Atrophic gastritis of the stomach

Atrophic gastritis of the stomach Types of gastritis

Atrophic gastritis of the stomach –  what is it? Not only people are susceptible to stomach diseases, but also our smaller brothers. Gastritis in dogs is quite common, even more often than you think. Symptoms of gastritis in dogs can be quite diverse, but the most common sign is vomiting. Also, you can independently diagnose gastritis in a dog by a white plaque on the tongue, as well as by an increase in temperature, other symptoms of gastritis in dogs will be described below. Methods of treatment of gastritis can be found in the information below. Atrophic gastritis of the stomach – causes, symptoms and treatment, read more gastritinfo.com.

Atrophic gastritis of the stomach

Atrophic gastritis is prolonged recurrent recurrent chronic inflammation of the gastric mucosa

Atrophic gastritis is a long–term recurrent chronic inflammation of the gastric mucosa. With the disease, the physiological renewal of the cells of the mucous surface is disrupted, its constituent parts are rearranged. Due to the long course of structural disorders, the gastric glands lose the ability to function fully. The process of producing secretions (pepsin, acid), gastric motility, and digestive processes in the intestine are disrupted. Intestinal metaplasia of the mucous environment is formed – the replacement of the gastric glands with intestinal epithelial tissue.

Atrophic gastritis of the stomach

Atrophic gastritis is the leading background precursor of stomach cancer. A high risk of cancer formation is noted in those who suffer from pathology from youth.

Causes of atrophic gastritis

Atrophic gastritis is formed by internal and external factors.

The leading causes of the disease are as follows:

  • disorders of the mucous surface of an autoimmune nature – 10% of pathologies, type of gastritis – A;
  • infection of the gastric mucosa with the bacterium Helicobacter pylori – 85% of observations, type of gastritis – B;
  • duodenal reflux – throwing the contents of the duodenum into the stomach cavity and the damaging effect of bile acids, lysolecitin on the mucous surface – 5% of observations, type of gastritis – C.

Helicobacter pylori (Helicobacter pylori) is an unusual bacterium. It survives in the acidic environment of the stomach and actively advances in it. The microorganism produces urease, an environment that reduces the aggressiveness of hydrochloric acid produced by gastric juice. A neutral environment is formed around each bacterial cell, preserving the pathogen of infection. Colonization of microorganisms on the mucous membrane damages epithelial tissue and develops inflammation in the submucosal layer. Internal superficial gastritis recurs and flows into a chronic process.

A good acid background for the active activity of Helicobacter pylori is an indicator from 3.0 to 6.0. Therefore, the pathogen resides in the antrum (lower) part of the stomach, passing into the duodenum. If the acidity increases, the pathogen moves to the duodenum. If the acidity decreases, the bacterium migrates to the area of the body and the bottom of the stomach.

Atrophy of the mucous surface is also developed by autoimmune disorders: the immune system produces antibodies to the parietal gland cells that produce gastric secretions. This destroys the cells of the mucous surface, atrophic gastritis of the autoimmune type is formed.

The formation of duodenoastric reflux is associated with incomplete closure of the sphincter at the pylorus opening, chronic inflammation of the duodenum, increased pressure in it. Reflux gastritis leads to damage to the inner surface of the stomach by bile acids, their salts, pancreatic enzymes, lysolecitin and other components of the contents of the small intestine.

Reflux gastritis is also called “chemical-toxic gastritis”. Pathology develops with the constant intake of certain medications (mainly nonsteroidal anti-inflammatory drugs), chemicals.

There are other circumstances that provoke the formation of atrophic gastritis:

  • mental disorders;
  • violations of the principles of healthy nutrition – unstable rhythm, oversaturation, swallowing large chunks, increased consumption of hot, spicy food, coffee, monotonous diet;
  • tobacco smoking, alcohol abuse;
  • long-term medication treatment, having a harmful effect on the inner lining of the stomach – acetylsalicylic acid and its derivatives, the glucocorticosteroid prednisolone, digitalis-based drugs and others;
  • chemical agents;
  • radiation;
  • infectious diseases of a chronic nature – tuberculosis, cholecystitis, infections of the oral cavity, nasopharynx and others;
  • chronic obstructive bronchitis, emphysema of the lungs, bronchial asthma;
  • diseases associated with disruption of the endocrine glands – bronze disease, decreased thyroid function, Itsenko-Cushing’s disease, Bazedov’s disease, diabetes mellitus;
  • metabolic disorders – overweight, gout, anemia;
  • diseases leading to oxygen starvation of the gastric mucosa – pulmonary insufficiency, heart failure;
  • cirrhosis of the liver;
  • self–poisoning – retention of toxic products due to kidney failure – uremia;
  • heredity.

The occurrence and development of atrophic gastritis is associated with the multiple influence of various adverse circumstances.

Atrophic gastritis

Prevalence of atrophic gastritis

Most researchers are of the opinion that HCG affects more than 1/3 of the adult population, but only 10-15% of them turn to doctors. Helicobacter gastritis prevails and accounts for 80-90% of all gastritis, autoimmune causes only 10%. The true prevalence of gastric mucosal atrophy is unknown, but if we consider it as a manifestation of autoimmune and the outcome of long-term helicobacter gastritis, its prevalence can reach 50-60%!

Pathogenesis of atrophic gastritis

Atrophic gastritis is a multifactorial condition. There are more than a dozen reasons, each of which can lead to atrophy of the mucous membrane and, accordingly, to the development of functional insufficiency of the stomach. The development of atrophic changes in the CO may be the result of a pathological process or age–related involutional changes, and genetically determined hypo- or atrophy of the stomach is also possible.

The most common etiological factors causing atrophic gastritis are Helicobacter pylori infection (H. pylori) and autoimmune gastritis, which is quite rare

Atrophic gastritis of the stomach: diagnosis

The diagnosis of “atrophic gastritis” is made according to the results of the examination:

  1. symptoms of the disease;
  2. study of secretion production;
  3. x-ray transmission of the organ;
  4. information obtained during endoscope examination;
  5. check for the presence of helicobacter infection;
  6. histological analysis of biological tissue.

The main method for diagnosis is EFGDS (esophagogastroduodenoscopy). The probe examination makes it possible to see the condition of the mucous surface, take biological tissue to detect Helicobacter pylori, and confirm the diagnosis. The mucosa with atrophic gastritis becomes thinner, has a pale grayish color, the size of the folds decreases, and with the strong development of the atrophic process, the folds almost disappear completely.

Symptoms and treatment of atrophic gastritis in women

Atrophic gastritis is manifested by local and systemic disorders of the body. Local disorders are manifested by signs of stomach upset (dyspepsia):

  • feeling of heaviness, pressure, overcrowding in the stomach area (under the chest), arising, increasing during meals and some time later;
  • nausea, belching;
  • unpleasant taste in the mouth;
  • burning in the stomach;
  • burning sensation in the esophageal tube, confirming the throwing of stomach contents into the tube, violation of the passage of a food lump.

Atrophic gastritis of the middle part of the stomach notifies with a feeling of heaviness under the chest, under the ribs, appearing when eating, shortly after

These symptoms are manifested in some forms of gastritis of the antral part of the stomach, developing disorders of food promotion, an increase in pressure inside the stomach, activation of throwing its contents into the lumen of the esophageal tube and a corresponding exacerbation of these clinical signs of pathology.

Atrophic gastritis of the middle part of the stomach notifies with a feeling of heaviness under the chest, under the ribs, appearing when eating, shortly after.

In patients with infectious helicobacter-associated gastritis, long-term ongoing with an increase in the production of gastric secretions, clinical symptoms of intestinal dysfunction are possible. This is a violation of the emptying process: lack of stool, diarrhea, unstable rhythm of defecation, flatulence, rumbling.

Allergic gastritis occurs with the following symptoms:

  • constant diarrhea;
  • intolerance to certain foods, medications;
  • abdominal pain;
  • nausea, vomiting;
  • weight loss;
  • an increase in the number of eosinophils (eosinophilia).

Systemic disorders occur with such simtomocomplexes:

  1. Gastritis of the middle part of the stomach with the simultaneous formation of B12-deficient anemia is characterized by a constant feeling of fatigue, lethargy Asthenic (neurotic) syndrome is a general weakness, unstable mental state, disorders of the cardiovascular system (a feeling of compression in the heart area, a violation of the heart rate, instability of blood pressure with a predominance of its decrease).
  2. Gastritis at the stage of insufficient secretion production forms a complex of symptoms similar to dumping syndrome (accelerated movement of stomach contents into the intestine without proper digestion): sharp weakness, violation of the rhythm of defecation, sweating, hiccups, pallor, drowsiness, a rapid feeling of satiety that occur after eating.
  3. Gastritis of the middle part of the stomach with the simultaneous formation of B12-deficiency anemia is characterized by a constant feeling of fatigue, lethargy. The patient loses interest in life, his vitality decreases. It hurts and burns in the mouth, on the tongue, there are sensitivity disorders that occur simultaneously in the arms and legs and are expressed in burning, tingling, a feeling of crawling goosebumps.
  4. Antral infectious (helicobacter) gastritis, occurring with excessive secretion production, is manifested by a complex of symptoms similar to peptic ulcer disease, since the patient develops this pathology: vomiting, pain characteristic of ulcers.

There are also signs such as weight loss, symptoms of vitamin deficiency – congestion, excessive thickening of the stratum corneum of the epidermis, brittle hair and nails.

What is the danger of chronic atrophic gastritis

There is no single and comprehensive classification of chronic gastritis, typological varieties of this disease are usually distinguished for several reasons. Acute, chronic, antacid, atrophic gastritis and gastritis with an increased level of acidity are most often isolated. The most dangerous and insidious is considered to be chronic atrophic gastritis. The essence of the disease reflects its name: glandular tissue cells exposed to the process of atrophy eventually lose the ability to produce gastric juice, which negatively affects the digestive activity of the gastrointestinal tract.

Experts identify two main causes of the disease: bacterial infections and autoimmune processes. Inflammation of the gastric mucosa very often occurs under the influence of the bacterium Helicobacter pylori. It is its harmful influence that causes a decrease in the protective properties of the mucosa, as a result of which toxins and free radicals are able to penetrate into tissues and damage cells.

This process leads to the degeneration of gastric epithelial cells that produce gastric juice into intestinal cells. Attention! Today, Helicobacter pylori is included in the list of biological carcinogens. It is believed that it provokes the appearance of a cancerous tumor of the stomach. It is worth noting that according to analysts, more than 80% of the world’s population is carriers of this infection. With age, the frequency and severity of gastritic changes in the SOH increase. If atrophic gastritis is diagnosed in young people under 30 years of age only in 5% of cases, then in the age group from 31 to 50 years — already in 30%.

And among the elderly, chronic atrophic gastritis is diagnosed in about 70% of patients. If we talk about the importance of timely diagnosis and treatment, it should be emphasized that atrophic gastritis is considered a direct precursor of stomach cancer. If more than 20% of the mucosa is subject to metaplasia, then the probability of developing a cancerous tumor is approaching 100%. In other words, chronic atrophic gastritis develops into cancer in 13% of cases. This indicator is 5 times higher than in other types of gastritis.

What is the danger of chronic atrophic gastritis
And among the elderly, chronic atrophic gastritis is diagnosed in about 70% of patients

Therefore, the main task of gastroenterologists is to develop and widely use simple and effective methods of accurate diagnosis of gastritis at an early stage. Timely diagnosis and the appointment of competent treatment of the cause of the disease can restore the working capacity of the gastric mucosa and significantly reduce the area of the degenerated area.

Of course, atrophied cells of the stomach walls at this stage of the development of medicine can no longer be returned to their original state. But it is quite possible to significantly reduce the risk of a malignant tumor of the stomach, provided proper drug therapy, diet and adherence to the rules of a healthy lifestyle.

Treatment of atrophic gastritis

Exacerbation of the disease requires compliance with a diet with restrictions that apply only during this period. After the onset of remission, it is necessary to eat fully. Patients with suppressed, low production of gastric gland secretion adhere to the regime of their stimulation in nutrition.

With any gastritis, it is forbidden to use the following products:

  • alcoholic beverages, coffee, carbonated drinks;
  • canning, spices, smoked products;
  • fried, fatty, seasoned with spices;
  • surrogates, concentrates of any products;
  • chocolate;
  • fast food – fast food;
  • muffin;
  • products that stimulate fermentation – black bread, dairy products, grapes.

It is necessary to eat a little, but often – 5-6 times a day. The diet is balanced, varied, not limited exclusively to cereals and broths. The presence of a sufficient amount of protein food is important in nutrition.

Treatment of atrophic gastritis type A (autoimmune)

At the initial stage of the disease, with its progression, if the stomach produces a secret, but the immune processes are deeply disturbed, the patient is prescribed glucocorticosteroid hormonal drugs. If the painful symptoms do not bother (in remission), there is no need for treatment.

If the production of gland secretion decreases, the patient is prescribed diet No. 2 according to Pevsner (see Table 1), a combination of natural gastric juice preparations with medications that improve the motor activity of the lower part of the stomach, accelerating its emptying – Motilium, Motilac.
Table 1

Description of the diet table Diet Caloric content of the table Dietary products Culinary processing Meal mode
A complete diet with a high content of extracts. Products that are difficult to digest by the stomach, lingering in it for a long time, are excluded. The diet stimulates the production of secretions, inhibits the progression of the disease. 90 – 100 g of proteins, 90 – 100 g of fats, 400 – 450 g of carbohydrates, 1.5 liters of liquid, no more than 10-12 g of table salt. The daily norm is 3 kg of food. 3000 kcal Egg dishes, porridges, casseroles, vegetable purees, meat gravies, soups with meat and fish vegetables, stale white bread, mousses, compotes.</td Grinding of products of varying degrees, frying without breading, boiling, baking dishes. The temperature of ready–made hot dishes is about 60C, cold dishes are below 15C, meals in small portions, frequent (4-5 times a day).

In the formation of anemia associated with vitamin B12 deficiency, this vitamin is prescribed for treatment. With reduced production of pancreatic juice, patients take Creon, Pancreatin, Panzinorm.

More information: Symptoms of atrophic gastritis

Treatment of atrophic gastritis type B (helicobacter) with increased acidity

Treatment of type B gastritis is aimed at eliminating the causative agent of infection. The clinical recommendations of the World Health Organization specialists are called first-line antihelicobacter drugs metronidazole (tinidazole), clarithromycin, amoxicillin, tetracycline, de-nol.
The types of the main antisecretory drugs are listed in Table 2.
Table 2

Group of medicines Drug names
Cholinolytics atropine sulfate, gastrocepin
H2 blockers
  • cimetidine (due to numerous undesirable effects, it is rarely prescribed);
  • ranitidine (Ranisan, Zantak);
  • famotidine (Ulfamide, Gastrosidine, Pepsid, Lecidil, Kvamatel);
  • nizatidine (Axid);
  • roxatidine
Proton pump inhibitors
  • omeprazole (Omez, Omeprol, Losek, Zerocide);
  • lanzoprazole (Lansap);
  • pantoprazole (Controlok);
  • rabeprazole
Combined drug Pyloride

A month and a half after the end of the course of therapy, a control examination is carried out. If the treatment has not completely eliminated the infection, the sensitivity of Helicobacter pylori to antimicrobial drugs is determined for the appointment of a repeat course.

Treatment of atrophic gastritis type C (reflux gastritis)

The diagnostic conclusion “reflux gastritis” is given to several groups of patients:

  • those who had part of the stomach removed;
  • treated with nonsteroidal anti-inflammatory drugs;
  • patients with chronic alcoholism who developed reflux gastritis.

Treatment is focused on eliminating the main causes of the disease: restoring the motor activity of the digestive tract, removing excess bile acids. Proton pump inhibitors, dopamine receptor blockers (Domperidone), ursodeoxycholic acid are prescribed.

In the treatment of symptoms of the disease, prescribe:

  • diet;
  • drugs that activate intestinal peristalsis – prokinetics;
  • drugs that restore the movement of contents through the intestine;
  • silicon-containing drugs that prevent the accumulation of gases;
  • medications that normalize stools with a tendency to delay defecation.

When prescribing medications for the treatment of atrophic gastritis, the phase of the disease, its type, features of the stomach – secretion, motility, evacuation of contents are taken into account.

Domperidone

With a severe form of exacerbation of pathology – severe pain, deep disruption of the stomach, weight loss – the patient is hospitalized. Being under the supervision of doctors is also necessary in case of danger of bleeding from erosions, with difficulties in making a diagnosis.

What to do with exacerbation of chronic gastritis

Any form of chronic gastritis, as a rule, accompanies a person for many years of his life, and periods of remission are often replaced by exacerbations. Exacerbation of chronic gastritis can be caused by both a seasonal spike in morbidity and provoked by the use of foods and beverages from the prohibited list, taking medications, psychological factors such as frequent stress or fatigue, and other circumstances.

Often, various concomitant diseases, occupational hazards or hereditary features of the gastrointestinal tract lead to an exacerbation of the inflammatory process in the stomach. Chronic gastritis in the acute stage can cause a lot of trouble, therefore, in order to minimize the harmful consequences, you should seek qualified medical help at the first symptoms and in no case self-medicate.

Often, inpatient treatment, multicomponent drug therapy and the strictest therapeutic diet are required to relieve an acute attack of gastritis. With severe pain syndrome, diet No. 1a is prescribed with minimal digestive load. This variant of therapeutic nutrition fulfills its main task — reducing the reflex excitability of the coolant.

Food is allowed only in the form of liquid or puree, steamed, boiled, mashed. When the acute inflammatory period subsides, the patient is transferred to a more loyal option — diet No. 1, which promotes the restoration of the mucosa affected by inflammation, normalization of secretory and motor functions of the stomach.

Prevention of exacerbation of chronic gastritis involves strict adherence to the prescribed gastroenterologist course of therapy. As a rule, it includes medications, a therapeutic diet, physiotherapy procedures, mineral water intake and phytotherapy. It is worth noting that the leading place in the fight against exacerbations of gastritis is occupied by gastroprotectors with local bactericidal activity based on bismuth tricalium dicitrate. These medications are often prescribed specifically for secondary and tertiary prevention of complications.

Thanks to the active substance, they quickly, effectively and permanently relieve unpleasant symptoms, as well as eliminate the very cause of inflammation, destroying the walls of Helicobacter pylori. Preparations based on bismuth form a protective layer that protects the affected areas of the mucous membrane from the influence of aggressive factors for a long time, have an anti-inflammatory and astringent effect, and also help restore damaged cells and activate regeneration, which is especially important in the treatment of atrophic gastritis.

More information: Treatment of chronic gastritis

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