Atrophic gastritis is a type of gastritis, for which its characteristic feature is the thinning of the mucous membrane of the walls of the stomach, in connection with which the production of gastric juice decreases. The number of epithelial cells that participate in regeneration of the gastric mucosa. After that, the formation of secretory deficiency of the stomach.
In medical practice, atrophic gastritis of the stomach is a fairly common disease. Until now, scientists are arguing about the etiology of his appearance. Many of them believe that the emergence of this type of gastritis begins due to chronic inflammation.
Atrophic gastritis causes
In a healthy organism, the cells of the gastric mucosa are continuously updated. This is due to their permanent damage due to constant contact with hydrochloric acid and pepsin - the digestive enzyme. But not all of this protective mechanism works perfectly.
There are certain causes of this gastritis. When the process of cell renewal is broken, then the irreversible decrease in the number of gastric glands begins to occur. Atrophic-degenerative changes in the mucous membrane can also be the result of inflammation, age changes. There is also a genetic predisposition to the occurrence of hypotrophy or to atrophy of the mucous membrane (CO) of the stomach.
The most reliable factor due to which atrophic gastritis of the stomach arises is Helicobacter pylori infection. It is associated with the emergence of most of these gastritis. Bacteria, persisting on the epithelium of the walls of the stomach, cause chronic gastritis, which, with prolonged existence, degenerates into an atrophic one.
These bacteria block the receptors regulating the production of hydrochloric acid. Although normally it should stop the excessive production of acid. Thus, increased acidity leads to tissue inflammation and cell death, and when the regeneration mechanism ends, atrophy develops.
Inflammation of the gastric shell ( gastritis ) is a fairly common phenomenon. And he is treated faster than atrophic.
There is also such a thing as "atrophic antral gastritis" and "atrophic hyperplastic gastritis."
Antral atrophic gastritis is determined by inflammation of the mucosa in a certain part of the stomach that goes into the intestine and is called pyloric. Usually from this department the atrophic process originates. Gradually it will spread throughout the stomach. In the pyloric department of the stomach, the greatest number of glands is noted, which secrete mucus, which protects the walls of the stomach. Atrophic antral gastritis leads to the necrosis of these glands and the replacement of their connective tissue. As a result, mucus secretion is reduced and the compartment is exposed to acid.
Atrophic hyperplastic gastritis determines itself by combining atrophy sites with areas of hyperplasia arising from undifferentiated cells of the affected area of the stomach and the antrum. Patients with this type of gastritis are in a zone of increased risk for gastric carcinoma.
Atrophic gastritis symptoms
It should be noted that some patients may have no pain symptoms. This is a very sad sign. He then indicates the beginning of malignant process.
Characteristic for atrophic gastritis symptoms are a feeling of heaviness after eating, as well as a feeling of "fullness" of the stomach, which can be accompanied by an eructation with an unpleasant odor. In general, in itself, an unpleasant smell from the mouth distinguishes this type of gastritis from others. It can also be confused with the smell of "rotting teeth".
In connection with the weakened local immunity of the stomach, frequent poisoning occurs. If before hydrochloric acid coped with many pathogenic microorganisms, now its functions are not enough for this. And that a healthy person will not cause even an indulgence of the stool, then a person with atrophic gastritis can cause the strongest poisoning.
With antral atrophic gastritis, the patient may have heartburn, as this localization of gastritis produces a very high amount of acid. But with atrophic hyperplastic form there is no symptoms at all, except for the deterioration of appetite and weight loss.
It should also be noted that due to the deterioration of absorption of vitamins and minerals, the appearance of the patient worsens and immunity decreases. Nails become brittle, iron deficiency anemia appears, hair loss, headaches and dizziness occur.
There are instability of food, the imposition of the tongue with a thick white coating, rumbling in the abdomen and gas formation.
In the diagnosis of this disease, endoscopic examination of the stomach can help a lot, where a visual examination is performed using an endoscope followed by a histological analysis of the affected mucosa. Also, with the help of endoscopy you can see what kind of atrophic gastritis - atrophic antral gastritis or atrophic hyperplastic gastritis has settled in the stomach; the presence of a malignant process; determine the volume of hydrochloric acid in the stomach.
Also resort to the method of gastroscopy, coprologic examination of feces, x-ray of the abdominal cavity, ultrasound diagnosis, immuno-enzyme analysis of blood.
Chronic atrophic gastritis
Atrophic chronic gastritis appears to be a precancerous disease, as against such a pathology, such changes as, for example, intestinal metaplasia (replacement of the epithelium) often develop. Also, rapid growth of the epithelium of the mucosa promotes the development of tumors.
HG takes the first place among the "gastric" diseases. And because it is the most common disease of the digestive tract, which contributes to the development of ulcers, and then stomach cancer . It is based not only inflammatory, but also dystrophic - atrophic processes in the mucous membrane, which lead, in the end, to its insufficiency. Chronic gastritis affects almost half the population of mankind, although only 10 percent of them apply for help to specialists. Therefore, such a degeneration from chronic gastritis to chronic atrophic gastritis progresses.
Patients with chronic atrophic gastritis complain of a feeling of transfusion in the stomach after eating. Food for a very long time is not digested, which is accompanied by putrefactive processes in the stomach, causing a general intoxication of the body.
In urine tests, the detection of acetone can be constant. In blood tests, hypoproteinemia can be detected. In this form of HCG, as a rule, the work of not only the stomach but also the intestine is disrupted. And in general, the poor performance of the stomach can not but affect the work of the entire digestive system. Patients with atrophic HG may suffer from a lack of body weight, because with it there is a sharp decrease in body weight.
Treatment of this type of gastritis is to comply with a strict diet, with the appointment of enzyme preparations, steroids with pronounced weight loss, the appointment of funds for the production of hydrochloric acid. The physician must take into account PH acid, so as not to worsen the course of the disease. For this, a prerequisite is to take hydrochloric acid to study ph.
But, as it was said before, timely prevention of this disease is a timely visit to the doctor ...
Focal atrophic gastritis
This type of gastritis distinguishes itself from other forms of gastritis by the appearance of atrophied areas of the mucosa. In other words, such areas with a decrease in the volume of the secreting glands and their partial replacement with epithelial tissue.
Atrophy of the glands is the necrosis of a part of the cells that produce the digestive enzyme pepsin and which also participate in the production of a certain volume of hydrochloric acid.
Mucosal atrophy is a mucosal site that has lost its normal function and is sometimes replaced by either a connective tissue or some other tissue.
This type of gastritis occurs due to autoimmune gastritis, and also because of Helicobacter. With auto-immune gastritis, antibodies appear that block the work of their own glands.
Symptomatic of focal atrophic gastritis differs little from manifestations in the usual atrophic gastritis of the stomach. One can only observe the patient's aversion to dairy products, as well as the non-digestibility of these products.
Very often this kind of gastritis is accompanied by enterocolitis, cholecystitis and pancreatitis , because the work of other digestive organs slows down due to poor gastric activity.
An obligatory and successful pledge of treatment for this type of gastritis is a timely visit to the doctor who will give a referral for the examination, after which he will appoint the right treatment.
For the treatment usually prescribed drugs to improve gastric motility, for the production and secretion of gastric juice, fermentotherapy. In some cases, surgery may be required. There are cases when after surgical intervention with subsequent antibiotic therapy it was possible to achieve a permanent cure. But nevertheless it is necessary to consider, that to such method it is necessary to resort only in the started forms of focal atrophic gastritis.
Atrophic gastritis treatment
The main and radical method of treatment of atrophic gastritis is drug therapy. The physician's tactics should be very selective, which can present many difficulties for him in that sense, because it is quite difficult to identify the correct form of atrophic gastritis. In this regard, the doctor faces a choice - where to start treatment?
It is necessary to identify the cause of the disease. If it is Helicobacter pylori infection, it is advisable to prescribe eradication therapy (De-nol, Wilprafen, Ammoxylicin, Metronidazole, etc.). When identifying autoimmune gastritis as a consequence of the development of atrophic gastritis, the appointment of glucocorticosteroids is used.
When prescribing an antisecretory drug, you need to conduct ph metric (acidity assessment). At ph less than 6, proton pump inhibitors are prescribed.
Substitution therapy includes administration of hydrochloric acid preparations (natural gastric juice in a dosage of a tablespoon with meals up to three times a day), pepsin Acidin-pepsin enzymes (tablets that contain acidol and pepsin, from which hydrochloric acid is formed) is taken by 500 mg to three times a day with plenty of water; Abomin is a preparation obtained from the mucous membrane of calves of milk age (take one tablet up to three times a day). Also, injection therapy with vitamins B6, B12 is carried out. Obligatory is the appointment of gastroprotectors (Solcoseryl), enveloping agents (preparations of aluminum and bismuth), agents that affect gastric motility (Cisapride, Domperidone, etc.)
Carry out dietetics with diets №1А , with the subsequent transition to a diet №2 . They also prescribe the use of medicinal and mineral water Essentuki No. 4 and 17, Narzan 15 minutes before meals. This method helps stimulate the glands.
They also take phytotherapy (hips, plantain, St. John's wort, wormwood, etc.) 30 minutes before eating.
During periods of atrophic gastritis remission, substitution therapy and stimulating therapy are a good incentive.
It should also focus on the fact that in the treatment of this disease should abandon bad habits, such as drinking alcoholic beverages, smoking, so as not to jeopardize the result and not exacerbate the mucosa. Otherwise, treatment can be delayed for a long time.