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September 12, 2011
Gastritis represents an inflammation of an internal cover of a wall of intestines. 2 forms of gastritis — acute, violently proceeding and chronic, proceeding with frequent recurrence are allocated. Chronic gastritis is the disease caused by a chronic inflammation of a mucous internal wall of a stomach and disturbances of production of hydrochloric acid, leading to a degeneration and reorganizations of a cover. The disease leads not only to pain, to disturbance of process of digestion of food, but also and to decrease in working capacity, emergence of irritability, increased fatigue. The main forms of chronic gastritis are chronic autoimmune gastritis And (to 5% of all cases) and chronic gastritis In (85% of cases, the helikobakter of a pilora caused by a bacterium), other forms of gastritises meets much less often.
Chronic gastritis And proceeds with normal secretion of a gastric juice, but when deepening inflammatory process there is a reduction of allocation of a gastric juice. Hemorrhagic (eroziyny) gastritis is followed by gastric bleedings, emergence of erosion on a mucous membrane of a stomach, at preservation of gastric secretion. Rigid gastritis is characterized by inflammatory and cicatricial changes of antral department of a stomach, its narrowing. Also the reflux gastritis is considered by an independent form of gastritis. Conditionally it is possible to carry huge hypertrophic gastritis to chronic gastritises (or Menetriye's illness). Besides, gastritises happen to the lowered and increased secretory activity.
Chronic gastritis — very eurysynusic disease which is suffered by more than 50% of adult population of the planet and among diseases of a stomach makes 85%.
The disease is result of development of acute gastritis, however most often are its reasons:
- disturbances of a diet, food with no drink, use of spicy food, excessive use of hard alcoholic beverages;
- defective food (deficit of proteins, vitamins), meal at which there are emulsifiers, preservatives, the refined oils;
- stress which leads to disturbance of a normal rhythm of life, for example work days at night;
- long reception of medicines which annoyingly affect a mucous membrane of a stomach;
- the adverse factors connected with production (metal dust, compounds of lead);
- genetic predisposition;
- influence of toxic products of the broken exchange (diabetes mellitus);
- chronic infectious diseases (syphilis, tuberculosis).
Symptoms of chronic gastritis
Chronic gastritis But has no specific symptoms, and the clinical picture of an illness is rather various. At chronic gastritis with secretory insufficiency, the most frequent symptoms of a disease the feeling of a raspiraniye, the short aching pain in epigastric area, especially in time and after food are. Other frequent symptoms of chronic gastritis the dispepsichesky phenomena — nausea, vomiting, heartburn, an eructation, unpleasant smack in a mouth. Also at patients the abdominal murmur, a meteorism, disturbance of a chair can be observed. At a palpation the epigastric area can be painful.
If chronic gastritis In proceeds with normal or hypersecretion of a gastric juice, then it is considered superficial, and arises more often at men at young age. In this case patients are tormented by an abdominal pain, an eructation acid, heartburn, heavy feeling in a stomach after food, locks. Pain can also develop at night.
At hit of a bacterium a helikobakter of a pilora in a stomach, she begins to breed actively that leads to change of normal development of a gastric juice, both emergence of an erosion, and stomach ulcer.
The general condition of the patient usually is not broken, however at chronic gastritis with insufficient secretion of a gastric juice decrease in body weight, fast fatigue can be observed.
Very often at the patient with chronic gastritis symptoms of damage of a liver, intestines, a pancreas are observed, however in this case gastritis is a consequence of these diseases.
Diagnosis of chronic gastritis
At suspicion the doctor appoints carrying out ultrasonography and X-ray inspection, and also ezofagogastroduodenoskopiya during which it is possible to carry out a biopsy of a gastric cover for identification of a bacterium a helikobakter of a pilora to gastritis. Diagnosis of chronic gastritis includes research of gastric secretion by method of an intragastralny rn-metriya or by method of frakionny sounding. An informative method in diagnosing of chronic gastritis is gastroscopy. With its help it is possible to see an overall picture of gastritis — nature of pathological process, its localization and prevalence.
However the gastroenterologist makes the final diagnosis based on a complex assessment of a clinical picture and results of laboratory researches. Here it is important to exclude other diseases, for example, an ulcer, high-quality new growths of a stomach, etc.
Treatment of chronic gastritis
Usually treatment of patients with chronic gastritis is carried out in out-patient conditions, and hospitalization is necessary in cases of an exacerbation of a disease and difficulty in diagnosing.
If when carrying out analyses at the patient chronic gastritis was revealed In the helikobakter of a pilora is caused by a bacterium, then the doctor appoints carrying out the eradikatsionny therapy directed to destruction of a bacterium. In this case within 7-10 days according to special schemes 2 forms of antibiotics and anti-secretory drugs are taken (lansoprazol, omeprazol). Eradikatsionny therapy is a reliable way of fight against a bacterium.
During an exacerbation of an illness the special diet is appointed. The gastroenterologist or the nutritionist will help to pick up the most suitable diet and the list of the recommended dishes.
Treatment of chronic gastritis a dietotherapy depends on a type of gastritis, a condition of secretory function of a stomach and a phase of an illness, and has to be carried out taking into account associated diseases of a liver and bilious ways, intestines, and also anemia, a vitamin deficiency.
Food is recommended fractional, 5-6 once a day. Within the first days of an aggravation abstain from food, later pass to dietary food — kissels, the ground soups. The food has to be thermally and mechanically sparing, it is impossible smoked, acid, I go to use only in a warm look. At the same time appoint the medicines enveloping stomach walls, and also adsorbing toxins.
At gastritis with normal or hypersecretion of a gastric juice food is directed to elimination of an inflammation in mucous membranes of a stomach and normalization of its work. In this case the nutritionist appoints a diet No. 1a (till 7 days), then — a diet No. 16 (till 14 days), and for 3 months the diet No. 1 stretches. At observance of these diets food the patient is given in the liquid or wiped look, in addition enter vitamins (ascorbic acid, Riboflavinum). Alcohol intake, juice is forbidden, to coffee, strong tea, hot fat dishes, canned food, to haricot, peas.
At chronic gastritis with insufficient gastric secretion, the dietotherapy is directed on reduction of an inflammation in a stomach and stimulation of its ferruterous device. In this case it is shown observance of a diet No. 2 which provides a stomach shchazheniye at chemical stimulation of secretory activity. The organism receives the increased amount of vitamins (Riboflavinum, Retinolum) and enough salt. Food in this case fractional, food is eaten in well crushed and boiled thoroughly look, and reception of coffee, tea, juice, vegetable gains, beef-infusion broths, meat and fish of low-fat grades provides stimulation of secretory function of a stomach. Due to not enough development of a gastric juice, products which are rich with a cellulose, namely grapes, a garden radish, dates, and also acute, smoked and very salty dishes, cold drinks, dough products are excluded from a diet. Whole milk, cream, porridges from buckwheat and pearl barley, bean, marinated vegetables, mushrooms, carbonated drinks are not recommended.
During the periods out of aggravations sick chronic gastritis And recommends to adhere constantly to a diet, limiting itself in alcohol, coffee, hot, hot dishes, marinades, preservation. Such prevention of chronic gastritis helps to avoid frequent aggravations.
In the period of an exacerbation of autoimmune gastritis And replacement therapy — the drugs stimulating development of a gastric juice, drugs of hydrochloric acid is appointed. For stimulation of secretory activity of a stomach join in a food allowance strong broths, meat and vegetable soups, low-fat meat, fish, vegetables, fruit. At the same time passes also treatment of anemia.
The bilious reflux gastritis is required careful observance of a diet. The basic diet is formed as at liver diseases, in the period of aggravations are appointed treatment of chronic gastritis antiacid drugs (maaloks, Almagel), also drugs for neutralization of bile acids (ursodezoksikholevy acid, holestiramin), and for normalization of motility of a digestive tract — Metoclopramidum drugs (a raglan, cerucal) are appointed.
At treatment of hypertrophic gastritis the high-calorific diet, protein-rich is appointed.
Drug treatment of chronic gastritis is carried out at an exacerbation of a disease. In the period of an aggravation antacids (Roterum, Vicalinum, Almagel) are appointed sick chronic gastritis. For elimination of the dispepsichesky phenomena use Metoclopramidum drugs (cerucal). At chronic gastritis with insufficiency of development of a gastric juice appoint means of a plant origin which possess antiinflammatory properties: infusion of a camomile, St. John's Wort, mint, valerian.
From physiotherapeutic methods at complex treatment of exacerbations of chronic gastritis, the novocaine electrophoresis, and various thermal procedures, and also the diadynamic modulated currents are applied. The physical therapy reduces symptoms of chronic gastritis, and normalize motor function of a stomach.
The patients having chronic gastritis have to be under supervision of the doctor and pass routine inspections of 2 times a year for correction of treatment and a dietotherapy.
Prevention of chronic gastritis
Prevention of progressing of chronic gastritis consists in the prevention of its aggravations. It is important to observe the correct diet and rest, timely treatment of associated diseases, exceptions of an overeating, alcohol, smoking, long reception of some medicines.