Erosive-ulcerative gastritis with high acidity

09.10.2019

The intense rhythm of life in big cities, huge distances from work to home and back - all this leaves an imprint on human health. Improper diet, snacks on the go, late dinners - this is the scourge of modern man. And as a result - a bunch of diseases in the gastrointestinal tract. Gastritis gastric mucosa . One of the types of gastritis is erosive-ulcerative. The main factor in its occurrence is an enzyme that contains hydrochloric acid in the stomach and destroys the mucous membrane.

Causes

One of the most important is an incorrect diet if you already have gastritis . Endless preservatives, food additives, flavor enhancers - these are the hidden enemies of gastritis . stomach functions . Sometimes the cause of the disease is the insidious bacterium Helicobacter pylori.

Symptoms of the disease

Acute ulcerative gastritis is dangerous because its development occurs suddenly and rapidly. to develop signs of ulcerative gastritis after stress on the stomach :

severe pain in the stomach ;
putrid breath ;
vomiting with added bleeding;
temperature increase;
acute stomach cramps.

Taken together, these signs indicate that it is necessary to take emergency measures to stop the further development of the disease. If help is not provided in time and further treatment is neglected, this can give impetus to the development of cancer.

Often people do not pay attention to such seemingly simple functions of the stomach . Bloating, gas formation, frustration, chronic constipation , recurring at certain intervals, are factors that indicate the need to visit a doctor and undergo an examination. First of all, the acidity in the body is checked, which indicates the occurrence of acute or chronic ulcerative gastritis .

Treatment of erosive and ulcerative gastritis

The course of treatment should only be prescribed by a doctor . Self-treatment, which can only lead to a negative result, is not suitable. The doctor develops a complex therapy , which includes taking the necessary medications and diet required for this disease. Strict adherence to all prescriptions will help the patient get rid of severe symptoms and prolong the remission of the disease.

Proper diet

A balanced diet is one of the methods for treating ulcerative gastritis . At the very beginning, fasting is effective, which occurs under the supervision of a doctor . After the pain goes away, a special diet . gastric mucosa , would force the digestive tract to work in a lighter mode, and would help stop the formation of erosive defects.

Forewarned is forearmed

Prevention, first of all, is to prevent the disease, for this it is necessary:

proper nutrition 4-5 times a day, physical exercise, active sports, sleep patterns, annual sanitation of the oral ;
compliance with preventive measures when in contact with patients.

For those who have already been diagnosed with peptic ulcer disease, secondary prevention is offered:

regular medical examination:
medication treatment;
measures aimed at reducing the risk of exacerbation - therapeutic diets and exercise, herbal medicine, visits to mineral springs.

Preventive measures for peptic ulcers are not only of a personal nature, but also of social significance. Many people eat in crowded places, for example, in school and student canteens, cafes for workers, where food quality control must be properly ensured.

You should not consider a peptic ulcer as a death sentence for the rest of your life. This complex disease can be avoided if you take a little closer look at yourself, monitor your health and live in harmony with the world and loved ones.

Published in Gastroentorology Premium Clinic

Is it possible to cure gastritis?

Gastritis is an inflammation of the mucous membrane of the gastric walls, leading to an imbalance in the functioning of the stomach and dysfunction of the gastrointestinal tract. Gastritis occurs quite often in both adults and children. There are acute and chronic gastritis, but the main criterion for determining the type of disease is the acidity of the stomach, which can be normal, low or high.

REASONS FOR THE DEVELOPMENT OF GASTRITIS

The most common cause of the disease (up to 80% of cases) is the action of Helicobacter pylori bacteria. In addition, the disease can develop as a result of:

hereditary predisposition;
poor diet or alcohol abuse;
increase or decrease in gastric secretory function;
gastric dysbiosis;
metabolic disorders in the body;
stress, neurosis, depression;
parasitic infestations;
irritation of the stomach by chemicals (toxins) - in this case, erosive (corrosive) gastritis often develops, which, in the absence of proper treatment, leads to gastric ulcer.

In addition to the listed factors, gastritis can be caused by other diseases, as well as by taking certain medications, including non-steroidal anti-inflammatory drugs.

SYMPTOMS AND DIAGNOSIS

The disease may not manifest itself in any way for a long time, but sooner or later the following signs appear:

decreased appetite;
heaviness in the upper abdomen, abdominal pain before and after eating;
belching, nausea, vomiting;
weight loss;
constipation or diarrhea.

Diagnosis and treatment is carried out by a gastroenterologist. After talking with the patient and identifying the main complaints, the following examinations are prescribed:

blood tests (general and biochemistry);
stool test for occult blood;
ultrasound examination of the retroperitoneal space and abdominal organs;
gastroscopy (fibrogastroduodenoscopy) is the most informative diagnostic technique aimed at assessing the condition of the gastric mucosa, the presence and size of erosions, scars and other manifestations of gastritis.

In some cases, additional tests are prescribed - biopsy, manometry, and pH-metry, which determines the level of acidity in the stomach.

TREATMENT AND LIFESTYLE FOR GASTRITIS

The effectiveness of treatment for this disease directly depends on the individual characteristics of the patient’s body, the form of the disease, the level of stomach acidity, the area of inflammation and many other factors. It is very important to consult a doctor promptly if any alarming symptoms appear, since without treatment, gastritis can lead to serious complications, including peritonitis, internal bleeding, ulcers and stomach cancer.

Important conditions for effective treatment are adherence to diet and daily routine, proper rest, and cessation of smoking and alcohol. The patient is also prescribed a special diet prohibiting the consumption of too spicy or hot foods, lactose, and wheat gluten.

Complex drug treatment includes:

drugs that destroy Helicobacter pylori (if the presence of the bacterium was confirmed by examinations);
antacids and other medications to reduce acidity;
antibiotics (for infectious gastritis);
sedatives to normalize the patient’s mental state;
vitamin complexes and monopreparations.

The main goal of treatment is to eliminate the causes of the disease. In most cases, acute and chronic gastritis responds well to treatment (provided the patient follows all medical recommendations).

Sometimes patients can also use traditional medicine recipes, for example, decoctions of flax seeds and herbal infusions, to which flax is also added, which significantly reduces the acidity of the stomach. But before taking such drugs, you should definitely consult your doctor.

In case of complications, frequent relapses, as well as the formation of rough scars and long-term healing of erosions, surgical treatment may be indicated.

Qualified gastroenterologists in Almaty are able to completely cure various forms of gastritis in children and adults. These are the doctors who see you at the Gastroclinic , successfully fighting gastritis and other gastrointestinal diseases. Self-medication for gastritis is strictly contraindicated, as it can not only be ineffective, but also harm your health even more.

Erosion of the stomach and duodenum

Classification:

Erosion as a manifestation of a malignant or systemic process in the gastric mucosa (cancer, lymphoma, Crohn's disease, etc.).
Benign erosions: acute erosions (hemorrhagic);

“chronic” erosion (erosion completa); erosions can be single or multiple;
chronic erosive (lymphocytic) gastritis;
erosive-hemorrhagic gastritis and duodenitis.

In addition, it is advisable to distinguish primary erosions and so-called secondary erosions that accompany the underlying disease.

Classification issues remain relevant to this day.

At the World Congress of Gastrointestinal Endoscopy, a Round Table meeting was devoted to terminology and semantics in endoscopy, in particular, it was discussed what terminology and classification of erosions to use when interpreting endoscopic examinations and when there is erosion as a complication or as a disease.

Attempts to classify erosive processes have been made by other authors. The definition of chronic erosions seems especially difficult.

In the medical literature, along with the term “chronic erosion,” the term “complete” erosion (erosion complete) is widely used, and with the development of numerous chronic erosions, the term “smallpox” (varioloform) gastritis, chronic erosive (verrucous) gastritis is used. In our opinion, the most The term “chronic erosion” seems acceptable, indicating the phase of the process (exacerbation or remission).

It is much more difficult to classify duodenal erosions. It is proposed to distinguish between acute and chronic erosions of the duodenum, but the authors admit that it is much more difficult to differentiate erosions of the duodenum than the stomach.

As a result of studies, it was established that the concentration of serum gastrin in patients with gastric erosions corresponds to normal values; in patients with erosive duodenitis and duodenal ulcer in the phase of incomplete scarring, the concentration of gastrin is almost the same. A slight difference was noted in the content of pituitary hormones (GH, TSH), progesterone and estradiol in patients with erosive duodenitis and with incomplete scarring of the duodenal ulcer.

Gastroduodenal erosions occur in various conditions of the acid secretion function of the stomach; There is no clear relationship between the tendency of erosion to heal and the level of gastric acid secretion.

An important practical issue is the question of the characteristics of the course of erosive damage (the duration of their existence, the tendency to relapse).

Studying the evolution of erosions and acute ulcers and determining the duration of their existence is a difficult task, largely dependent on the timing and thoroughness of endoscopic examination of the stomach. Dynamic endoscopic observation of patients with gastroduodenal erosions (endoscopy was carried out at various intervals from 2 to 7 times) showed that flat (acute) erosions last on average 7-10 days, but sometimes up to 2-8 weeks (depending on the prevalence and severity of the process ). Acute erosions almost always affect the proximal parts of the stomach (subcardial section, body of the stomach). Chronic erosions can be detected in the stomach for a long time (up to 6 years or more). Erosion of this type is localized, as a rule, in the antrum of the stomach. Duodenal erosions exist for a long time, for many weeks and months.

The question of the tendency of erosions to relapse is important. We concluded that only a portion of the erosive lesions recur. In these cases, chronic erosions occur in the antrum of the stomach, and flat defects of the mucous membrane are more often observed in the duodenal bulb. In most cases, there was no tendency for the reappearance of erosions of the stomach and duodenum.

Various clinical syndromes have been identified in patients with gastroduodenal erosions. Hemorrhagic syndrome is observed in approximately 20% of patients with erosive lesions of the stomach and duodenum, often in the form of repeated bleeding. Sometimes this syndrome is manifested by black stools (melena), less often by vomiting mixed with blood or “coffee grounds” vomiting, a collapsed state, and a decrease in hemoglobin. But, as a rule, the bleeding is hidden, so-called occult, in nature. Patients gradually develop chronic posthemorrhagic anemia. Signs of occult bleeding - general weakness, slowly progressing anemia, the presence of occult blood in the stool - are a direct indication for a thorough examination of the upper gastrointestinal tract. Of course, it is necessary to exclude damage to the colon and rectum during a comprehensive diagnosis. An ulcer-like syndrome is most often observed in patients with gastroduodenal erosions. Patients complain of periodic pain in the epigastric region associated with food intake, heartburn, belching, and nausea.

In patients with erosions and ulcers of the stomach and duodenum, symptoms of chronic diffuse liver diseases, lesions of the biliary tract and pancreas, diseases of the esophagus, tumors of the gastrointestinal tract, diseases of the cardiovascular system,

Dynamic endoscopic observation of patients with gastroduodenal erosions makes it possible to speak in favor of the hypothesis that acute and chronic erosions are stages of the same process. Chronic erosions can exist for many months and even years. They usually disappear, but sometimes transform into polyp-like folds or changes in the mucous membrane such as focal hyperplasia (“warty gastritis”).

One of the most difficult problems is the relationship between erosions and chronic ulcers. The hypothesis about the continuous development of the process from ecchymosis through hemorrhagic erosion to ulcer did not meet with unanimous support. Some scientists argue that erosions and ulcers are different lesions that do not transform into one another. There is doubt that erosion is a prestage of an ulcer. Others do not completely deny the possibility of acute erosions turning into chronic ulcers. T. loshida during dynamic endoscopic examination observed the transition of acute erosions into acute multiple gastric ulcers.

We observed that erosive gastritis and duodenitis often precede the development of duodenal ulcers. It is also possible to develop erosions at the site of a duodenal ulcer during its healing. As you know, Japanese researchers consider this outcome to be one of the options for healing duodenal ulcers. A unique variant of peptic ulcer disease can also be considered simultaneous or staged recurrent damage by erosions of the terminal part of the esophagus, the outlet part of the stomach and duodenum, which was observed in several patients in the autumn and spring periods over a number of years.

Thus, there is an undoubted relationship between gastroduodenal erosions and peptic ulcer disease. This is evidenced, firstly, by relapses of the ulcerative process, starting with erosive lesions of the stomach, the debut and healing of duodenal ulcers in the form of erosions of the bulb, as well as the very frequent combination of erosive gastritis and duodenitis with duodenal ulcer (in 37 and 44% of cases, respectively ).

Undoubtedly, the question of the possibility of transforming erosive lesions into polyps and (or) stomach cancer is always very important.

The hypothesis of Japanese researchers about the transition of erosions through the stage of verrucous changes into polyps and cancer has been studied in different countries. L. It is possible to transform chronic erosions into polypoid formations, the morphological study of which reveals moderate changes in the gastric glands and cystically dilated ducts, but at the same time does not reveal typical signs of an adenomatous polyp. A group of researchers did not observe the development of polyps in patients with chronic erosions for 4 years.

Sometimes erosions develop at the apex of polyps; in this case, it is difficult to resolve the issue of the primacy of erosive damage. Long-term dynamic observation of 90 patients with chronic erosions revealed their disappearance, or the appearance in their place of focal hyperplasia (what endoscopists usually call “warty”, or verrucous, gastritis of the stomach). Nevertheless, the presence of focal hyperplasia at the site of chronic erosions, the peculiarities of the histogenesis of the epithelium in their area, and the identification of chronic erosions at the apex of polyps do not exclude the possibility of the evolution of chronic erosions with focal foveolar hyperplasia into hyperplasiogenic polyps. In any case, in our opinion, there is a possibility of such a transition.

The hypothesis about the natural evolution of chronic erosions into a cancer process is supported by few authors studying this issue. The research results do not confirm the hypothesis about the transition of erosions into a cancerous process.

Studies of the severity of dysplasia found in various lesions of the stomach (polyps, ulcers, erosions, chronic gastritis) indicate that with gastric erosions, mostly mild or moderate dysplasia is detected.

In our opinion, these data serve as indirect evidence of the thesis about the insignificant probability of malignancy in chronic erosions, but, of course, it is difficult to completely exclude such a possibility in a particular case. Therefore, the doctor must carefully examine the patient using gastrobiopsy and morphological study of drugs over time.

Summarizing the results of observations and literature data, we can assume that it is not yet possible to confidently support the hypothesis about the natural evolution of chronic erosions into a cancer process. We should first of all exclude the possibility of the existence of an early form of cancer (type II c) or ulceration that arose against the background of an infiltrative process in stomach (cancer, lymphomatosis). We cannot exclude the possibility of the simultaneous existence of a cancer process and chronic erosions in the stomach.

It is necessary to remember the existence of an early cancer process in the form of erosive and ulcerative lesions, which has been proven by the work of Japanese doctors (type II c). Secondly, we should talk about gastric erosions that accompany the development of a cancerous process in the stomach or tumors of the colon and rectum.