Gastritis at children – the inflammation mentioning a blanket of a stomach and leading to morfofunktsionalny changes of a mucous membrane. The eructation, nausea, vomiting, diarrhea, a salivation or dryness in a mouth are characteristic of sharp gastritis at children severe pain in an epigastriya; for a chronic form - a loss of appetite, moderate belly-aches, the phenomena of dyspepsia and intoxication. Diagnosis of gastritis at children is based on clinical symptoms and the anamnesis, data of gastroscopy with a biopsy, a X-ray analysis of a stomach, ultrasonography of an abdominal cavity. Treatment of gastritis at children includes observance of an age diet and medical mode, medicamentous therapy, physiotherapeutic and sanatorium treatment.
Gastritis at children
Gastritis – the most widespread disease of the digestive system in children's gastroenterology. Formation of a gastrointestinal tract of the child comes to the end only to seven-year age; its feature during this period is the low content and smaller activity of hydrochloric acid, insufficient motor function of a stomach. The incidence of gastritis is higher at children during the periods of the most intensive growth and development (at the age of 5-6, 10-15 years).
Gastritis at children can proceed in sharp and chronic forms. Sharp gastritis at children is shown by the pronounced inflammation of a mucous membrane of a stomach connected with short-term impact on it of strong irritants. Chronic gastritis at children has the long progressing current, with a periodic recurrence and gradually leads to a degeneration and an atrophy of epitelialny cages and glands of a mucous membrane. Gastritis causes violation of sekretorny and motor functions of a stomach, and also a metabolism in children; its consequences depend on weight of damage of a mucous membrane.
The gastritis reasons at children
Sharp gastritis at children can arise initially (independently) or again complicate the course of some infectious and somatic diseases. At the child the excessive overeating or the use of fat, spicy, too hot or rough food inappropriate to children's age, hit in a stomach of chemicals (the concentrated solutions of alkalis, acids), reception of some medicines can provoke sharp gastritis (NPVS, salycylates, steroid hormones). At alimentary sharp gastritis at children inadequate food and products of its incomplete splitting render irritant action on mucous and the sekretorny device of a stomach, breaking and slowing down digestion process. Sharp gastritis at children can be connected with a food toksikoinfektion at the use of substandard food, obsemenenny pathogenic bacteria (colibacillus, proteas, a klebsiyell, a salmonella, etc.).
The main reason for endogenous sharp and chronic gastritis at children is infection with the helikobakteriya living in pilorichesky department of a stomach. Pathogenicity of H. pylori is connected with high adhesion with membranes of epitelialny cages, release of aggressive enzymes (urease, protease, a phospholipase) and the toxins causing destruction of a protective layer of slime, damage of epitelialny cages, development of an inflammation, formation of erosion and ulcers, dysfunction of a stomach and duodenum, oppression of immune system.
Autoimmune chronic gastritis at children is caused by development of antibodies to sekretorny cages mucous a stomach that leads to decrease in acidity of gastric juice and insufficiency of digestion. Developing of gastritis at children is promoted by fermentopatiya, chronic gastrointestinal diseases (hepatitis, pancreatitis), a duodeno-gastralny reflux, food allergy.
Sharp infectious processes (flu, measles, diphtheria, viral hepatitis, tuberculosis), condition of the general intoxication at heavy burns, radiation defeat and a sharp renal failure can provoke development of secondary gastritis in children. At the same time leads hematogenic spread of an infection and toxins to inflammatory changes of a mucous membrane of a stomach.
At children treat risk factors of gastritis: deterioration of food (abundance of dyes, preservatives, fast food, carbonated drinks), helminthic and parasitic invasions (, ); teenagers have addictions (alcohol, smoking), psychosomatic violations (aggression, uneasiness), stresses.
Classification of gastritis at children
On the nature of inflammatory changes children can have a catarrhal sharp gastritis (with superficial hyperaemia, hypostasis, dot gemorragiya and erosion, dystrophic changes of an epithelium); fibrinozny (with superficial and profound necrotic changes and formation of fibrinozny films); korrozivny (with a necrosis, an ulceration, hemorrhages and deep damage of a gastric wall) and to flegmonozny (purulent).
On extent of distribution of damage of a stomach allocate focal forms of gastritis at children (fundalny, antralny, piloroantralny, piloroduodenalny) and diffusion (widespread).
On etiologichesky factors distinguish the gastritis at children associated with H. pylori; autoimmune, eozinofilny (allergic); jet (against the background of other diseases); idiopathic. Gastritis at children can proceed with the increased production of hydrochloric acid (giperatsidny) and with its lowered secretion (gipoatsidny).
Gastritis symptoms at children
Clinical displays of sharp gastritis at children can develop 4-12 hours later after influence of the irritating agent. At the same time the general condition of the child is broken, he is disturbed pain in the top part of a stomach, by an eructation, heartburn, nausea, vomiting, salivation or dryness in a mouth. Language is laid over by a white raid, integuments pale, pulse frequent, HELL is lowered. Duration of alimentary sharp gastritis at children averages 2-5 days.
At toksiko-infectious sharp gastritis at children the expressed intoxication, the temperature increase of a body, the repeating vomiting undigested food with slime and bile, a frequent liquid chair leading to dehydration, increase of weakness and slackness is noted. The Dispepsichesky phenomena (dyspepsia) at sharp allergic gastritis at children are followed by a skin itch, rash and Quincke's hypostasis.
The heavy current characterizes the korrozivny gastritis at children at chemical burns which is followed by burning intensive stomach pain and when swallowing; repeated vomiting with impurity of slime, blood and fragments of fabrics. Depending on weight of korrozivny gastritis at children asphyxia, perforation of a wall of a stomach and bleeding, peritonitis, damage of kidneys, a liver, cardiovascular insufficiency, shock and a lethal outcome can develop.
Sharp flegmonozny gastritis at children is shown by high fever, severe pains in a stomach, vomiting with pus impurity, a serious general condition and can lead to peritonitis and a perigastrit.
At the child with chronic gastritis the gradual loss of appetite, the stupid and aching belly-aches (amplifying in 10-15 min. after meal), an eructation by acid, nausea, an unstable chair is observed. At chronic gastritis at children symptoms of intoxication and violation of digestion develop: general malaise, increased fatigue, weight loss, pallor of integuments, slight increase of body temperature.
Diagnosis of gastritis at children
Presence of sharp gastritis at children is defined on the basis of a clinical picture and the anamnesis. Chronic gastritis is the histologic diagnosis, for its confirmation at children carry out gastroscopy with the biopsy and a morphological research of a mucous membrane of a stomach allowing to estimate defeat type, prevalence and activity of inflammatory process, contamination of H. pylori.
At chronic gastritis to children are in addition appointed an intragastric rn-metriya (determination of level of acidity of gastric juice); X-ray analysis of a stomach, ultrasonography of abdominal organs.
Chronic gastritis at children needs to be differentiated with stomach ulcer of a stomach and stomach ulcer of 12 items of a gut, pancreatitis, chronic appendicitis, holetsistokholangity, a helminthic invasion.
Treatment of gastritis at children
During the sharp period of gastritis the bed rest, abstention from food for 8-12 hours, if necessary - washing of a stomach, a cleaning enema is shown to children. At sharp gastritis children need plentiful frequent drink in the small portions. For the termination of vomiting and as anti-reflux means in pediatrics use pro-kinetics - and ; the expressed pain syndrome is stopped by spazmolitikam (a papaverine, ) and antatsidam.
At toksiko-infectious gastritises at children antibiotics, enzymes (Pancreatinum), adsorbents are applied (smektit dioctahedral, silicon dioxide); at dehydration infusional therapy is carried out. In 12 hours dietary fractional food (low-fat broths, mucous cream soups, porridges, kissel) with gradual extension of the menu and transfer to the table d'hote excluding spicy, smoked, fried and rough food is allowed to the child. At suspicion of flegmonozny gastritis at children and perforation of a stomach surgical treatment is shown.
The complex of medical actions for the children having chronic gastritis includes strict observance of the medical and guarding mode and diet, medicamentous therapy, physiotherapeutic and sanatorium treatment.
The dietotherapy at chronic gastritis at children is based on the principles of a mechanical, chemical and thermal shchazheniye, fractional frequent meal (7-8 times a day).
At gipoatsidny gastritis at children in 10 — 20 minutes prior to food reception of solution of hydrochloric acid with pepsin is shown; at the increased acidity appoint antatsida, antisekretorny medicines.
In the presence of a helikobakterny infection to children with chronic gastritis various schemes of the therapy including antibiotics (amoxicillin, ), derivatives of nitroimidazoles are appointed (nifuratet, furasolidone), colloidal salts of bismuth, inhibitors of a proton pomp (, ), a probiotics (lakto-and bifidobacteria). Duration of treatment of chronic gastritis at children depends on sharpness of process, expressiveness of symptoms, association with H. pylori, and makes about 3-4 weeks.
Recovery treatment of chronic gastritis at children includes: physical therapy (an electrophoresis with calcium, bromine, diadynamic currents, hydrotherapy, acupuncture), reception of mineral waters (Borjomi, Yessentuki No. 4, Slavyanovskaya, Smirnovsky), sanatorium treatment in 3 months after clinical remission.
Children with chronic gastritis stay on the dispensary registry at the children's gastroenterologist not less than 3 years. For prevention of exacerbations of chronic gastritis at children 2 times a year are appointed repeated courses of antirecurrent treatment, gastroscopy with control of an eradikation of H. pylori is carried out once a year.
The forecast and prevention of gastritis at children
In most cases at adequate treatment sharp gastritis at children recovers completely; sometimes inflammatory process in a stomach gets a chronic current and can be followed by development of a gastroduodenit, pancreatitis, cholecystitis, colitis. For lack of treatment of chronic gastritis children have a risk of development of stomach ulcer of a stomach.
Prevention of gastritis at children consists in respect for the principles of the balanced diet corresponding to age of the child, timely treatment of gastrointestinal diseases, sanitation of the centers of a chronic infection of a nasopharynx.