Chronic gastroduodenitis symptoms
Chronic gastritis, gastroduodenitis is a chronic inflammatory-dystrophic lesion of the gastric and duodenal mucosa prone to progressive exacerbation with periodic exacerbations.
The incidence increases with age. Only 10-15% of children have isolated gastric or duodenal ulcers( gastritis or duodenitis), in 85-90% of cases the lesion of these organs is combined. The morbidity rate rises at the age of 7-14 years. Girls get sick 1,5 times more often than boys.
Chronic gastritis and gastroduodenitis are multifactorial diseases. The following factors are important in their development: hereditary predisposition to diseases of the digestive system, infection with a special microorganism( Helicobacter pylori), nutritional errors( irregular, inadequate nutrition, poor chewing, abuse of spicy food), chemical, including medicinal,physical and psycho-emotional overload, food allergy, the presence of foci of chronic infection, helminthiases, diseases of other digestive organs.
Against the background of a hereditary predisposition and prolonged exposure to these damaging factors, there are three main mechanisms for the development of the disease, according to which chronic gastritis is divided into three types:
1) endogenous-autoimmune. This type of gastritis is caused by the formation of antibodies to the cells of the stomach( gastritis A).The frequency of this gastritis is 1-3% of all cases of chronic gastritis;
2) exogenously infectious. This type of gastritis occurs when the stomach is infected with Helicobacter pylori( gastritis B).In the structure of chronic gastritis it is about 85%;
3) exo-endogenous. The development of this type of gastritis is associated with gastric irritation with medications or a pronounced casting of the contents of the duodenum into the stomach( duodenogastric reflux).This type of gastritis is referred to as gastritis C. In the structure of chronic gastritis, it accounts for about 10-12% of all cases of the disease.
The manifestations of chronic gastritis depend on the localization and prevalence of the inflammatory process. With chronic gastroduodenitis, periods of exacerbation last from a few days to 2-3 weeks. During this period, all the characteristic features that are described above arise. In addition, the appearance of all signs of gastroduodenitis is associated with the intake of food and depends on its nature. As a rule, exacerbations of the disease occur in the spring-autumn period, i.e. gastroduodenitis is seasonal in nature. In the ulcerative type of chronic gastroduodenitis, the leading sign is abdominal pain that occurs on an empty stomach or 1.5-2 hours after ingestion, sometimes at night. After eating, the intensity of pain is reduced. Often, pain in the abdomen is accompanied by heartburn, sometimes with acidic eructations, occasionally vomiting, which brings relief. When the doctor examines the abdominal area, soreness in the projection of the stomach and duodenum is determined. With this form of chronic gastroduodenitis, there is an increased tendency to constipation, while the appetite remains good. An additional method of investigation in this case is the EGF, during which changes characteristic for this type of gastroduodenitis are determined. In most cases, the ulcerative type of chronic gastroduodenitis occurs when Helicobacter pylori is infected with Helicobacter pylori.
A disckinetic type of disease usually manifests with early aching pains that are localized over the navel after eating, especially the intake of large amounts of fried and fatty foods. Pain passes independently through 1 -1,5 hours. Often disturbs feeling of gravity, overflow in a stomach, fast saturation, the lowered and selective appetite. Sometimes there can be a belching of air, nausea, occasionally vomiting of food eaten, bringing relief. When you feel the doctor in the abdomen area, a slight soreness over the navel or at the site of the projection of the duodenum is determined.
Along with the main forms of chronic gastroduodenitis, there are many atypical and asymptomatic forms. Almost 40% of cases of chronic gastroduodenitis occur secretly. In this case, the degree of changes in the stomach and duodenum and the degree of expression of the signs may not coincide.
Treatment of chronic gastroduodenitis is complex. During an exacerbation, physical and mental rest, medical nutrition, medication and physiotherapy are necessary.
Food during the exacerbation period should be fractional. Food should be mechanically and chemically sparing. From the diet it is necessary to exclude stomach irritating dishes( fatty, fried, spicy, salted, smoked, spices and extractives).
With normal and increased acidity of gastric juice( determined during the examination) antacid preparations are used: phosphalugel, megalac, maalox, protab. In cases of pronounced increase in the acidity of gastric juice, drugs such as gastrocepin or riabal are used. With erosion, film-forming agents, such as sucralfate and denol are effective.
In cases of detection of Helicobacter pylori, specific treatment is performed.
In addition to medical treatment, methods of physiotherapeutic treatment are used: inductothermy, ozocerite or paraffin applications.
Prophylaxis of chronic gastroduodenitis consists in creating conditions for rational nutrition, optimizing the regime of the day and the level of physical and psychoemotional loads. A prerequisite is the treatment of foci of chronic infection( chronic tonsillitis, adenoids, carious teeth) and various parasitoses( helminths, amoebas, lamblia).
Persons suffering from chronic gastroduodenitis, are on a dispensary record with a gastroenterologist for at least three years. In the absence of all manifestations of this disease, it is necessary to carefully maintain a sparing diet( except for the diet of roasted, fatty, acute, salty, smoked, spices and extractives).It is recommended to use phytotherapy - decoctions of St. John's wort, yarrow, celandine, chamomile. The course of herbal medicine usually lasts for 2-3 weeks( in autumn and spring).In addition, the methods of physiotherapy - electrophoresis of calcium, bromine, diadynamic currents, hydrotherapy, mud therapy. It is recommended to take mineral water( Essentuki No. 4, Slavyanovskaya, Smirnovskaya, Borzhomi) by repeated courses for 2-3 weeks after 3-4 months. To strengthen the body and restore metabolism used vitamins( A, group B, C) repeated courses. During the remission period, not earlier than three months after the exacerbation of the disease, it is recommended to undergo sanatorium treatment. Once a year, the FGDs are performed and the control of the presence of Helicobacter pylori in the stomach. From dispensary registration is removed after a full recovery, in the event that the exacerbation and any signs of gastroduodenitis do not disturb for three years.