Antralny gastritis – the chronic inflammatory disease of a stomach affecting mucous in output department (antrum). Treats chronic gastritis of type B – bakterialno caused. It is shown by pains in an epigastriya (hungry or in a couple of hours after food), nausea, an eructation acid, the dispepsichesky phenomena at the kept appetite. The main method of diagnostics is the fibrogastroduodenoskopiya, a research regarding existence of helikobakteriya. Treatment surely joins the antikhelikobakterny antibiotics, antatsida regenerating and anesthetizing medicines.
Antralny gastritis – a chronic inflammation mucous a stomach, localized in pilorichesky department. This department of a stomach performs function of alkalization of a food himus before transition to intestines. The inflammation in an antruma causes blocking of production of bicarbonates, acidity of gastric juice increases, and sour contents get into a duodenum, provoking formation of ulcers. Antralny gastritis usually is considered as an early stage of chronic gastritis, at this form of an inflammation of a helikobakteriya come to light in very large number. At spread of an infection the quantity of a bacterium decreases by other departments. Antralny gastritis has the symptomatology very similar to stomach ulcer of a stomach. 85% of all diseases of a stomach are the share of this pathology, nevertheless, address the gastroenterologist of only 10-15% of all patients with chronic gastritis.
Reasons of antralny gastritis
About 95% of all cases of chronic antralny gastritis are connected with detection in a mucous bacterium of a stomach under the name Helicobacter pylori. This activator can comfortably live in gastric slime at from 4 to 6, though in more acidic environment keeps the activity. For helikobakteriya the gipokhlorgidriya (the lowered acidity of gastric juice) is pernicious. In adverse conditions the bacterium can take the special form of rest, and at hit on comfortable Wednesday – again becomes active.
Feature of helikobakteriya is production of a number of enzymes by them which I promote change of the environment around them. So, urease splits the urea which is in a stomach to ammonia, zashchelachivy the environment around a microorganism. Mutsinaza promotes decrease in viscosity of gastric slime. In such conditions mobile bacteria easily get through a layer of protective slime to an antralny epithelium of a stomach where begin to breed actively, causing damage mucous and violation of work of gastric glands. The Pilorichesky department ceases to produce bicarbonates (the alkalizing environment) in this connection acidity of gastric juice gradually increases, in addition damaging an epithelium of a stomach and in other departments.
Promote a helikobakterny invasion a duodeno-gastralny reflux (throwing of contents of intestines in a stomach because of weakness of a pylorus), reception of some medicines (salycylates, NPVS, antitubercular means), food allergy, improper feeding, the use of alcohol, smoking. Also some internal factors contribute to development of this pathology: centers of a chronic infection, endocrine pathology, lack of iron, heart and respiratory failure, chronic renal failure.
Symptoms of antralny gastritis
Usually the inflammation of an antralny part of a stomach passes at initial stages as not atrophic process without insufficiency of secretion of gastric juice. Clinic of this pathology of a yazvennopodobn: pains in epigastralny area, hungry or in several hours after food; heartburn, eructation sour and air, tendency to locks. Appetite at the same time does not suffer.
At survey language pure, damp. At a stomach palpation morbidity is localized in an epigastriya on the right (a piloroduodenalny zone). Loss of weight happens only at the heavy course of a disease.
Diagnosis of antralny gastritis
At a gastrografiya with contrasting the thickening of relief folds in pilorichesky department, a pylorus spasm, the segmenting vermicular movement, chaotic evacuation of gastric contents is noted.
At FEGDS spotty hyperaemia mucous, hypostasis of fabrics in antralny department is visible, hemorrhages and erosion can be found. The raised ekssudation, stagnation of contents in a stomach because of a pylorus spasm is noted. During the endoscopic research the fabric biopsy is surely made for a histologic research and allocation of the activator. At the same time the expressed inflammation, a large number of helikobakteriya histologically is defined on epithelium surfaces.
The Ureazny test for definition of helikobakteriya is carried out by means of special express sets during gastroscopy. For this purpose mucous place on special Wednesday which changes the coloring depending on concentration of microorganisms for crimson – from an hour to one days. If coloring did not change within a day – the test negative. Also exists S-ureazny the respiratory test. For its carrying out enter marked C13 into a stomach urea, and then in the exhaled air define concentration of C13. If in a stomach there are helikobakteriya, they will destroy urea, and concentration of C13 will be higher than 1% (3,5% - easy degree of an invasion, 9,5% - extremely heavy).
From bioptat by mucous surely do crops which incubation occurs at extremely low concentration of oxygen (less than 5%) on blood environments. The result of crops with sensitivity to antibiotics will be received in 3-5 days.
IFA a method of identification of antibodies to helikobakteriya in blood, saliva and gastric juice is rather sensitive. Antibodies appear in blood within a month after infection, keep the activity also within a month after full treatment. For definition of acidity of gastric juice use an intragastric rn-metriya, a fractional research of gastric juice with application of stimulators of secretion.
At diagnosis antralny gastritis is differentiated with functional disorders, stomach ulcer of a stomach.
Treatment of antralny gastritis
Therapists, gastroenterologists, endoscopists are engaged in treatment and diagnosis of this pathology; at aggravations of the patient is in office of gastroenterology or therapy. Treatment of antralny gastritis begins with purpose of a special medical diet: in the period of an aggravation a table 1b with gradual expansion to the first table within several weeks or months.
Antikhelikobakterny medicines are surely appointed. Etiotropny therapy of H.pylori is rather difficult as the microorganism quickly adapts to popular antibiotics. Most often appoint the double or threefold scheme of treatment in which include metronidazole, , ampicillin or . It is recommended to add inhibitors of a proton pomp which oppress helikobakteriya to the scheme, and carry out by antibacterial medicines their full eradikation.
Anti-inflammatory therapy can be carried out by both pharmaceutical medicines, and herbs according to recipes of traditional medicine. So, in the period of an aggravation it is recommended to use infusions of a camomile, mint, a St. John's Wort, flax seeds. At emergence of erosion on mucous antralny department of a stomach, the increased acidity of gastric juice appoint antisekretorny means. At a spasm of a pylorus miotropny spazmolitik are successfully applied: , papaverine. For normalization of a vermicular movement and elimination of a duodenogastralny reflux it is used .
Indispensable condition of an absolute recovery is purpose of reparative means. It can be the medicines stimulating protein synthesis (inosine, anabolic steroids), a carnitine, sea-buckthorn oil.
The important place is taken also by physical therapy: galvanization of a stomach with an electrophoresis of medicines (at a spasm of pilorichesky department), UVCh-therapy, treatment by ultrasound (with the anesthetizing purpose), diadynamic currents of Bernard, the sinusoidal modulated currents (for elimination of pain and dyspepsia). After knocking over of an aggravation recommend carrying out gryaze-and parafinoterapiya, treatment by mineral waters.
Forecast and prevention of antralny gastritis
To avoid development of heavy inflammatory process in a stomach, it is necessary to eat, refuse properly addictions (smoking, spirits), to avoid a physical and emotional overstrain, to observe a day regimen.
The forecast at this type of chronic gastritis favorable only at a timely initiation of treatment, observance of all recommendations, a day regimen and food. If in time not to address the gastroenterologist, gastritis passes into a diffusion form which can end with formation of ulcers (at hyperfunction mucous) or stomach tumors (at an atrophy mucous).