pour a glass of boiling water and leave for 2 hours. The resulting infusion is consumed three times a day, 20 minutes before meals.
  • White cabbage juice - grated cabbage or chopped with a meat grinder, filter the juice through gauze. The resulting juice should be stored in the refrigerator and drink 30 minutes before eating 1/3 cup. Pre-need to be heated to body temperature.
  • Beet juice is consumed before meals for half a cup.
  • Potato juice - grate potatoes on a fine grater, strain through cheesecloth. The resulting juice to drink 1/3 glass 3 times a day. The duration of treatment is 10 days, after which you need to take a break for 10 days.
  • Pickled cabbage pickle - enhances the production of gastric juice. Strain the infusion of cabbage and drink 1/3 cup 3 times a day before meals.
  • Sugar-free broth hips - drink freshly brewed tea before meals.

Diet therapy in the treatment of atrophic gastritis

During the exacerbation of the pathological process in the stomach, the patient is shown the therapeutic diet No. 1a. It consists in maximal stomach cleansing - thermal, mechanical, chemical and functional. Food is served warm, ground, steamed or stewed with a minimum of salt and oil. Such a strict diet the patient must comply with 3-4 days. This time, as a rule, is enough to subside the acute inflammatory process in the stomach. After that, the patient is transferred to the table number 1. As the inflammatory process is eliminated, patients with a chronic form of atrophic gastritis show a gradual stimulation of the glands of the stomach. To this end, the patient is shown a table number 2. Diet number 2 is to shave off the gastric mucosa, but with the preservation of chemical stimuli. This is necessary so that the glands of the stomach gradually begin to independently produce the enzymes necessary for digestion and gastric juice.

When moving to table No. 2, the patient is allowed dishes of varying degrees of heat and mechanical processing - boiled, baked, fried without a crust (without breading with bread crumbs or flour). Allowed pureed foods rich in fiber fiber.

From the diet exclude dishes that are digested for a long time, irritate the mucous membrane, cold or too hot foods. The number of meals should be at least 5 times a day, in small portions. The basic principle of nutrition for gastritis is often a little.

The list of recommended and prohibited dishes for atrophic gastritis:

  • Soups - allowed on the water or second broth of lean meats, fish or poultry. Finely chopped potatoes, carrots, boiled cereals, small vermicelli, meatballs are added to the soup. Exclude - milk soups, soups with beans, peas, millet, and okroshka.
  • Bakery products - allowed the use of sweet crackers, white yesterday's bread, lean rolls, cookies and dried biscuits. Excluded from the diet products from puff pastry, fresh pastries and baking.
  • Meat - low-fat meat is allowed (turkey, rabbit, lean beef, chicken, veal). It is best to serve meat in the form of meatballs. It is allowed to eat boiled tongue and milk boiled sausages. Excluded from the diet - duck, pork, lamb, goose, smoked sausages, canned meat stew.
  • Fish - you can bake, fry without crust and breading in breadcrumbs, serve as steam cutlets. Fatty fish, salted fish, canned fish are excluded.
  • Dairy products - kefir, sour milk, low-fat cottage cheese, cottage cheese dishes (baked cheese cakes, casseroles, cottage cheese soufflé), hard cheese of not spicy sorts, sour cream, milk and cream are allowed.
  • Eggs - steamed omelets, fried without crust, boiled soft-boiled. Exclude hard-boiled eggs.
  • Cereals - all cereals are allowed except wheat and pearl barley. It is recommended to serve porridge boiled in water with the addition of milk or cream, lean meat broth cooked in the second water, with the addition of fruit, honey, cottage cheese.
  • Vegetables and fruits - potatoes, zucchini, pumpkin, carrots, beets, green peas, onions are allowed in limited quantities. Apples, bananas, plums, pears, apricots, peaches, banana. Vegetable dishes are best served stewed or baked, ground or chopped into small pieces. Exclude: garlic, mushrooms, radishes, cucumbers, peppers, grapes, citrus, cherries, currants.

Dieting during gastritis treatment is very important! During the period of subsiding of the acute form of the inflammatory process, the patient should also adhere to restrictions in the diet.

Remember that timely initiated treatment and proper nutrition greatly reduce the risk of developing various complications of gastritis.

| November 23, 2014 | | 6 608 | Diseases of the digestive tract