Subatrophic gastritis is a special form of the disease, which gives its carrier a lot of inconvenience. Flatulence, stool disorders, sour breath, belching are a brief list of symptoms. The cause of subatrophic gastritis can be the bacterium Hilobacter pylori, as well as autoimmune processes occurring in the body. Treatment of subatrophic gastritis in a short time will help prevent the further development of the disease and the transition to the form of atrophic gastritis. Subatrophic gastritis is a harbinger of the atrophic form of the disease and stomach cancer.
What is subatrophic gastritis
Subatrophic gastritis is distinguished into a separate form by practicing clinicians. Currently, the term focal atrophic gastritis is used to refer to this condition, but quite often one can also encounter the somewhat outdated concept of subatrophic gastritis. With subatrophic gastritis, the process of thinning and death of normal cells of the gastric mucosa is at the initial stage.
Moreover, the degree of damage to the mucous membrane did not reach that of atrophic gastritis. In other words, subatrophic gastritis can be considered as an earlier stage of atrophic, in which changes in the mucous membrane are less pronounced. In addition, subatrophic gastritis is characterized by damage to individual sections of the mucous membrane located in different parts of the stomach.
Subatrophic gastritis is caused by Helicobacter pylori infection or autoimmune mechanisms. Subatrophic gastritis reflects the beginning of a pathological process that can be stopped. That is, adequate and high-quality treatment of subatrophic gastritis will completely stop the further progression of the disease and prevent its transition to the atrophic form.
Manifestations of subatrophic gastritis are associated with dyspepsia. Milk intolerance is very common. In addition, people are concerned about rotten belching, sour breath, flatulence, heaviness in the abdomen after eating, and unstable stools.
Is it possible to use caffeine for gastritis
What is the danger of subatrophic gastritis
What is the danger of chronic atrophic gastritis? There is no unified and comprehensive classification of chronic gastritis, typological varieties of this disease are usually isolated for several reasons. Most often, acute, chronic, antacid, atrophic gastritis and gastritis with an increased level of acidity are distinguished. The most dangerous and insidious is considered to be chronic atrophic gastritis.
The essence of the disease reflects its name: cells of the glandular tissue, subject 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 onset 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 effect that causes a decrease in the protective properties of the mucosa, as a result of which toxins and free radicals get the opportunity to invade tissues and damage cells. This process leads to the degeneration of the cells of the gastric epithelium, which produce gastric juice, into intestinal ones.
Attention! Today Helicobacter pylori is included in the list of biological carcinogens. It is believed that it provokes the occurrence of a cancerous tumor of the stomach. It is worth noting that, according to analysts, more than 80% of the population is carriers of this infection in the world. With age, the frequency and severity of gastric mucosal changes increase. If in young people under 30 years old atrophic gastritis is diagnosed only in 5% of cases, then in the age group from 31 to 50 years old – 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 must be emphasized that atrophic gastritis is considered a direct precursor of gastric cancer. If more than 20% of the mucosa is subject to metaplasia, then the probability of developing a cancerous tumor approaches 100%. In other words, chronic atrophic gastritis in 13% of cases develops into an oncological disease.
This figure is 5 times higher than with other types of gastritis. Therefore, the main task of gastroenterologists is the development and widespread use of simple and effective methods for 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 efficiency of the gastric mucosa and significantly reduce the area of the degenerate area. Of course, atrophied cells of the walls of the stomach at this stage in 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 with the right drug therapy, diet and adherence to the rules of a healthy lifestyle.
Disease diagnosis
The diagnosis of “atrophic gastritis” is made according to the results of the examination:
- disease symptoms;
- study of secretion production;
- X-ray transillumination of the organ;
- information obtained during the examination with an endoscope;
- checking for the presence of Helicobacter pylori infection;
- histological analysis of biological tissue.
The main method for establishing the diagnosis is EFGDS (esophagogastroduodenoscopy). Examination with a probe makes it possible to see the state 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 a strong development of the atrophic process, the folds practically disappear completely.
What foods can be eaten with gastritis
Symptoms and diagnostic signs of subatrophic gastritis
The main evidence of the insidiousness of this disease is the absence of certain and pronounced symptoms at an early stage. There is not even pain that could force the patient to see a doctor.
Symptoms of chronic gastritis in adults, by and large, do not have much specificity and are common to all types of this disease. The main complaint is a feeling of heaviness in the stomach, which appears after eating. However, as the disease progresses, the patient develops symptoms that allow a complete clinical picture to be formed.
For example, dyspeptic syndrome, which manifests itself as heaviness and dull aching pain in the upper abdomen, heartburn, regurgitation, belching, nausea, and even vomiting with impurities of mucus and bile. Also, one of the manifestations of this syndrome is a decrease or complete lack of appetite. It is worth noting that indigestion occurs in other parts of the gastrointestinal tract.
Discomfort and bloating are characteristic, the stool becomes irregular, with constipation or diarrhea. The tongue is covered with a gray coating with imprints of teeth, an unpleasant taste and smell appears in the mouth.
Anemia develops due to malabsorption of iron and vitamins. Its manifestations are weakness, fatigue, drowsiness, chronic fatigue, as well as pallor of the skin and mucous membranes. The patient is tormented by pain and burning in the tongue, the sensitivity of the limbs is disturbed. Hair becomes dry, and nails become brittle, shortness of breath appears, stabbing pains in the heart.
Therapy of subatrophic gastritis
Exacerbation of the disease requires adherence to a diet with restrictions that apply only during this period. After the onset of remission, you need to eat fully. Patients with suppressed, low gastric secretion adhere to a dietary stimulation regimen.
For any gastritis, it is forbidden to use the following products:
- spirits, coffee, carbonated drinks;
- canning, spices, smoked products;
- fried, fatty, spiced food;
- surrogates, concentrates of any products;
- chocolate;
- fast food – fast food;
- space;
- products that stimulate fermentation – black bread, dairy products, grapes.
You need to eat a little, but often – 5 – 6 times a day. The diet is balanced, varied, not limited solely to cereals and broths. In the diet, the presence of a sufficient amount of protein food is important.
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 preparations. 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 Pevzner (see Table 1), a combination of natural gastric juice preparations with drugs that improve the motor activity of the lower part of the stomach, accelerating its emptying – Motilium, Motilak.
Table 1
| Description of the diet table | Diet | Table calories | Diet foods | Culinary processing | Eating mode |
| A complete diet with a high content of extracts. Foods that are difficult for the stomach to digest and linger in it for a long time are excluded. Diet stimulates secretion production, inhibits the progression of the disease. | 90 – 100 g of proteins, 90 – 100 g of fat, 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, cereals, casseroles, vegetable purees, meat sauces, meat and fish soups with vegetables, stale white bread, mousses, compotes.</td | Grinding products of varying degrees, frying without breading, boiling, baking dishes. | The temperature of ready-made hot dishes is about 60 ° C, cold – below 15 ° C, meals in small portions, frequent (4-5 times a day). |
With 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.
Treatment of atrophic gastritis type B (Helicobacter pylori) with high acidity
Treatment of type B gastritis is aimed at eliminating the causative agent of the infection. The clinical recommendations of the World Health Organization experts call first-line anti-Helicobacter drugs metronidazole (tinidazole), clarithromycin, amoxicillin, tetracycline, de-nol.
Types of major antisecretory drugs are listed in Table 2.
Table 2
| Group of medicines | Drug names |
| Cholinolytics | atropine sulfate, gastrocepin |
| H2 blockers |
|
| Proton pump inhibitors |
|
| Combination drug | Pyloric acid |
A month and a half after the completion of the course of therapy, a follow-up examination is carried out. If the ongoing treatment has not eliminated the infection completely, the sensitivity of Helicobacter pylori to antimicrobials is determined for the appointment of a second course.
Treatment of atrophic gastritis type C (reflux gastritis)
The diagnostic conclusion “reflux gastritis” is made to several groups of patients:
- those to whom part of the stomach was removed;
- treated with non-steroidal 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 appoint:
- diet
- drugs that activate intestinal motility – prokinetics;
- drugs that restore the movement of contents through the intestine;
- silicon-containing drugs that prevent the accumulation of gases;
- medicines that normalize stools with a tendency to delay defecation.
When prescribing drugs for the treatment of atrophic gastritis, the phase of the disease, its type, and the features of the work of the stomach are taken into account – secretion, motility, evacuation of contents.
In a severe form of an exacerbation of the pathology – severe pain, a deep disruption of the stomach, weight loss – the patient is hospitalized. Being under the supervision of doctors is also necessary in case of a risk 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. An exacerbation of chronic gastritis can be due to both a seasonal surge in the incidence, and provoked by the use of foods and drinks from the prohibited list, taking medications, psychological factors, such as frequent stress or overwork, 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, to minimize the harmful effects, you should seek qualified medical help at the first symptoms and in no case self-medicate. Often, in order to relieve an acute attack of gastritis, inpatient treatment, multicomponent drug therapy and the strictest therapeutic diet are required.
With a pronounced pain syndrome, diet No. 1a is prescribed with a minimum 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 a liquid or mashed potatoes, steamed, boiled, mashed. When the acute inflammatory period subsides, the patient is transferred to a more loyal option – diet No. 1, which helps to restore the mucosa affected by inflammation, normalize the secretory and motor functions of the stomach.
Prevention of exacerbation of chronic gastritis involves strict adherence to the course of therapy prescribed by the gastroenterologist. As a rule, it includes medications, a therapeutic diet, physiotherapy, mineral water intake and herbal medicine. It should be noted that the leading place in the fight against exacerbations of gastritis is occupied by gastroprotectors with local bactericidal activity based on tripotassium bismuth dicitrate. These drugs are often prescribed specifically for secondary and tertiary prevention of complications.
Thanks to the active substance, they quickly, effectively and permanently relieve unpleasant symptoms, and also eliminate the very cause of inflammation, destroying the walls of Helicobacter pylori. Bismuth-based preparations form a protective layer that for a long time protects the affected areas of the mucous membrane from the influence of aggressive factors, has anti-inflammatory and astringent effects, and also helps to restore damaged cells and activate regeneration, which is especially important in the treatment of atrophic gastritis.
Subatrophic gastritis: a reader’s question
Good afternoon My mother is 64 years old. She is registered with an endocrinologist (takes L-thyroxine 100 constantly). In May, she went to the doctor with complaints of pain in the stomach (sometimes cutting, sometimes aching), accompanied by severe heartburn and nausea, bloating and constipation. An abdominal ultrasound was performed: visualization is difficult due to intestinal pneumatosis. The structure of the liver is heterogeneous, echogenicity is increased, vessels and bile ducts are not dilated.
The size of the gallbladder is normal, the shape is S-shaped, the contents are homogeneous. The contours of the pancreas are indistinct, finely wavy, enlarged (head 34mm, body 22mm, tail 36mm), Wirsung’s duct is not dilated. The spleen is not enlarged. Conclusion: fatty hematosis, bowel dysfunction, cholecystopancreatin. A colonoscopy was performed (the endoscope was inserted at 55 cm) – the tone was normal.
It was recommended to take pancreatin, but the attacks continue. In July, EGD was performed: the esophagus is passable, the mucosa is pink, the walls are elastic, the cardia closes completely, there are no ruptures of the mucosa, there is no gastroalimentary reflex, the contents are transparent, focal atrophy in the fundus, there is no ulcerative defect.
Conclusion – chronic subatrophic gastritis, duodenitis. No treatment was prescribed other than diet. But the attacks are repeated (a day or two is normal, and then again pain and nausea, though the last time without heartburn). During such pains, he practically does not eat anything, because a small meal causes nausea and increased pain. Prompt, please, 1 what preparations to accept during an exacerbation, 2 what inspections it is necessary to pass or take place still.