Akhlorgidriya – total absence of free hydrochloric acid in a stomach cavity owing to violation of its development by obkladochny cages. It is shown by feeling of a raspiraniye and weight in a stomach, pains in an epigastriya, nausea, an eructation, an abdominal distension. It is possible to make the diagnosis when carrying out FEGDS with coloring of Congo companies, a biopsy of a stomach and a rn-metriya; the research on existence of helikobakteriya, antibodies to obkladochny cells of a stomach is surely conducted. Specific treatment is developed insufficiently, generally use exogenous hydrochloric acid and symptomatic treatment, physical therapy.
Akhlorgidriya – process of decrease or complete cessation of production of hydrochloric acid in a stomach. According to the conducted researches of this pathology, an overwhelming part of patients faces it in old age. So, about 20% investigated were at the age of 50-60 years, 70% - are more senior than 80 years. It is considered that it is connected with more frequent infection with the helikobakterny infection at advanced age raised by the frequency of diseases of a stomach at elderly people. At initial stages at treatment of the main pathology secretion restoration is possible. At later stages the forecast adverse. Development of an akhlorgidriya in elderly patients often is associated with stomach cancer. Despite the used efforts in studying of this pathology, effective methods of treatment it is not revealed yet. Today it is possible to maintain acidity of a stomach at the sufficient level only when performing replacement therapy.
According to modern researches, various background diseases of a stomach and other bodies can serve as the reason of development of this pathology. Most often lead to decrease in acidity of a stomach an atrophy mucous as a result of a heavy and long helikobakterny infection, autoimmune gastritis – at the same time antibodies are struck by own cells of a stomach, uraemia at a renal failure and age changes. Also decrease in acid-forming function of a stomach stresses and endocrine diseases (autoimmune tireoidit can cause, diabetes, an autoimmune poliglandulyarny syndrome).
At the beginning of an akhlorgidriya decrease in production of acid can be caused by the functional reasons. Acidity of a stomach is defined by two mutually proceeding processes: development of HCl in mucous bodies of a stomach and production of slime with bicarbonates. Substances two these counterbalance each other, at the same time prevalence of free hydrochloric acid is usually noted. If for various reasons begins influence of slime and bicarbonates amplifies, the amount of free hydrochloric acid in a cavity of a stomach decreases, sometimes to zero, even at slightly reduced its development.
If to remove the cause of development of this pathology before emergence of organic changes, the disease can be cured completely. At organic defeat of a mucous cell of a stomach cease to produce hydrochloric acid and completely atrophy, in this situation even elimination of the reason will not lead to restoration of gastric secretion.
Even at total absence of hydrochloric acid in a stomach the disease can not be shown by the expressed symptomatology in this connection the patient a long time can not guess it. In this situation development of irreversible changes in mucous a stomach even prior to treatment is possible. Sometimes much the reduced acidity is incidentally found at inspections concerning other pathology. Fortunately, in most cases the akhlorgidriya is shown by symptoms of damage of a stomach which allow to carry out diagnostics and to expose the correct diagnosis at early stages of a disease.
Patients are usually disturbed by feeling of a raspiraniye and weight in a stomach after food, the dull aching aches in an epigastriya. Nausea, an eructation and an abdominal distension can be noted. These symptoms are caused by violation of digestion of food, especially proteinaceous, at decrease in amount of hydrochloric acid in a stomach.
Diagnostics of an akhlorgidriya
There are several methods of a research for statement of this diagnosis. The most exact method – FEGDS (gastroscopy) with a simultaneous rn-metriya and an endoscopic biopsy mucous. Assessment of content of free hydrochloric acid in gastric juice will allow to decide on acidity of a stomach. And the research of a bioptat will reveal an atrophy mucous or destruction of the cages producing acid. Also in a bioptata it is possible to find helikobakteriya which can cause heavy chronic gastritis. During gastroscopy coloring mucous by means of Congo companies dye is possible – this method of diagnostics will allow to estimate acid-forming function of cells of a stomach.
Blood test on the content of specific hormones - pepsinogens and a gastrin undertakes. At an atrophy mucous a stomach the quantity of a gastrin in blood increases, and pepsinogens - decreases. Also in blood define existence of antibodies to cells of a stomach, carry out PTsR-diagnostics a helikobakter of a pilora.
Akhlorgidriya can be combined with various diseases of a stomach. So, at pernitsiozny anemia in blood antibodies to own obkladochny cells of a stomach circulate that can provoke development of an akhlorgidriya. At detection much of the reduced amount of hydrochloric acid in a stomach it is necessary to exclude at the patient chronic gastritis (helikobakterny, atrophic, autoimmune), and also stomach cancer.
Treatment of an akhlorgidriya
The gastroenterologist in close cooperation with endoscopists, therapists and physiotherapists usually is engaged in treatment of an akhlorgidriya. Unfortunately, at the moment for methods of full treatment of this state are developed. Usually therapy comes down to replacement of the reduced function of a stomach, symptomatic treatment.
First of all at decrease in acidity of a stomach the special diet is appointed: food has to be semi-fluid and warm, it is necessary to take it often and small portions. In a sharp phase of a disease appoint a table 1a, at improvement of a state pass to a table 2, then to the good vitaminized nutrition. It is necessary to include products which stimulate secretion of a stomach in a diet: sour juice (lemon, cranberry, cabbage, tomato), rather weak coffee, cocoa, greens and vegetable broths. Broths of herbs will be also useful: wormwood, root of a dandelion, fennel, parsley, plantain.
Replacement therapy of an akhlorgidriya includes reception of natural gastric juice during food. The tablespoon of juice is dissolved in a half-glass of water, it is necessary to drink solution small drinks during reception of food. Also the combined fermental medicines are appointed. Well help to restore mucous a stomach and its function medicine on the basis of haemo dialyzate of blood of cattle, a nandrolon , a carnitine, sea-buckthorn oil. At heavy autoimmune gastritis kortikosteroidny hormones can be used.
After the end of treatment in office of gastroenterology performing sanatorium treatment with use of medicinal mineral waters is recommended. In treatment and prevention of an akhlorgidriya hydrocarbonate, chloride sodium waters are applied.
Forecast and prevention of an akhlorgidriya
The forecast of an akhlorgidriya favorable at timely diagnostics and an initiation of treatment. Highly it depends on background pathology which caused an akhlorgidriya. Functional defeats will respond to treatment better, and organic changes mucous most often define the irreversible nature of a disease.
Prevention of an akhlorgidriya consists in timely detection of diseases which can lead to this pathology as the early initiation of treatment of chronic gastritises and other states reduces probability of irreversible defeat of cells of a stomach.