Chronic gastritis

Chronic gastritis characterized by progressive atrophy of the mucous membrane of the stomach, which develops as a result of long-current of inflammatory process. These changes lead to the violation of secretory and motor and in some cases the endocrine function of the stomach. In chronic gastritis can be involved in the process and other organs (intestines, liver, biliary tract, pancreas, the blood system, the nervous and the endocrine system).
Etiology. Chronic gastritis occurs as a result of influence of exogenous factors (long improper feeding, alcohol, nicotine) and endogenous (serverelement effects on the stomach with other affected organs of digestion; violations of the endocrine system, metabolic and others).
Pathological anatomy. Histologically, chronic gastritis (in the study of remote stomach) found atrophy of the mucous membrane and inflammatory changes, exciting all its layers. The nature of morphological changes of chronic gastritis share on the surface, atrophic and atrophic-hyperplastic.
The clinical picture and diagnosis. Chronic gastritis, confirmed histologically (on the basis of gastrobiopsy), may be asymptomatic or accompanied by symptoms of gastric and intestinal dyspepsia. First there is a sense of gravity in the epigastric region after eating, belching, nausea in the morning or after meals, occasional vomiting. Intestinal dyspepsia is manifested by bloating, a feeling of fullness after eating, rumbling, transfusion in the abdomen, diarrhea, alternating constipation. You may experience a dull, aching pain, worse after eating. The General state often does not change. Dramatically expressed in decrease of secretion of stomach observed weight loss, anorexia (lack of appetite), weakness, hypotonia. When studying belly - sometimes diffuse pain in epigastralna area.
When pronounced atrophy of the mucous membrane in the gastric contents no free hydrochloric acid and pepsin. Motor function overwhelming majority of patients with chronic gastritis reduced.
The differential diagnosis of chronic gastritis spend two diseases: "an irritated stomach" (a form of functional neurosis stomach, proceeding with high secretory function and functional ahilia (see). The last form with the help of aspiration biopsy is determined perfectly normal mucous membrane of the stomach.
The forecast. Periodic aggravation of chronic gastritis, which occurs under the influence of various exogenous and endogenous factors that determine the constant progression of the process. However, the development pace of the process that leads to atrophy, various on time. In this disease there is a danger of transition in cancer.
Treatment. When nerverending forms of chronic gastritis appoint atropine (0.1% solution 5-8 drops 2-3 times a day before meals), gangleronum or kvataron (no prescription), bromides (Sol. Natrii bromati 6,0:200,0. D. S. 1-2 table. L. at night), bellaid (1 tab. 3 times a day), papaverine (0.04 g 3-4 times a day), no-Spa (1 tab. 2-3 times a day).
When insomnia recommended to be taken before going to sleep one of the following drugs: pipolfen, Dimedrol, meprobamate, oxirane and other Useful lesson for sports, physical therapy, hydrotherapy. Shows the use of steroid therapy. Shall be appointed by the doctor.
Vitamins for chronic gastritis use Niacin, ascorbic acid, vitamins B2 and B12 in usual dosage. Patients with decreased food shows a blood transfusion in the 75-100 ml at intervals of 2-4 days. When diarrhea is prescribed hydrochloric acid and pepsin (Acidi hydrochlorici diluti 4,0; Pepsini 2,0; Aq. destill. 200,0. M.D.S. On 1 table. L. 2 times a day during a meal), natural gastric juice (on 1 table. L. 3 times a day during a meal), Pancreatin to 4-6 g / day, pentauxil (0.1-0.2 g 3 times a day for three weeks). The nature of clinical nutrition depends on the stage of the disease. In case of exacerbation appoint a light diet with regard to its effect on the secretory and motor functions of a stomach. Part of such a diet includes: non-soups from cereals and vegetables, thin soup, butter, fresh cheese, provernut meat through a meat grinder. This diet is prescribed for the short term, replacing it in the future, more extensive and complete menu, which should be diverse, sufficient calories, protein, vitamins. Carbohydrates should be limited.
Sanatorium-resort treatment are subject to patients with chronic gastritis without exacerbations. Shows the resorts of drinking mineral waters: Borjomi, Arzni, Jermuk, Druskininkai, Essentuki, Zheleznovodsk, Kashin, Krainka, Morshyn, Sairme, Pyatigorsk, Truskavets and other
Prevention. Timely and correct treatment of acute gastritis. Adherence to sound diet, excluding alcohol, termination or sharp reduction of the area; the rehabilitation of chronic foci (chronic tonsillitis, sinusitis and others), fight with ascariasis. Patients suffering from chronic gastritis, subject to dispensary observation.