Chronic superficial gastritis
Chronic superficial gastritis – the disease which is characterized by an inflammation of a mucous layer of a wall of a stomach at which pathological process does not extend to deeper layers and does not worsen sekretorny function of body. The discomfort and dull ache in the top departments of a stomach which appear after food are considered as the main symptoms. Also the disease can be followed by periodic nausea, an eructation and heartburn. A key role in diagnostics is played by an ezofagogastroskopiya, an endoscopic biopsy and the respiratory test on a helikobakter of a pilora. For treatment of chronic superficial gastritis antisekretorny medicines, antatsida, antibiotics are used. The forecast favorable at timely therapy.
Chronic superficial gastritis
Chronic superficial gastritis represents the persistiruyushchy disease in which pathogenesis the inflammation of a mucous membrane of a stomach lies is long. This pathology also carries the name "not atrophic gastritis" or "gastritis of type B". Precisely it is quite difficult to estimate prevalence of a disease as at many people superficial gastritis proceeds asymptomatically. On statistical data, this pathology occurs more than at 50% of the population of the planet, irrespective of age. More often it is diagnosed for men. The clinical importance of chronic gastritis consists not so much in prevalence of a disease how many in its progressing and possible transition to an ulcer or cancer of a stomach. The gastroenterology is engaged in studying of features of emergence and development of pathology, and also development of new methods of diagnostics and treatment.
Reasons of chronic superficial gastritis
Factors of development of chronic superficial gastritis are divided on external and internal. From the exogenous reasons which influence mucous it is possible to allocate irrational food, long alcohol intake, smoking, reception of medicines and infection a helikobakter of a pilora. Can lead irregular food, an insufficient chewing of food, reception of products to development of chronic superficial gastritis with no drink, the use of rough or spicy food, hot drink. All these factors influence a mucous membrane and can provoke increase in acidity. Alcohol intake oppresses formation of slime, breaks regeneration of epitelialny cages and reduces microcirculation in a mucous membrane. The long experience of smoking can lead to progressing of a disease owing to deterioration in blood circulation in a stomach, strengthenings of production of hydrochloric acid and violation of motor function.
In emergence of chronic superficial gastritis a part is played by the use of medicines, such as nonsteroid anti-inflammatory medicines, corticosteroids, separate antibiotics, antitubercular medicines and so on. Most often leads reception of NPVS which reduce production of protective prostaglandins in a stomach to development of pathology.
The leading role in progressing of a disease is played by Helicobacter pylori infection. This bacterium destroys a mucous and bicarbonate barrier, strengthens production of hydrochloric acid, breaks blood supply of a mucous membrane. Originally she colonizes antralny area of a stomach most of which often is surprised at chronic superficial gastritis.
From the endogenous reasons the main role is played by various diseases of internals. In particular, nadpochechnikovy insufficiency, anemia, hypovitaminoses, heart and pulmonary failure can lead to development of superficial gastritis. At all these diseases there is a hypoxia which causes malfunction of a mucous layer of a stomach.
Symptoms of chronic superficial gastritis
The main symptom of a disease is dull ache in the area an epigastriya. Unpleasant feelings, as a rule, arise at the use of spicy, rough or low-quality food that leads to development of an inflammation in a mucous membrane. Pain has widespread character, unlike an ulcer at which pain mainly dot. Often chronic superficial gastritis is combined with an inflammation of a duodenum (gastroduodenit). In this case pains have character, similar to an ulcer, that is can arise on an empty stomach and at night.
At chronic superficial gastritis pain less intensive, than at stomach ulcer of a stomach. It often has character of discomfort. Also patients often complain of heartburn, periodic nausea, an eructation sour or air and existence of locks. In some cases the disease can be asymptomatic and come to light only when carrying out an ezofagogastroskopiya. The objective research does not give any essential information and is used generally for an exception of other gastrointestinal diseases. In certain cases at a palpation small morbidity in the area an epigastriya can be observed.
Diagnosis of chronic superficial gastritis
Key method of diagnosis of a disease is the ezofagogastroduodenoskopiya with a biopsy of a mucous membrane. When carrying out this research find the increased release of slime, hyperaemia and puffiness of mucous. Often similar changes are available also in a duodenum. In a stomach bile can sometimes be visualized that is a consequence of a duodeno-gastralny reflux. For final confirmation of the diagnosis the endoscopic biopsy at which in histologic material find signs of a superficial inflammation in the form of a lympho-plazmotsitarnoy of infiltration of a mucous membrane is used. According to modern recommendations undertakes from antralny and fundalny departments of a stomach. At chronic superficial gastritis pathological process is most often localized in antralny department.
The stomach X-ray analysis with double contrasting can be applied to diagnosis of a disease. In pictures hyper secretion signs, increase in thickness of folds of a mucous layer and violation motor functions come to light. However today the X-ray analysis of a stomach concedes to the fibrogastroscopy on informational content. An important role in diagnosis of chronic superficial gastritis is played by a research of the level of secretion of hydrochloric acid determined by means of a daily intragastric rn-metriya. the rn-metriya can be carried out with the help one - or multichannel probes or the special radio capsule. At superficial gastritis, unlike atrophic, the normal or increased acidity level is noted. For assessment of function of gastric glands definition of a pepsinogen of I and II in blood which level at this pathology remains normal is shown.
By all patient with the established diagnosis of chronic superficial gastritis examination on existence of a helikobakterny infection has to be conducted. Definition of H. pylori in Calais by the IFA method, the respiratory test on a helikobakter or definition in blood of antibodies to a helikobakter can be for this purpose used. Treatment tactics in many respects depends on existence or absence of this infectious agent.
Chronic superficial gastritis is differentiated with stomach ulcer, ezofagity, functional dyspepsia, pancreatitis, cholecystitis, enteritis, stomach cancer, etc. For differential diagnostics with these diseases such methods as an ezofagoskopiya, an ezofagealny manometriya, ultrasonography of abdominal organs, the analysis a calla on the hidden blood can be used.
Treatment of chronic superficial gastritis
Therapy of chronic superficial gastritis is carried out by the gastroenterologist. At treatment of this pathology it is important to consider the major etiologichesky factors, the nature of morphological changes mucous and acidity level. Therapy of a disease is appointed generally on an outpatient basis. Hospitalization in a hospital can be recommended at the expressed aggravation or need for performing comprehensive examination. At the kept acidity purpose of an antiulcer diet which provides a chemical, thermal and mechanical shchazheniye is shown. Not less than five times a day are desirable to eat small portions. From a diet remove the products stimulating acid secretion and damaging mucous: strong broths, spices, coffee, carbonated drinks, fried dishes and so on.
For drug treatment antisekretorny medicines, such as , ranitidine, and , reducing production of hydrochloric acid are used. The antatsidny and enveloping means which neutralize acid are appointed and protect mucous from adverse effects. Has cytotyre-tread properties concerning cells of a stomach . In the presence of an infection a helikobakter of a pilora eradikatsionny therapy which can be three - or four-component is shown. The three-component scheme includes antisekretorny medicine or , and also two antibiotics – and amoxicillin. Four-component therapy includes antisekretorny means, metronidazole, and bismuth citrate.
Prevention of a disease is directed to normalization of a diet, an exception of uncontrolled reception of anti-inflammatory medicines and timely treatment of a helikobakterny infection. The forecast of chronic superficial gastritis for life favorable, however to achieve an absolute recovery happens rather difficult.