Atrophic gastritis is a chronic form of gastritis, which leads to the disappearance of parietal cells of the stomach and, consequently, to a decrease in the secretion of hydrochloric acid, deficiency of vitamin B12 and megaloblastic anemia.
This type of gastritis leads to the fact that the gastric mucosa is dramatically thinning, and the glands atrophy. The onset of the disease is characterized by damage to the bottom of the stomach, then the production of hydrochloric acid and pepsinogen, the enzymes responsible for digestion, is disturbed. After this process is only aggravated, the stomach is traumatized by food ingested. The area of atrophy depends on the degree of trauma.
Atrophic gastritis is one of the most dangerous forms of chronic gastritis. If time does not begin to carry out a comprehensive treatment of atrophic gastritis, it can quickly develop into stomach cancer.
Focal atrophic gastritis
This type is manifested by the formation of pathological inflammatory foci in the wall of the stomach with a compensatory increase in the function of those parts of the body that have not been affected.
Mild forms of focal gastritis are accompanied by slight discomfort in the epigastric region, a burning sensation and pain after eating immediately. Nausea and a feeling of heaviness may appear not only after a hearty meal, but even after a light breakfast.
If you ignore these symptoms, the disease progresses:
- the patient loses his appetite
- heartburn is added to the initial symptoms,
- pain syndrome increases
- man loses weight
- weakness and subfebrile temperature appear.
Often the course of focal gastritis is accompanied by an increase in the secretion of hydrochloric acid into the lumen of the stomach and an increase in total acidity, as in gastritis with increased acidity.
Antral atrophic gastritis
It is characterized by the development of atrophy in the antrum - the place where the stomach passes into the duodenum. In most cases, the defeat of the mucous occurs first in this section, and then begins to spread to the rest of the stomach. The cells responsible for mucus production are located in this area.
The main symptoms of gastritis of the antrum of the stomach, in which this section is deformed and narrowed, are as follows:
- decreased appetite;
- belching with an unpleasant taste;
- heartburn after eating;
- feeling of overcrowding, heaviness, bloating in the stomach;
- diarrhea (sometimes constipation);
- rumbling in the stomach;
- intense spasmodic pain in the stomach, occurring after half an hour - an hour after eating;
- general weakness;
Atrophic changes in this department lead to cessation of mucus production, which can provoke an increase in gastric acidity, which in turn will eventually lead to the development of peptic ulcer. Cicatrisation of ulcers causes narrowing of the pyloric department.
Why does atrophic gastritis arise, and what is it? At present, the causes of atrophic gastritis are not fully understood, but, despite this, specialists in the field of gastroenterology refer to the following list of suspected factors causing the pathological process:
- When consumed too spicy, spicy foods, too cold, poorly chewed and hot food.
- Chemicals - when released into the cavity of the stomach or with inhalation of alkaline vapors and acid, a violent chemical reaction occurs that damages the condition of the gastric mucosa.
- The presence of bad habits - alcohol abuse, smoking, frequent use of carbonated drinks and coffee also leads to the development of the disease.
- Medications - Prolonged use of medications may adversely affect the mucous membrane.
- Reflux - the process of throwing the contents of the intestine into the stomach. Due to this process, the mucous membrane is injured, which leads to the emergence of atrophic gastritis.
- Also, the occurrence of gastritis can be the result of a bacterial infection or autoimmune processes in the body. In the first case, the disease manifests itself as a result of the proliferation of the bacteria Helicobacter pylori. Initially, due to their vital activity, superficial atrophic gastritis is manifested, then it goes into a more serious stage. The second case is characterized by a malfunction of the immune system, when the body “eats” its own cells, which are perceived by the body as alien.
Atrophic gastritis is dangerous because the treatment no longer guarantees a complete recovery and recovery. Gastroenterologists regard this form of gastritis as a precancerous condition. Atrophy of the mucous membrane and glands of the internal secretion of the stomach seriously weakens the immune system as a whole.
The body begins to produce an insufficient amount of immunoglobulin, and antibodies, which must fight with foreign microorganisms, begin to "kill" their cells. Against this background, the patient develops an autoimmune disease.
Symptoms of atrophic gastritis
It is believed that in the first stages of moderately pronounced atrophic gastritis, the clinic is erased and has no specific symptoms. But at further stages, symptoms appear that make the doctor think about the pathology of the stomach, and not of another organ.
Common symptoms of atrophic gastritis in adults:
- loss of appetite;
- heaviness and rumbling in the stomach after eating, bloating;
- constant burping (air) with an unpleasant smell rotten eggs;
- then constipation, then diarrhea;
- sometimes aching stomach after eating;
- B12 deficiency and iron deficiency anemia;
- polished tongue;
- weakness sweating rapid fatigability;
- weight loss in the late stages of the disease.
Sometimes there can be pain syndrome when the feeling of discomfort occurs in the form of dull aching pains, especially after eating. However, a distinctive feature of atrophic gastritis is that there may be no pain at all, or they may manifest weakly, almost imperceptibly for a person and, as a rule, transient. Acute pains are absent in atrophic gastritis.
Over time, due to impaired absorption in the stomach and intestines of nutrients and vitamins, patients may experience dryness and paleness of the skin, due to the development of anemia. Due to a lack of vitamin A, vision may be impaired, and a lack of ascorbic acid may cause increased bleeding of the gums, which further exacerbates the manifestations of anemia.
Diagnosis of atrophic gastritis is based on an analysis of the clinical manifestations of the disease, endoscopic data, histological examination of coolant biopsy specimens, data on the evaluation of the functional activity of the stomach and the diagnosis of Helicobacter pylori infection.
Functional diagnosis of atrophic gastritis includes:
- pH measurement of metry, with which you can determine the secretory ability of parietal cells;
- study of the activity of gastric enzymes and the total proteolytic activity of gastric juice;
diagnosis of motor function of the digestive tract, based on the results of gastrography.
Daily pH-metry is the "gold standard" for evaluating gastric secretory function in atrophic gastritis. Her conduct is necessary to determine the tactics of treatment of the patient, the prognosis and control the effectiveness of therapy. On average, the daily pH ranges from 3 to 6.
A mandatory study for any form of gastritis is the determination of the presence on the mucosa of the bacterium Helicobacter pylori. This study allows us to determine the cause of the lesion of the mucous membrane of the organ, as in most cases the current Helicobacter infection is a predisposing factor in the development of atrophic gastritis.
Treatment of atrophic gastritis
In the case of atrophic gastritis, treatment is prescribed taking into account the stage of the destructive process, the state of the secretory function, the general condition of the patient and taking into account associated diseases:
- It is necessary to start the treatment of atrophic gastritis in women and men with a change in the regime and diet. The diet is aimed at preventing mechanical traumatization of the gastric mucosa, so food should be thoroughly minced and taken warm. Fatty meats and fish, meat broths, mushrooms, spices and products that irritate the stomach membrane should be excluded from the diet - sour, fried, spicy, pickled, smoked, pickles are also removed. In addition, it is not recommended to eat sodas, coffee, alcohol, easily digestible carbohydrates (chocolate, sweets, cakes, baking).
- The destruction of Helicobacter pylori, if acid-resistant bacteria have a significant impact on the pathogenesis. Helicobacter pylori eradication methods are constantly being improved.
- Replacement therapy. With a serious violation of the secretion of hydrochloric acid and pepsinogen, you can use natural gastric juice - Abomin, Pepsidil, Atsidin-pepsin. As well as pancreatic enzyme preparations - Mezim, Pankurmen, Creon, Pancreatin.
- Pain relief. For severe pains, it is possible to use anticholinergic drugs - Metacin, Platyphyllin, Gastrotsepin, and antispasmodic drugs - Noshpa, Galidor, Buscopan, Papaverine.
- Stimulation of the muscles of the stomach. Drugs such as Reglan, Motilium may be prescribed to improve the motor function of the stomach.
All of the above drugs are prescribed during the active phase of inflammation of the stomach with symptoms of atrophy. During remission, the main principle of treatment is the replenishment of substances that are missing for proper digestion.
Is it possible to cure atrophic gastritis?
This disease can be cured, but only under the supervision of physicians. Treatment of atrophic gastritis in women and men is prescribed solely taking into account the general health of the patient, stage, state of the secretory function, related problems and so on.
Diet for atrophic gastritis is selected in accordance with the age of the patient, his individual characteristics, stage of the disease and related diseases. It aims to reduce thermal, chemical and mechanical trauma to the stomach.
As a rule, during the exacerbation of the disease, diet No. 1 is prescribed - mechanically, thermally and chemically sparing: food 5-6 times a day in small portions, muffled mashed soups, mashed potatoes, low-fat broths, crackers, kissels, and cereals are eaten.
When reducing the signs of inflammation dietary recommendations become less stringent, is assigned a diet number 2. Its purpose is to restore impaired digestive functions and limit the load on the gastrointestinal tract while maintaining the full value of the patient's diet.
Important conditions of this diet, contributing to the stimulation of gastric secretion, are strict adherence to the diet, thorough chewing of food and a calm atmosphere while eating.
The prognosis of the disease is worse in patients of the age group over 50 years old - at this age, metaplastic processes develop much faster and more often lead to malignancy.
Early treatment and the degree of eradication of the infectious agent are of great importance for complete recovery. If after repeated examination after a course of anti-Helicobacter therapy in the gastric contents microorganisms are determined, then the course should be repeated.
Doctors consider the timely treatment of helicobacter pylori a major factor in the successful prevention of atrophic gastritis. All that is needed for this is to undergo a special course of treatment, which on average lasts from seven to fourteen days. Usually, I prescribe three drugs to patients, most of them antibiotics.
It is strictly forbidden to personally engage in choosing the right medication, as this can be fraught with complications. Only a professional doctor is competent in such matters.