Acute gastritis
Content:
- Causes of acute gastritis
- Types of acute gastritis
- Symptoms of acute gastritis
- Diagnosis of acute gastritis
- What diseases can be confused with acute gastritis?
- How is the survey?
- Treatment of acute gastritis
- Prevention of gastritis
- Acute gastritis in pregnant women
- Acute gastritis in children
Acute gastritis - acute inflammation of the gastric mucosa. Depending on the etiology, it can affect only the surface of the gastric membrane, or extend to its entire thickness. According to medical statistics, gastritis leads among gastrointestinal diseases - 80–85%. Forms of acute gastritis are common even among children of primary school age.
Causes of acute gastritis
One of the most common causes of acute gastritis is the wrong diet:
- swallowing badly chewed food;
- food too hot or too cold;
- drinks - carbonated, low alcohol;
- dry food;
- fasting and overeating;
- abuse of spicy, salty, smoked, fried foods.
Irritant effect on the gastric mucosa vinegar, pepper, mustard. In 69% of cases, the cause of acute gastritis is strong coffee.
Other irritating factors also cause acute inflammation of the mucous membrane:
- Medications - sulfonamides, salicylates, corticosteroids, bromides and others. Clinical and experimental studies have confirmed that a therapeutic dose of indomethacin, acetylsalicylic acid (aspirin) has an irritating and damaging effect on the surface of the walls of the stomach.
- Smoking appears as a cause of acute gastritis in 48% of cases.
- Pathological effect on the stomach has alcohol, especially alcoholic beverages with a strength of 20 degrees. In a small amount, ethanol stimulates the separation of gastric juices, but a high concentration destroys the “protective barriers”, causing rejection of the surface layers of the mucous epithelium, increasing its permeability. The inverse diffusion of H + increases, protein is lost, regeneration processes are inhibited and microcirculatory disorders are activated.
- Acute gastritis is not an infectious disease, but infections can provoke a disease - Salmonella, Shigella, Staphylococcus, Yersinia, E. coli.
- Inflammation and damage to the mucous membranes can be caused by frequent endoscopic studies, the study of gastric secretion with the support of pH meters, probes.
- Burns with acidic and alkaline solutions, toxic substances, acute renal failure, viral hepatitis, pneumonia, influenza, scarlet fever and other diseases, or a center of purulent infection.
- Mechanical damage to the walls of the stomach - injuries from bruises, blows, intense physical exertion, or if foreign objects get inside the stomach (bones of fish, birds, needles, chips).
The appearance of acute gastritis can be triggered by an allergic reaction of the body to food — fruits, vegetables, certain types of seafood, etc. Depressive disorders, stress, and neuroses also cause inflammation of the gastric mucosa.
Types of acute gastritis
According to the features of the clinical picture and the nature of damage to the gastric mucosa, there are four types of acute gastritis:
- catarral (banal),
- fibrinous (diphtheria),
- corrosive (necrotic, toxic-chemical),
- phlegmonous.
Catarrhal acute gastritis
Catarral - banal, alimentary, superficial, allergic - the most common type of acute gastritis. Causes of catarrhal gastritis can be:
- alcohol consumption;
- gross errors in the diet;
- physical or psycho-emotional stress;
- irritant effects of drugs;
- acute infections;
- food allergies - oranges, strawberries, mushrooms, fish, etc.
In catarrhal acute gastritis, inflammation captures only the surface of the mucous membrane, possibly causing damage to the deep layers. The process is accompanied by increased mucus formation, swelling of the mucous membrane, its hyperemia (local plethora). Allergic form is accompanied by various manifestations of dermatosis - edema, rash, redness, urticaria , angioedema , etc. The first symptoms of allergic gastritis can appear immediately after the allergen enters the stomach - within a few minutes.
Pathogenesis
The stomach lining becomes covered with mucus and thickens due to swelling. The surface is covered with point erosions (ulcers) and hemorrhages, serous or sero-mucous exudate. Dystrophy, dying off, desquamation of epithelial cells (sometimes by layers) occurs, ulcers form. Diffuse infiltration of the epithelium by leukocytes arriving at the site of inflammation with blood flow.
Fibrinous acute gastritis
The cause of fibrinous (diphtheria) acute gastritis is a serious infectious disease:
- scarlet fever,
- measles,
- sepsis,
- typhoid fever.
Also, this form of acute gastritis can occur when poisoning with solutions of concentrated acids, mercury.
Pathogenesis
The form of the disease is characterized by necrotic changes in the gastric mucosa. Zones of necrosis are impregnated with purulent exudate. A distinctive feature of acute fibrinous gastritis is the formation of a diphtheria film on the mucosal surface. When the surface necrosis of the compound film with the underlying tissues loose. The film is easily removed - its particles are present in vomitus (lobar gastritis). In the case of deep lesions, the fixation of the shroud is more durable and when it is removed, numerous ulcers open.
Corrosive acute gastritis
Causes of acute corrosive gastritis - poisoning with concentrated chemicals. There are two types of necrotic (corrosive) gastritis:
- coagulative (dry) necrosis - in case of acid poisoning;
- colliquation (wet) necrosis - salt poisoning.
Necrotic gastritis affects the deep layers of gastric tissue.
Pathogenesis
Necrotic changes with hemorrhages, ulcerations are observed not only in the stomach, but also on the mucous membranes of the esophagus, oral cavity.
Corrosive acute gastritis may be complicated by renal, hepatic, and cardiovascular failure. After poisoning possible perforation of the gastric wall, the penetration (penetration) of the inflammatory process, the contents of the stomach into nearby organs, the development of peritonitis.
Phlegmonous acute gastritis
The main condition for the development of purulent gastritis is a violation of the integrity of the gastric mucosa and the spread of inflammation to all its layers. Causes:
- injuries - strikes, swallowed objects (bone, needle, etc.);
- ulcers;
- disintegrating tumors.
May develop as a result of a pneumococcal, streptococcal, staphylococcal infection.
Pathogenesis
The gastric walls are sharply thickened. The coarse folds formed are covered with fibrinous overlays. Diffuse leukocyte infiltration covers all layers of the stomach wall, including the serosa. Perhaps the development of perigastritis, peritonitis.
Symptoms of acute gastritis
The course of acute gastritis, the clinical picture is largely determined by the nature of the damaging factor, the duration of its impact, the individual response of the body. The first symptoms may appear after 6-12 hours or much earlier. First there are signs of dyspepsia:
- unpleasant taste in the mouth;
- lack of appetite;
- moderate pain, heaviness in the stomach;
- nausea, drooling, belching food and air;
- vomiting - the contents of the stomach with impurities of bile, mucus;
- unpleasant smell of abundant vomit.
The consequence of poisoning infected food may be speeded up liquid or pasty stools. There are bloating, rumbling of the abdomen. Possible increase in body temperature.
Poisoning by food infected with staphylococcus, salmonella:
- private diarrhea;
- progressive weakness;
- dehydration;
- body temperature up to 39 0 C.
In this case, urgent hospitalization is required.
The main symptoms of phlegmonous (purulent) gastritis are:
- frequent vomiting;
- pus in vomit;
- fever and chills;
- severe pains
Markedly rapid deterioration of the patient.
Reception of concentrated poisons causes burning pains in the mouth, throat, stomach, esophagus. Hyperemia, edema and burns of the mucous membranes of the oral cavity, pharynx.
The most unfavorable prognosis for corrosive and phlegmonous gastritis.
In the first case, fatal in 50% of cases. As a result of chemical damage to the stomach and esophagus, cicatricial deformities of the stomach, strictures (narrowing) of the esophagus are possible. Surgical intervention is required - gastrostomy, cave-house plastics.
When purulent acute gastritis may develop peritonitis, mediastinitis, pleurisy, sepsis, abscesses of the abdominal cavity. The indication for urgent surgical intervention is gastric perforation.
Regardless of the severity of symptoms, it is necessary to consult a doctor for diagnosis and choice of treatment.
Diagnosis of acute gastritis
When diagnosing, first of all, data of the anamnesis are taken into account:
- consuming poor food;
- the possibility of mechanical damage to the gastric mucosa - bruises, injuries, swallowing of any objects;
- alcohol intake;
- intake of poisons.
Bacterial gastritis usually affects a group of people - a family, a company sitting at the same table. In acute corrosive gastritis, a survey of the relatives of the victim will help determine the nature and dose of the chemical taken.
Vomit and feces, remnants of food, drinks or chemicals used as a poison have a certain value for diagnosis.
In addition to conventional laboratory tests of biological materials, instrumental studies are carried out:
- x-ray
- Ultrasound,
- endoscopy.
The degree of violation of gastric functions allows to determine the study of gastric secretion.
During an attack of acute gastritis, gastroscopy and gastric sensing are not recommended.
What diseases can be confused with acute gastritis?
Differential diagnosis is necessary to exclude diseases that have similar symptoms. For example, with a history of hypertensive patient, angina attacks, severe pain in the epigastric region, an ECG is made behind the sternum, which allows to exclude the gastralgic form of myocardial infarction.
Vomiting debut many acute inflammatory diseases:
- pancreatitis ,
- cholecystitis ,
- appendicitis.
Suppose acute phlegmonous gastritis can be with these symptoms:
- high fever;
- severe pain;
- manifestations of peritonitis in the upper abdomen.
How is the survey?
During the reception, the gastroenterologist will ask about the symptoms, history of their development, medications taken, lifestyle. It should also be remembered about all non-prescription drugs, vitamins, nutritional supplements.
Laboratory tests are prescribed to exclude other diseases:
- complete blood count - bacteriological and to determine signs of anemia after bleeding;
- special blood tests - RW, for sugar, etc .;
- urinalysis - determination of kidney function;
- the analysis of feces - for bacteriological studies and to detect hidden secretions of blood;
- pregnancy test;
- if poisons are suspected, vomitus is investigated.
If necessary, consultations with other specialists are recommended - gynecologist, neuropsychiatrist, cardiologist, etc.
Treatment of acute gastritis
The first actions of medical personnel are aimed at eliminating the causes of gastritis. The patient's stomach is cleaned, sometimes a probe is used for this, if necessary, the intestines are also cleaned. After the first day of rest, a warm fractional drink may be prescribed. The diet expands gradually with the introduction into the diet of mucous soups, liquid grated porridges, jelly, crackers from white flour, etc.
Pains are relieved by antacids, anticholinergics or spasmolytics. Recommended intake of enterosorbents, prokinetics (vomiting). In the case of toxico-infective form of gastritis, antibiotics are prescribed. Water-electrolyte balance is adjusted by the introduction of physiological solutions, potassium preparations, glucose solutions.
The general condition of the patient in case of catarrhal gastritis improves quickly enough, but it takes about 2 weeks to fully restore the functions of the gastrointestinal tract. Treatment of other forms of the disease will take a longer time.
After the end of treatment, observation of the physician is required, even in the absence of seizures - a survey 2 times a year.
Prevention of gastritis
The prevention of all forms of acute gastritis is primarily associated with the implementation of food hygiene, sanitary hygiene:
- compliance with the terms and conditions of food storage, including in freezers - it is prohibited to freeze re-thawed products;
- Do not store food that needs to be processed near food ready for cooking, for example, chilled meat and cheese;
- restricting the use of seasonings, fried, fatty, poorly tolerated and difficult to digest food;
- prevention and treatment of infectious diseases;
- oral hygiene - brushing your teeth, timely treatment of dental diseases;
- eating only washed vegetables and fruits;
- washing hands upon entering the house, after visiting the toilet, before eating.
You should also monitor the reaction of the stomach to the treatment of drugs, to reduce organic or functional disorders apply special means.
One of the effective preventive measures is to quit smoking and alcohol. With the manifestation of gastritis at least once, should be regularly observed by a gastroenterologist, even in the absence of repeated symptoms.
Acute gastritis in pregnant women
Hormonal changes, nausea and vomiting during toxicosis seriously worsen the condition of the expectant mother's gastric mucosa. Acute gastritis does not have a direct impact on the health of the baby, but in order to prevent the development of complications of an inflammatory disease, its treatment is not worth it. Self-treatment during pregnancy is dangerous not only for the health of the mother, but also for the child, since in severe cases, intoxication of the whole body is possible.
Factors that are prerequisites for the development of acute gastritis in pregnant women:
- toxicosis;
- excitement;
- violation of nutritional conditions;
- overdose with vitamin complexes, etc.
Prevention of acute gastritis in pregnant women
General preventive measures to prevent the occurrence of acute gastritis and its complications include the prevention of toxicosis:
- adherence to diet;
- full night rest;
- walks in the open air;
- regular adequate physical exertion;
- control over psycho-emotional state;
- rejection of bad habits;
- timely treatment to the doctor at the first alarming symptoms.
Self-medication with medicinal preparations and folk remedies can harm the health of the mother and child. Remedies for nausea should be chosen only by a doctor.
Acute gastritis in children
Attacks of gastritis are observed in children aged 5-6 and 9-12 years. A simple catarrhal acute gastritis in a child can manifest itself not only in the form of disorders of the stomach, but also in the form of intoxication of the whole organism, disorders of the functions of the cardiovascular system. With frequent vomiting, diarrhea, the child's body is quickly dehydrated, creating a threat to the development of acute renal failure.
In 25% of cases of gastritis in schoolchildren, various malnutrition with the start of school attendance becomes the cause. Crackers, chips, move dogs, fanta, cola often replace lunch for the modern schoolchild. The following factors can provoke an attack of acute gastritis in a child:
- mouth infection - the habit of nibbling nails, pens, pencils, hygiene;
- intense physical, emotional stress;
- puberty.
Causes of acute gastritis in babies - feeding the child "adult" products.
The method of treatment of acute gastritis in a child is chosen by the doctor individually. The general scheme of therapeutic measures:
- gastric lavage, sometimes intestines;
- bed rest;
- frequent warm drinks in small portions;
- diet.
For the child, the observance of the daily regimen and the moral situation in the family are of great importance.
Prevention of acute gastritis in children
Prevention of acute gastritis in children has several distinctive features:
- Lures introduced to young children should be freshly prepared - practicing pediatricians strongly discourage feeding children with canned baby food;
- the transition to “adult” food should be gradual - details can be obtained from the pediatrician,
- it is necessary to teach the child to wash their hands after walking on the street, before eating, after using the toilet;
- eat only washed fruits and vegetables;
- convince the child not to chew the chewing gum in turns with friends, or after the child has played with her hands;
- it is necessary to prohibit the child during a meal to talk, watch TV, read;
- it is necessary to control psycho-emotional stress at home and at school.
One of the preventive measures is timely rehabilitation of the child’s mouth. Children do not always attach importance to caries.
- Gastritis: symptoms, treatment
- Erosive gastritis
- Chronic gastritis
- Catarrhal gastritis
- Hypertrophic gastritis
- Gastritis with low acidity
- Gastritis with high acidity
- Atrophic gastritis