Allergic gastritis - clinical option of an allergy to foodstuff which main manifestations are symptoms of damage of a stomach. This state can be the first display of an allergic disease, develops at direct hit in an anti-gene stomach. It is often combined with damage of intestines and proceeds in the form of a gastrointestinalny allergy, develops at children's age more often. The major etiologichesky factor are proteins of cow's milk, and also egg, fish, some fruit, mushrooms. Treatment is based on purpose of an eliminative diet, specific immunotherapy, symptomatic actions.
Allergic gastritis – the immunomediated damage of a stomach serving as manifestation of hypersensitivity to foodstuff. Often the disease is followed by involvement of other bodies and systems: in 60% of cases also skin symptoms take place, is more rare – respiratory manifestations, visceral violations, gemopatiya, is extremely rare – anaphylactic reactions. Due to a large amount of potential allergens, existence of the cross, latent allergy, similar symptoms of other diseases of digestive tract exact verification of the diagnosis is at a loss in this connection it takes place hyper - and hypodiagnostics. About 65% of patients with allergologichesky pathology indicate intolerance of food, but true allergic gastritis takes place approximately at a third from them. Histologically the disease is characterized by eozinofilny infiltration mucous and deeper layers therefore this pathology also carries the name "eozinofilny gastritis".
Reasons of allergic gastritis
Hit in a stomach of anti-genes of foodstuff is the reason of this pathology. The leading role is played by an allergy to proteins of cow's milk which is defined at 90% of children about one year after transfer to artificial feeding. Cow's milk contains about 20 proteins having the high sensibilizing potential. Also powerful allergens are eggs, fish, cereals, some vegetables and fruit, mushrooms.
Often reaction develops on the additives which are contained in products: fragrances, emulsifiers, preservatives. Ethylene – oil product which process collected unripe fruit can become the reason also. It is proved that allergic gastritis at children of early age allergens of cow's milk, cause strawberries in patients of advanced age more often – chocolate, a citrus.
Often the sensitization develops not only to foodstuff, but also to allergens of the nonfood nature. It is explained by the cross allergy caused by similarity of anti-gene determinants of food, pollen of plants, household allergens, medicines. For example, the cross allergy between natural latex (nipples, toys, gloves) and avocado, a kiwi and other products is quite widespread.
Development of a gastrointestinalny allergy is promoted by such factors as hereditary predisposition to an atopiya, an adverse ecological situation, gestoza at mother, maintaining a feeding up at children, to feature of a mucous membrane of a GIT earlier.
Formation of allergic gastritis is closely connected with violation of tolerance to anti-genes, shifts in local immunity of a GIT and the general changes of immune system, functional disorders of digestion owing to deficiency , decrease in acidity of gastric juice, violation of a microbiocenosis of a GIT, excess release of biogenous amines (a histamine, acetylcholine, serotonin).
An important role in development of a gastrointestinalny allergy in children is played by improper feeding of mother during pregnancy, and also irrational feeding of the child within the first year of life, including early introduction of a feeding up, feeding by not adapted dairy mixes.
Symptoms of allergic gastritis
At this pathology eozinofilny infiltration is extremely seldom limited to one department of digestive tract. Most often the stomach and a small intestine are involved in process. The symptomatology depends on that, how deeply a wall of body of an infiltrirovan eosinophils. If only the mucous membrane is affected, such symptoms as pain in epigastralny area, diarrhea, nausea, vomiting prevail. When involving a muscular layer signs of impassability of intestines (an abdominal distension, nausea, vomiting) prevail. Infiltration of a subserous layer is followed by development of ascites, at the same time in astsitichesky liquid a large number of eosinophils is defined.
Hit in a stomach of allergen leads to increase in motility, strengthening of secretion of glands of a mucous membrane, spastic reductions of antralny department. The gastroezofagealny reflux can develop, at the same time there is a burning, pain in epigastriya, plentiful office of saliva, nausea, vomiting. Vegetative violations are characteristic: weakness, pallor of skin, tachycardia, dizziness.
Diagnosis of allergic gastritis
Diagnosis of this pathology is carried out in two directions: assessment of clinic, laboratory, tool researches and diyetodiagnostika. An important role in verification is played by determination of interrelation between the use of allergen and emergence of symptomatology. Special attention is paid to data of the food, allergologichesky, pharmacological anamnesis, the analysis of the diary of food. Extent of damage of a gastrointestinal tract, a combination to symptoms from other bodies is estimated.
For establishment of a cause of illness the specific allergodiagnostika (skin prik-tests, assessment of level of specific IgE, provocative tests) is carried out. Maintaining the food diary is obligatory. The patient notes in him the used products, registers the appeared symptoms. For definition of an etiologichesky factor eliminative test is carried out. It is that potential allergens for 1-2 weeks are excluded from a diet. If the suspected products a little, test is carried out consistently with an exception of each of them. The most reliable information is given by provocative food tests. These methods are carried out not earlier than in a month after disappearance of complaints of acuity.
For an exception of other diseases, and also assessment of a damage rate mucous endoscopic diagnostics with a research of bioptat is performed. Gastroscopy with a simultaneous endoscopic biopsy is carried out. Data of a histologic research of a bioptat show increase in maintenance of eosinophils. In blood test the increased maintenance of eosinophils against the background of lack of other changes is defined.
Differential diagnosis of allergic gastritis is carried out with other diseases and anomalies of a digestive tract (first of all with catarrhal, atrophic and hyper plastic gastritis, stomach ulcer), metabolic violations, intoxications, infectious, endocrine diseases, immunodeficiency.
Treatment of allergic gastritis
The gastroenterologist together with the allergist is engaged in therapy of this disease. Techniques of treatment of a gastrointestinalny allergy are subdivided on specific and nonspecific. To specific methods an exception of food allergen (purpose of a specialized diet), and also ASIT – an anti-gene - a specific immunotherapy treat with use of food allergens.
The nonspecific pharmacotherapy means purpose of antiserotoninovy medicines, system glucocorticosteroids, the medicines preventing emission of biological and active components from corpulent cages, immunomodulators, and also the means normalizing the GITs functions: pancreatic enzymes, gepatoprotektor, enterosorbents, probiotics, prebiotics.
Eliminative actions assume a complete elimination not only the anti-gene, and also products as a part of which it is even in extremely small quantities. At the same time the patient has to receive the food corresponding to energy and nutritious needs. If it is unknown what product became the gastritis reason, carry out an empirical eliminative dietotherapy – exclude all potential food allergens.
Forecast and prevention of allergic gastritis
Basis of prevention of a gastrointestinalny allergy is prevention at early children's age of contact with allergen, a balanced diet of women during pregnancy, natural feeding, at its impossibility – use of the adapted mixes, individual drawing up a diet at patients with burdened allergoanamnezy.
The forecast of a disease at adequate treatment, a balanced diet favorable. Food allergy loses the dominating role with age, however is long the existing allergic gastritis can become the reason of ulcer colitis, other immunomediated diseases.