Gastritis

Gastritis
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Гінекологія Gastroenterology
Consultation of a gastroenterologist
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Follow-up consultation of a gastroenterologist in English
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Online consultation of a gastroenterologist in English
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The human stomach is lined with a special type of tissue that forms folds and is called the mucous membrane. It protects the stomach from the action of hydrochloric acid, which is released during digestion. However, when something damages or thins the membrane, it becomes inflamed and this is called gastritis. The most common cause of this condition is considered to be a bacterium called Helicobacter pylori.

As of today, gastritis affects about half of the world's population and provokes the development of many complications such as gastric ulcer, anemia, or cancer.

 

The main symptoms

Among the main signs that occur at an early stage of the disease are:

  • The appearance of pain in the stomach during or after eating food that burns or stings
  • Frequent belching and heartburn
  • Attacks of vomiting, nausea
  • Heaviness in the stomach
  • Bad breath
  • The presence of white plaque on the tongue
  • Decreased appetite, weight loss
  • Disorders of defecation

The appearance of a symptom also depends on the type of gastritis that occurs. Therefore, a clear description of the symptoms and products that provoke their occurrence plays an important role in the diagnosis.

 

Types of gastritis

There are several classifications for this disease, based on its clinical, physiological and histological characteristics. The main ones can be distinguished by the following points.
1. Depending on how it runs:
1.1. Acute. Occurs suddenly with severe symptoms (often under the influence of a new provoking factor, such as stress)
1.2. Chronic.It lasts for a long period of time with alternating periods of exacerbation and remission (significant improvement)

2. According to a certain level of hydrochloric acid:
2.1. Hyperacid - with high acidity in the stomach, which can exacerbate symptoms and provoke aggressive corrosion of the mucous membrane. Most often caused by either the bacterium Helicobacter pylori, or taking drugs, smoking.
2.2. Hypoacid - in which the content of hydrochloric acid is reduced due to disturbances in the cells that produce it. May be the result of prolonged untreated hyperacid gastritis, resulting in massive damage to the gastric mucosa. Helicobacter pylori infections and eating disorders are also among the causes.

3. By type of lesion of the mucous membrane:
3.1. Non-erosive. Inflammation without additional defects on its surface
3.2. Erosive (reactive - another name). In which due to inflammation in the wall there are erosions - areas of epithelial damage
3.3. Atrophic is a dangerous type of gastritis in which the gastric mucosa is damaged so badly that it can provoke the formation of cancer cells and the development of tumors

 

Causes

Since gastritis occurs when the gastric mucosa is damaged, the causes are those factors that can affect it. And this is a fairly large number of different states and consequences:

  • Influence of alcohol. Irritating and corrosive to mucous membranes each time it comes in contact with it
  • Eating disorders.Irregularity, abuse of foods high in salt, pepper and other spices, carbonated beverages, fast food and dry food
  • Infection with bacteria: H.pylori - penetrates the mucous membrane, provoking an inflammatory process in it.
  • Reflux - throwing bile into the stomach. Normally, it is produced by the liver to digest food and is excreted in the duodenum, the walls of which are adapted to its passage. When the sphincter is disturbed, the return flow of bile can get to the gastric mucosa
  • Medicines. These are mainly long-term treatment of chronic pain with the use of nonsteroidal anti-inflammatory drugs (NSAIDs - ibuprofen, aspirin, paracetamol) and glucocorticosteroids (prednisolone, dexamethasone), which have a detrimental effect on the gastric mucosa
  • Stress and other psycho-emotional disorders that occur suddenly, can in a short time to provoke the emergence or exacerbation of the disease. Often the cause can even be the appearance of another serious pathology that does not affect the gastrointestinal tract (significant burns or injuries)
  • Autoimmune diseases, the process of which is still being studied. In this case, a problem arises, during which the body destroys healthy cells of the gastric membrane

Diagnosis

First of all, it should be noted that gastritis is a diagnosis that can be established only after histological examination of gastric tissue, which is carried out along with other methods of diagnosis.

  • Collection of complaints and history of their occurrence
  • Blood sampling to detect signs of inflammation (CBC, C-reactive protein) or dysfunction of other organs of the digestive system (biochemical analysis of blood - liver samples), antibodies to Helicobacter pylori
  • Determination of Helicobacter pylori antigen in feces
  • Breath test: you need to swallow a capsule or liquid containing urea (not harmful), which Helicobacter pylori is able to convert into carbon dioxide. Then exhale into a special bag to detect it there, which will be the result of a positive test
  • Videogastroduodenoscopy (VGDS) or capsule endoscopy. These are methods in which the doctor can see and evaluate the mucous membranes of the gastrointestinal tract by inserting a tube or swallowed capsule with a camera. Gastroscopy can also measure the acidity of the stomach, or take a piece of tissue for histological examination
  • Ultrasound examination of the abdominal cavity - to exclude the presence of complications (tumors) and other pathologies with similar symptoms (hernia, for example)

Treatment

Treatment of gastritis is aimed at eliminating the cause and reducing the symptoms of concern. To do this, use certain groups of drugs and adjust the diet, because everything a person eats is in direct contact with the gastric mucosa and can improve or worsen its condition. The choice of drugs is based on the type of gastritis that has been identified.

 

Medications that your doctor may prescribe include:

  • Antibiotics - necessary in case of detection of Helicobacter pylori to eliminate it
  • Drugs to reduce acidity (hyperacid type): this is a group of proton pump inhibitors such as omeprazole, rabeprazole and others
  • Preparations of bismuth for the correction of hypoacid species, as they are able to form a protective pellicle on the erosion surface and promote the healing of defects
  • Antacids that envelop the mucosa and reduce inflammation, reducing its impact on it
  • Enzyme preparations to eliminate digestive disorders and facilitate digestion
  • Antispasmodics to normalize the muscles of the stomach
  • Sedatives in the case of psycho-emotional cause as a major factor in the development of the disease

The second and no less important component of treatment is nutrition advice. Here it is important to start from the level of gastric acidity. If it is elevated, it is better to avoid:

  • food which can mechanically injure mucous membranes (bread with bran, fish bones in a dish, meat with fibers or veins)
  • Rich broths as provocateurs of gastric juice
  • Spicy, smoked, salted and pickled products
  • Citrus (in general, it is better to prefer baked apples or other heat-treated fruits)
  • Strong coffee, tea or any alcoholic beverages
  • Provocateurs of flatulence (legumes, dairy products, cabbage)
  • Sweets (except pastilles or marshmallows in moderation)

At the lowered allocation of gastric juice some recommendations are added:

  • Fish or meat broth is allowed to stimulate secretion
  • Choose baking or cooking as a method of cooking
  • Beets, carrots, pomegranate or plum juices (to improve the passage of food through the digestive tract)

It is also important to pay attention to the temperature of the food eaten. It should not be hot, so as not to aggravate inflammation, and not cold, so as not to slow down the digestive process. The basis of nutrition is mucous porridge, steamed vegetables and low-fat boiled poultry or rabbit.

 

Advices

You should not be afraid of gastritis if you follow the rules of a healthy lifestyle and diet. This will be its best prevention. If it has already arisen, it is necessary to make every effort and to pass a full course of the appointed treatment that can take 2-4 weeks with obligatory further control over an assessment of quality of the carried-out therapy (the method will be defined by the doctor for a concrete case). 
It is extremely important to get rid of this condition once and for all, as well as to understand how to protect yourself from it in the future.

 

Our doctors
Kostanopulo Olena
Kostanopulo Olena
Family Physician, Gastroenterologist
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Ostapenko Lesia
Ostapenko Lesia
Therapist, Family Physician, Gastroenterologist, expert in the treatment of infectious diseases
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