Chronic gastritis: symptoms, causes, treatment, diet

Chronic gastritis is a nosological group of chronic pathological conditions of the stomach characterized by the presence of an inflammatory-dystrophic process localized in the thickness of its mucosa.

Associated pathogenetic mechanisms are a disorder of secretory, endocrine and motor functions of the stomach.

Gastritis is a disease that is most often acquired in childhood.

There is no predominance in terms of gender. There is a hereditary predisposition to the development of this pathology. Depending on the pH of the gastric juice, gastritis with increased and decreased acidity is isolated. The localization of inflammation can be any: body, antrum, cardia.

Causes of chronic gastritis

Causes, as well as provoking factors of the appearance of chronic gastritis are many. Depending on the specific etiologic factor, a separate type of disease can be distinguished.

Currently, the primary causes of the development of chronic gastritis are:

1. 1) Infection of the body with Helicobacter pylori( in this situation, Helicobacter pylori-associated gastritis develops);
   
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2. 2) The effect on the gastric mucosa of chemicals( including drugs: especially non-steroidal anti-inflammatory drugs) provokes the development of chemical gastritis;
   
3. 3) The pancreatic juice is affected and affected by the gastric mucosa in various diseases accompanied by duodenogastric reflux( chemical gastritis also occurs);
   
4. 4) Formation of autoantibodies to the internal factor of the Castle and / or parietal cells of the stomach( the main cause of autoimmune gastritis development);
   
5. 5) Food allergies can cause the development of an eosinophilic form of gastritis;
   
6. 6) Celiac disease( a pathological process characterized by an increase in the level of intraepithelial lymphocytes in the pit and cover layers of the epithelium of the stomach) is the cause of the development of lymphocytic chronic gastritis;
   
7. 7) Sarcoidosis, Crohn's disease, histiocytosis, Wegener's granulomatosis, eosinophilic granuloma, Whipple's disease, mycosis, foreign bodies often provoke the appearance and development of noninfectious granulomatous gastritis.

Among the predisposing factors, special attention is given to:

• inappropriate nutrition( irregular meals, the use of either excessively hot or too cold dishes, frequent use of fast food, uncontrolled use of alcoholic beverages);
  
• smoking;
  
• frequent stress;
  
• hereditary predisposition.

Symptoms of chronic gastritis

In general, chronic gastritis occurs almost asymptomatically, it is possible to suspect its presence during periods of exacerbation( when clinical symptomatology reveals itself most clearly) or during a prophylactic FGDS study.

The clinical picture of each type of chronic gastritis does not differ radically. There are "classic" symptoms that allow you to suspect the presence of this pathology.

Further, using various diagnostic methods, it is possible to determine both the type of disease and the direct cause of its occurrence. Among the main symptoms are the following:

1. 1) Pain in the epigastric region, which can occur either on an empty stomach or after a direct meal( or after 1 / 2-1.5 hours).The pain can be blunt, aching, and may be periodic cutting, cramping. A characteristic feature is a reduction in pain after taking antacid or antisecretory medicines;
   
2. 2) Feeling of heaviness and discomfort in the epigastric region, feeling of overflow of stomach after eating;
   
3. 3) Belching with air or sour, unpleasant taste in the mouth;
   
4. 4) Decreased appetite( characteristic of gastritis with low acidity);
   
5. 5) Nausea, rarely vomiting;
   
6. 6) Unstable chair;
   
7. 7) With a lack of vitamin B₁₂, general weakness, malaise, fatigue, dizziness, drowsiness, pale skin, burning sensation in the tongue.

Diagnosis

To suggest that chronic gastritis may be a clinical symptomatology of the disease, the final diagnosis can only be made after a thorough examination.

For differential diagnosis with other diseases of the digestive tract, research methods such as:

• feces analysis for detecting occult blood;
  
• study of the secretory function of the stomach( intragastric pH-metry);
  
• stool analysis for undigested food residues;
  
• FEGDS( "golden" method of diagnosing gastritis);
  
• tests to identify the causative agent of Helicobacter pylori( urease and respiratory tests);
  
• blood test for the detection of antibodies to parietal cells of the stomach, as well as the internal factor of the Castle;
  
• floor manometry( diagnoses reflux gastritis with increased pressure in the duodenum);
  
• assessment of motor-evacuation function of the stomach using specialized sensors( electroenceography);
  
• tissue biopsy( used both for determining the type of gastritis, and for differential diagnosis with the formation of the stomach and other inflammatory diseases);
  
• Ultrasonography of the abdominal cavity to exclude pathological processes in the hepatobiliary system, as well as the pancreas.

Treatment of chronic gastritis

The treatment of chronic Helicobacter pylori-associated chronic gastritis is based on the use of tri- and quadrotherapy.


The drug effect on a particular type of gastritis has its own individual characteristics and nuances, but there are groups of drugs that are applicable for the treatment of any of the species. These include:

• drugs that reduce acidity( Gelusil-lac, Phospholugel, Maalox);
  
• Proton Pump Blockers( Pantoprazole, Omeprazole);
  
• H₂-histamine blockers( Ranitidine, famotidine);
  
• polyfermentative medicines( Creon, Pancreatin);
  
• antispasmodics( Papaverin, No-shpa);
  
• drugs that regulate gastric motility( Trimedat);
  
• preparations that promote the regeneration of the damaged mucous membrane of the stomach( sea buckthorn or dog rose oil, Riboxin);
  
• vitamins( group B - B₁₂, as well as folic acid).

During the remission period, additional treatment is shown in the form of physiotherapy: EHF on the epigastric region, electro- and phonophoresis, balneotherapy. It is also important to maintain a diet for chronic gastritis to avoid exacerbation.

Preventive measures

The prevention of gastritis is based on the maintenance of a healthy lifestyle( avoiding smoking and drinking alcoholic beverages), adherence to a rational diet( restricting the use of fast food, fatty, acute, hard-digestible food), timely treatment of concomitant diseases, if necessary repeated eradication therapy of acute Helicobacter pyloriassociated gastritis.

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