How to diagnose gastritis? In case of unpleasant symptoms in the stomach, such as nausea, cramps, pain, heartburn, it is recommended that you diagnose gastritis. It is possible to check gastritis in classical ways, which include laboratory tests, the well-known standard FGS procedure, testing for the presence or absence of chylobacter pylori bacteria in the body. Want to know more about how to check for gastritis? Then we recommend reading the following material on the diagnosis of gastritis and the method of its investigation. Diagnosis of gastritis – read more gastritinfo.com.
What is gastritis
Gastritis is an inflammation of the gastric mucosa resulting from infection with the bacterium Helicobacter Pylori, as well as improper nutrition and lifestyle (stress, nicotine, alcohol), work in harmful production. An acute form of gastritis that is not stopped in time can turn into a chronic one, and in some cases (for example, with phlegmonous gastritis) end in death.
Peptic ulcer of the stomach and duodenum is a chronic, seasonally (spring, autumn) recurrent disease associated with the appearance of a characteristic defect (ulcers, ulceration) on the mucous membrane of the stomach or the initial parts of the duodenum. There may be several reasons for the occurrence of ulcers: infection with helicobacteria, regular intake of drugs irritating the mucous membrane, strong negative emotions, alcohol and even heredity.
The symptoms of H. Pylori infection manifest themselves differently depending on the type of disease, the size and location of the affected area.
Severe pain in the upper abdomen for many days and vomiting are the first signs of the need to do a gastritis test/stomach ulcer and consult a specialized doctor.
Diagnosis of gastritis
Any diagnosis begins with a doctor’s examination of the patient. Initially, a clinical examination is carried out, in which the doctor determines the condition of the skin and feels the stomach in the stomach area: if the patient suffers from gastritis, the pain during palpation worsens. A clinical examination can only give an assumption about a stomach disease. To find out the nature and extent of organ damage, instrumental and laboratory diagnostic methods are needed.
Gastroscopy (or fibrogastroduodenoendoscopy, FGDS) is a study of the upper gastrointestinal tract (esophagus, stomach, duodenum) using a gastroscope device – a probe equipped with a camera. The endoscopist sees the condition of the mucous membranes of the organs during the procedure itself, and if necessary, photographs or video recording of the image from the camera are taken. FGDS allows differential diagnosis of gastritis with peptic ulcer disease, as well as to determine the localization of gastritis and its type: erosive or non-erosive.
Erosive (or corrosive) gastritis is a type of acute gastritis that occurs against the background of exposure to toxic substances (acids, alkalis, alcohol, nonsteroidal anti–inflammatory drugs) and is accompanied by deep damage to the gastric mucosa – erosions. Non-erosive gastritis is associated with damage to the upper layer of the gastric mucosa, but with prolonged course it can turn into a chronic form or into an ulcer.
The gastroscope makes it possible to carry out not only visual diagnostics of the stomach, but also to take samples of its contents (gastric juice) and tissues, in other words, to conduct pH-metry and biopsy. A biopsy is the extraction of fragments of the gastric mucosa for their laboratory examination. This method is very informative for studying diffuse (and not point) lesions of the mucosa, samples are taken, as a rule, in three different parts of the stomach. The procedure is painless and safe, does not require additional anesthesia, the areas of the mucosa taken for analysis are very small and are plucked only from the surface of the shell. The method of pH-metry is to study the acidity of the stomach, as well as the duodenum and esophagus.
The level of acidity of the gastric contents allows us to judge the presence of an inflammatory process. The pH-metry procedure has several methods of carrying out. During rapid analysis, a thin pH probe is inserted into the stomach through the mouth, equipped with special electrodes for measuring acidity in different parts of the stomach. Daily pH-metry is the study of acidity in the stomach for 24 hours or more. In this case, the probe is inserted into the organ through the nose, and a pH measuring device is put on the patient’s belt – an acidogastrometer that registers the dynamics of changes in acidity.
A technically advanced version of the daily diagnosis is the ingestion of a mini–capsule, which is attached to the wall of the esophagus and transmits information to the acidogastrometer. After a few days, the capsule detaches itself from the esophagus and naturally exits the gastrointestinal tract.
Endoscopic pH-metry involves performing the procedure during FGDS, in which case the pH probe is located inside the gastroscope tube. The study of gastric juice is also performed by probing. Samples of gastric contents are taken with the help of special instruments embedded in the gastroscope.
As a rule, before this procedure, the patient is given so-called trial breakfasts that stimulate the production of gastric juice. The analysis of gastric contents allows us to determine not only the fact of gastritis itself, but partly its nature: in case of a disease caused by Helicobacter pylori, gastric juice contains a lot of gastrin. Probing of the stomach is not allowed in all cases (for example, after operations, with stenosis of organs). Then it is possible to measure the level of acidity using acidotest: the patient takes special drugs that, when interacting with hydrochloric acid in the stomach, form dyes detected in the urine.
Diagnosis and examination by a doctor
At the first manifestations of diseases of the gastrointestinal tract, it is necessary to seek qualified help as soon as possible. The fact is that the symptoms of gastritis are in many ways similar to the manifestations of diseases such as cholecystitis, pancreatitis or stomach ulcer.
So, after meeting the doctor:
- There will be a conversation and an initial examination.
- With the help of palpation, the doctor identifies painful points, after which there are suggestions about possible inflammation.
- This is how the diagnosis of acute gastritis is carried out, but corrosive gastritis can be detected by examining the oral cavity.
- The doctor will definitely pay attention to such indicators as increased body temperature, vomiting and its contents, how tense the gastric muscles are.
Visible changes in the mucous membrane in the oral cavity, which indicate gastritis caused by chemical poisoning. And these changes make it possible to identify what poisoned a person:
Important! When diagnosing gastritis, an initial examination of the patient is important, during which a conversation with the patient is conducted, an examination with palpation. After that, the doctor has assumptions about the existing pathology and further examinations are more informative.
| Reason: | Symptoms: |
|---|---|
| Chemical. | Visible changes in the condition of the oral mucosa, the color of necrotic areas with visible scabs. |
| Hydrochloric acid. | Defined by white. |
| Nitric acid. | It is defined in yellow. |
| Sulfuric acid. | Black. |
| Alkali. | Dirty brown-gray film. |
Classical methods of gastritis diagnosis
So, here are some the most common ways to determine the features of stomach inflammation.
Note: we will not talk in detail about X-rays and ultrasound here, the corresponding articles were published on the site earlier.
Standard FGS
Reliable and, perhaps, the most informative diagnostic technique. The procedure is done on an empty stomach.
The process, to put it mildly, is not very pleasant for the patient – he is sitting or lying down, a flexible endoscope equipped with a microcamera (“gut”) is inserted through his mouth and esophagus. FGS allows you to determine how much and in which areas the mucosa is affected, shows whether internal bleeding is possible.
It is important to emphasize that the procedure requires a very high level of qualification from a specialist. Otherwise, all unpleasant manipulations will be meaningless.
Intragastric pH-metric
This method is aimed at determining the characteristics of acidity. As you may know, digestion in the stomach is carried out under the influence of chemicals — hydrochloric acid and a number of enzymes.
When a deficiency or excess of HCl is formed, problems with digestion begin. Excessive amounts of HCl irritate the mucous membrane, deficient leads to insufficient processing of the food lump.
PH-metry is done using a probe or performed in combination with gastroscopy (FGS) through an endoscope.
Tests for helicobacter
Tests of various kinds help to establish the presence or absence of Helicobacter pylori bacteria. A breath test is sufficient for the initial diagnosis. It is based on the analysis of reactions that are caused by urease, a product of the vital activity of pathogenic microorganisms. Also, helicobacter is detected through other methods.
Laboratory diagnostics. By laboratory diagnostics we mean clinical tests of blood, feces, urine. The purpose of such a study is to clarify the cause of the disease. The method is quite convenient for the patient, but, unfortunately, it takes time. We have to wait several days for answers.
Biopsy
A biopsy should be mentioned separately, as it usually scares patients. It involves cutting a tissue sample from the inner lining of the stomach.
It is usually done in the FGDS process. You should not be afraid of the procedure — it does not cause significant pain and, as a rule, does not lead to internal bleeding.
The biopsy does not affect the muscle tissue, but only the superficial, mucous layer.
MEF assessment methods
MEF is the motor—evacuation function of the stomach, in other words, its ability to push food normally during contractions.
The methods of this group allow either to directly register the motor activity of an organ or to draw indirect conclusions based on data on electrical activity.
The internal pressure of the gastrointestinal tract can be measured through the introduction of small devices into the gastrointestinal tract – micro sensors, capsules. Contact of the sensor with the mucous surface causes artificially provoked contractions.
Electrophysiological methods involve the study of biopotentials of gastric walls (electrogastroenterography, also known as EGEG). Electrogastroenterography can be direct and peripheral, depending on how the electrodes are fixed — in maximum proximity to the organ or on the extremities. According to the time of the EGEG, it is divided into a daily and a short-term forty-minute.
Read more Gastritis with high acidity
Laboratory tests for gastritis
Blood test (general) – in the presence of gastritis, the level of leukocytes and erythrocytes decreases. In addition, hemoglobin and platelets will decrease.The most informative method of diagnosing inflammation is a series of laboratory tests. A gastroenterologist prescribes a number of such tests:
- The delivery of fecal masses will be mandatory – the analysis will show the presence of hidden blood and the bacterium Helicobacter pylori.
- General analysis of urine.
- In addition to blood donation for a general analysis, a biochemical analysis is carried out – this is necessary for the differentiation of gastritis, that is, so as not to confuse it with other diseases of the gastrointestinal tract.
Crucial in the diagnosis is the identification of factors that were the instigators of the development of gastritis. Very often the causes are Salmonella, Staphylococcus, the bacterium Helicobacter pylori. Instrumental diagnostics is a study of the patient, in which various devices and equipment are used. With their help, a biopsy is also performed.
The doctor may prescribe such measures:
FGDS is a rather unpleasant procedure, but it allows you to understand how badly the mucous membrane is affected, to find out the type of disease and not to confuse it with other pathologies of the gastrointestinal tract. To conduct this study, a flexible probe is used, the tip of which is equipped with a camera – thanks to this, the picture transmitted to the computer allows you to see the overall picture of inflammation and all changes in the mucosa.
- Biopsy is performed simultaneously with gastroscopy, as with this procedure it becomes possible to take stomach tissues for examination. The procedure itself is quite painless, for a more accurate picture, tissue is taken from several parts of the stomach at once, because when exposed to Helicobacter bacteria, activity can vary depending on the stomach area.
- It will also be important to determine the acidity of gastritis – this is important both for a therapeutic diet and for medications whose action is aimed at reducing pain and increasing the acidity of the stomach. An express test will allow you to find out about the level of acidity by inserting a probe with electrodes. There are other ways to clarify the values – they are called daily analyses. Without gastroscopy, the patient can swallow a special capsule – it gets into the stomach, attaches to the wall of the organ and collecting data transmits them to the acidogastrometer. Such a capsule is excreted naturally, a couple of days after ingestion.
Important! Sometimes the patient has contraindications for the introduction of the probe. In this case, a person is recommended to take a special drug that changes the color of urine by interacting with hydrochloric acid.
Stool and urine analysis for gastritis
Examining human bowel movements in laboratory conditions, deviations are determined:
- acid balance;
- the presence of undesirable substances such as starch and fatty acids;
- fermentation, which determines a person’s ability to digest food.
Feces are examined separately to reveal hidden blood in it. A scrupulous study allows us to identify a special type of gastritis – atrophic. With it, muscle fibers, intracellular starch, digested fiber, connective tissue are present in the analysis. Urine analysis is performed as a general examination to exclude the diagnosis of renal pathology.
X-ray examination
Perform radiology of the stomach, as well as the small intestine. Such a diagnosis of gastritis allows you to identify not only this disease, but also other pathologies of the gastrointestinal tract. Sometimes, before the procedure, the patient is forced to drink liquid barium, which covers the internal walls of the gastrointestinal tract, after which they are better seen in the pictures.
Read more: Symptoms of atrophic gastritis
Esophagogastroduodenoscopy
This type of examination involves a visual examination of the digestive tract in its upper part. Diagnostics helps to identify mucosal pathology, which is difficult to notice on an X-ray.
During esophagogastroduodenoscopy, a thin and very elastic controlled probe is inserted into the patient’s mouth, equipped with an optical device – a gastroscope. The patient is placed on the couch during the manipulation. The procedure is painless, but in order to exclude the possibility of a gag reflex, the throat is sprayed with an anesthetic, and the patient is given a special medicine to reduce discomfort.
The probe is lowered into the esophagus, then it reaches the stomach and stops in the upper part of the small intestine. When, as the doctor moves, he sees a suspicious tissue, a biopsy is performed with a special instrument built into the gastroscope. After that, the tissue samples are transferred to the laboratory, where a histological examination is performed.
The procedure lasts no more than half an hour, but after it the patient is left in the hospital for two hours. This is necessary so that the injected medicine ceases to work. The study is harmless to health, although bleeding is sometimes observed due to perforation of the mucosa with a gastroscope. Usually, esophagogastroduodenoscopy causes the only side effect – a slight sore throat due to swallowing the probe.
Breath test
To detect the presence of Helicobacter pylori-type bacteria in the body, the air exhaled by the patient is taken for analysis. This is a simple study that helps to detect the presence of infection.
FGDS
This type of examination is performed with a fibrogastroduodenoscope – a flexible probe equipped with a video camera. Thanks to this, the analysis shows the specialist both the places of gastric inflammation and the mucous tissues affected, while simultaneously allowing to exclude stomach ulcers. The equipment transmits the resulting image to the monitor, so that the doctor perfectly observes all the existing pathologies of the mucosa.
Tissue biopsy
The smallest samples of gastric tissue removed during gastroscopy are further examined in order to detect the presence of harmful bacteria. The material is selected in different areas of the stomach, since Helicobacter pylori is capable of uneven activity in different places of its presence.
Acidity
A study on acidity is able to determine the presence of gastritis. The analysis is performed in several ways, including express analysis (the introduction of a thin probe with an electrode capable of determining the acidity of the stomach) and a daily study of PH changes.
The last version of the study determines the dynamics of changes in the PH of the stomach environment per day. In this case, three options for performing the analysis are used:
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- swallowing a capsule that transmits the received data to the acidogastrometer;
- inserting a PH probe through the nose and fixing it on the waist;
if it is impossible to use the probe, an acid test is performed as an alternative – special drugs are injected into the stomach that change the color of urine when interacting with gastric acid.
Checking gastric juice
Performing gastroscopy, the specialist selects gastric juice from the patient as samples. Before the procedure, the patient should take special food that provokes copious secretion of gastric secretions. Thanks to the analysis, it turns out not only to confirm gastritis, but also to determine the cause of its occurrence. When a lot of gastrin was found, the disease was caused by bacteria.
Read more: Bitterness in the mouth with gastritis