Ahilia

Ahilia - absence in the gastric juice of hydrochloric acid and pepsina. There are filiu organic and functional. Organic ahilia developing in a result of atrophy of the mucous membrane of the stomach and its glands may occur with stomach diseases (tumors, and others) or other organs (inflammatory diseases of the gallbladder, liver, intestines, different types of anemia). When functional ahilii oppression secretory capacity of the stomach is temporary (serverelement impact); structure of the gastric mucosa not changed.
The absence of painful symptoms when compensated ahilii depends on compensatory activity of a pancreas and small intestine. Decompensated develops picture chronic dyspepsia: a feeling of fullness in the epigastric region, sometimes brief sharp pain, heartburn, nausea, vomiting. The main feature ahilii are diarrhea. They are associated with a rapid flow into the intestine insufficiently processed food because of siania gatekeeper, lack of disinfecting action of hydrochloric acid and its stimulating effect on the secretory function of the pancreas. Fermented and rotting food masses cause irritation of the mucous membrane of the intestines and secondary its inflammation. Nature ahilii is set by the application of histamine test (see Breakfast trial) and gastrobiopsiej (biopsy of the gastric mucosa - see Biopsy). For ahilii chronic. Forecast for functional ahilii favorable, with organic ahilii depends on the disease that caused the problem.
Treatment. If compensated ahilii exclude from dietary intake fatty, sinewy meat, smoked products, canned food, limit the amount of fresh fruit and vegetables. Appoint stomach acid or hydrochloric acid, mineral water (Essentuki # 4, 17, Jermuk and others) in the form of heat for 3 / 4 Cup 3 times a day 30 minutes before meals. When uncompensated ahilii food should be mechanically and chemically benign (table # 4, then № 2; see clinical nutrition). The fractional power. Vitamins administered in large doses of parenteral.

Ahilia stomach (achylia gastrica; from the Greek. negative prefix a -, and chylos - juice) - a condition in which the stomach does not emit free hydrochloric acid and enzymes. Ahilia stomach differs from ahlorgidrii (see Anaciditas) the fact that in the past only absence of free hydrochloric acid, and when ahilii - also and enzymes. Filiu stomach is divided into organic and functional.
To organic includes all kinds of ahilii stomach, caused by atrophy of gastric glands - as primary, that is caused by inflammation in the stomach and secondary, which are based on various diseases of the stomach (malignant and benign tumors, tuberculosis, syphilis, malaria) or other organs and systems (inflammatory processes in the gut, liver, biliary tract, different types of anemia).
Functional ahilia stomach is expressed in the temporary gastric secretory deficiency and can be called neuro-mental experiences, reflex inhibition and the impact of toxic substances on the nerve glandular apparatus of the stomach. Functional A. Zh. refer heterochila - periodic sharp fluctuations of gastric secretion (from A. J. to normal or elevated secretion), observed in persons with functional disorders of the nervous system. Functional A. Zh. there is malnutrition, particularly in protein and energy malnutrition food, some avitaminosis (scurvy, pellagra, sprue, beriberi), functional strain of gastric glands (Y. M. Lazovsky), with predominantly carbohydrate diet.
The symptomology. Compensated forms A. Zh. not accompanied by complaints of patients and often discovered by chance in medical examination. With decompensated forms patients complain of weight and a sense of fullness in the epigastric region shortly after a meal, heartburn, belching air or food. Appetite saved or slightly reduced. tongue coated. The stomach is empty stomach is empty. Pieces of bread in the gastric contents after the trial Breakfast Boas - Ewald (I. I. Boas, S. A. Ewald) is not changed, mucus lot in organic ahilii, little or not at all functional. Hydrochloric acid in the gastric juice is missing, the figures total acidity within 4-10%
Patients with ahilia stomach prone to gastrointestinal infections (gastroenterocolitis), which is explained by the loss of bactericidal properties of gastric juice, and diarrhea caused by violation of peptic digestion and accelerated gastric emptying. Diarrhea have the rotten nature, stool is stinking, alkaline, less acidic, if dominated by fermentation processes (gases, rumbling, transfusion in the intestines, and so on). In excrements find undigested muscle fiber and vegetable fiber abundant (lenceria), increased the number of neutral fat and fatty acids. Diarrhea occur and result in aterogennoe sensitization of the body food products (eggs, milk) and revenues in the blood incompletely split protein particles (O. L. Gordon). A. Zh. may cause weight loss, hypovitaminosis (a,b,C) and anemia due to violations of iron absorption and assimilation of vitamin B12.
The diagnosis. First of all establish primary or secondary nature ahilii. Organic A. Zh. apart from functional with the help of diagnostic samples. When functional ahilii stomach after subcutaneous injection before the trial Breakfast 0.5 ml of 0.1% solution of histamine or 5-10 UNITS of insulin in the gastric juice is found hydrochloric acid. Organic character ahilii is also gastrobiopsiej and exfoliative Cytology. When organic ahilii also identify the state of its compensation.
The prognosis for primary A. W., especially functional favorable, with secondary ahilii stomach - depends on the main disease-causing filiu.
Treatment. If compensated A. Zh. patients designate the table, when functional progressive form is well cooked and mashed food, strong sokogonnym substances (meat and vegetable Navara, lean meat, ham, herring, caviar, baked fish, stale white bread, crackers, eggs, diary products). From food eliminate coarse vegetable fiber, spicy dishes, fish, fresh bread, butter tarts, sinewy meat, bacon, spices. When organic ahilii prescribed mechanically and chemically light diet with the exception of strong stimuli secretion. In all forms A. Zh. prescribe vitamins: C (100 mg daily), B1, B2, B12, Niacin (from 50 to 100 mg). With the involvement of the liver and biliary tract use intravenous administration of 40% glucose solution, washing gallbladder 25% solution of magnesium sulfate using intelligent sensors. When combined A. Zh. hypochromic anaemia in the diet include foods rich in iron (raw vegetables, vegetable and fruit juices), appoint iron (Ferri reducti, Ferri carbonici 1 g 4 times a day); with hyperchromic anemia drugs liver, vitamin B12; if enterocolitis - Pancreatin 1 g 3-6 times a day; in acute enterocolitis - antibiotics, sulfanilamides, Acidi hydrochlorici diluti 15-20 drops on a glass of water, natural gastric juice, pepsin. Parenteral recommend gangleronum and arpenal (1.5% solution 2 ml 3 times a day); inside - kvataron (0.2% solution at 20 - 30 ml 3 times a day). Also used stomach (at the rate of 8-10 times) saline solution. Of mineral waters shown Essentuki № 4, 17, Izhevsk water 3/4 Cup 3 times a day in the form of heat for 30 minutes before eating.
The secondary prevention A. associated with the underlying disease, primary functional A. - with the elimination of the adverse conditions of the external and internal environment. The development of atrophic gastritis prevented mechanically and chemically sparing diet.