Gastritis Of The Stomach - Causes, Signs And Symptoms. Gastritis With High And Low Acidity

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, signs and symptoms of gastritis of the stomach

Content:

• What is gastritis?
• Signs and symptoms of gastritis
• Causes of gastritis
• Types of gastritis
• How to help yourself at home?
• Medicines for gastritis

Inflammation of the gastric mucosa is one of the most common human diseases. Approximately 80-90% of people have had at least one episode of this disease during their life. In old age, up to 70-90% of people suffer from various forms of gastritis. The chronic form of gastritis can transform into peptic ulcer, stomach cancer.

What is gastritis?

Gastritis is an inflammation of the lining of the stomach, leading to dysfunction of this organ. When gastritis occurs, food begins to be poorly digested, which results in a breakdown and lack of energy. Gastritis, like most diseases, is acute and chronic. In addition, there are gastritis with low, normal and high acidity of the stomach.

Currently, gastritis can already be called a disease of the century. It affects both adults and children. And according to health statistics, in Russia about 50% of the population has gastritis in some form.

Gastritis is characterized by a variety of external and internal causes that provoke the development of pathology. Clinically, it occurs in the form of inflammation (acute or chronic). Acute inflammation is short-lived. Damage to the mucous membranes of the stomach with concentrated acids, alkalis and other chemicals is dangerous and lethal.

Long-term (chronic) ailment reduces the quality of life and manifests itself in the form of pain, as well as:

• Heaviness in the abdomen;
• Heartburn;
• Belching;
• Vomiting;
• Diarrhea and / or constipation;
• Bloating;
• Flatulence - discharge of gases;
• Bad breath.

The chronic form is dangerous by atrophy of the gastric mucosa. As a result, the glands of the stomach cease to function normally. Atypical cells are formed in place of healthy cells. An imbalance in the self-healing process of the cells of the gastric mucosa is one of the causes of ulcers and cancer of the gastrointestinal tract.

The stomach is the most vulnerable part of the digestive system. At least three complex processes of digestion take place in it: these are mechanical mixing of the food coma, chemical breakdown of food and the absorption of nutrients.

Most often, the inner wall of the stomach is damaged - the mucous membrane, where the production of two mutually exclusive components of digestion occurs - gastric juice and protective mucus.

Digestion in the stomach is a finely tuned biochemical process in the body. This is confirmed by the normal acidic pH of the gastric juice medium (its main component is hydrochloric acid), but also by the difference in acidity parameters in different parts of it. High acidity (pH 1.0-1.2) is observed in the initial section of the stomach, and low (pH 5.0-6.0) - at the junction of the stomach with the small intestine.

The paradox is that in a healthy person, the stomach not only does not digest itself, but also the gastric juice produced by the glands in different parts of the organ has different properties. In this case, the pH-environment in the esophagus is neutral, and in the duodenum (the first section of the small intestine) - alkaline.

An unpleasant, painful sensation of a person with gastritis - heartburn - is primarily the result of a violation of the acid-base balance in one of the parts of the gastrointestinal tract. In addition, the deviation of the acid balance from the norm in certain parts of the stomach underlies the pathogenesis of gastritis with low or high acidity.

A gross effect on the digestive process: food or chemical poisoning, the release of bile into the stomach, intestinal infections, the regular intake of certain medications, carbonated drinks, alcohol and other factors negatively affects the state of the gastric mucosa. The serious influence of the microbial factor on the development of gastritis has been proven.

A short-term extreme effect on the digestive process is limited to clinical manifestations in the form of acute inflammation of the following nature:

• Catarrhal;
• Fibrinous;
• Necrotic;
• Phlegmonous.

Catarrhal gastritis is associated with poor nutrition and mild food poisoning. Fibrinous and necrotic gastritis are usually caused by poisoning with salts of heavy metals, concentrated acids and alkalis. Phlegmonous gastritis is caused by traumatic damage to the stomach wall.

Prolonged exposure to a weakened body ends with the development of chronic pathogenesis, aggravated by ulcerative processes on the walls of the stomach. Gastritis can be a precursor to cancer processes in the gastrointestinal tract.

The variety of manifestations of gastritis of the stomach in humans is confirmed by their complex classification. Detailing the clinical symptoms of gastritis is extremely necessary for gastroenterologists when prescribing medical procedures. In our case, this is an illustration of various forms of the disease for the formation of a generalized idea of gastritis in the reader.

The causes of gastritis can be microbes Helicobacter pylori, etc. In some cases, specific microorganisms provoke about 80% of gastritis. Helicobacter is not the only cause of this disease.

Another group of gastritis is not associated with microbes, although this connection may appear at certain stages.

Non-microbial gastritis is divided into several groups:

• Alcoholic. The disease develops under the influence of the regular use of strong alcoholic beverages (alcohol has an alkaline pH) against the background of numerous other factors associated with the general negative effect of large doses of ethyl alcohol on the body;
• NSAIDs due to gastritis. NSAIDs are non-steroidal anti-inflammatory drugs that are used in many diseases as antipyretic, analgesic and antiplatelet drugs. The most famous drugs of this pharmacological group are acetylsalicylic acid (aspirin), analgin, diclofenac, indomethacin, ketoprofen, ibuprofen, piroxicam. Uncontrolled use of NSAIDs stimulates the development of gastritis, and then its transformation into gastric ulcer.
• Post-resection. Such gastritis develops after the forced surgical removal of part of the stomach.
• Chemically caused gastritis. They develop as a result of accidental or special ingestion of chemicals that have aggressive properties against proteins of the gastric mucous membranes.
• Gastritis of unknown origin.

In professional medicine, other classifications of gastritis are also used, including, according to the type of spread of pathogenesis:

• Autoimmune gastritis (type A);
• Exogenous gastritis (type B), provoked by Helicobacter pylori;
• Mixed gastritis (type A + B);
• Gastritis (type C) provoked by NSAIDs, chemical irritants, or bile;
• Special forms of gastritis;
• Gastritis against the background of a decrease and increase in the secretion of hydrochloric acid;
• Other forms of morphological and functional manifestations of gastritis.

Their differentiation involves the use of complex medical laboratory or instrumental techniques at the stage of disease diagnosis. Therefore, the description of gastritis, which have approximately the same clinical symptoms, but differ in the underlying mechanisms of pathogenesis, is not of interest to a wide range of readers.

Let us dwell in detail on the main signs and symptoms of gastritis, which can serve as the basis for a person's appeal to a medical institution for help.

Signs and symptoms of stomach gastritis

• Acid symptoms
• Symptoms with low acidity
• Symptoms of exacerbation of gastritis
• Stomach pain with gastritis

Gastritis is distinguished by a variety of symptoms, but it can also occur without pronounced manifestations. The most common symptom is pain in the solar plexus area, which is aggravated by the ingestion of certain types of food, liquids and drugs, especially those with increased aggressiveness to the gastric mucosa. Sometimes the pain gets worse between meals. With gastritis, spicy food, alcohol, carbonated drinks and other foods are contraindicated, the use of which leads to an exacerbation of gastritis.

Heartburn, vomiting, and belching are important but less persistent symptoms of gastritis. The disease sometimes manifests itself as bloating and frequent gas. The appearance of two or more of the above symptoms against the background of abdominal pain is a reason to suspect gastritis.

The disease is indicated by the intake of spicy food, drugs and aggressive liquids shortly before an attack of pain.

It is much more difficult to identify the symptoms of chronic gastritis. For a long time, the signs of the disease are limited to irregular stools, bloom on the tongue, fatigue, rumbling and overflowing in the abdomen in the interval between meals, flatulence, recurrent diarrhea or constipation.

Chronic gastritis usually does not significantly affect the clinical condition of the patient, except for a decrease in the quality of life. In a mild form, chronic gastritis is characterized by constipation and diarrhea. In severe form, in addition to those indicated - frequent discharge of intestinal gases, anemia, drowsiness, cold sweating, increased peristalsis, halitosis.

Acid symptoms

The most common signs of gastritis with high acidity, apart from general symptoms (vomiting, nausea):

• Long-term pain in the solar plexus, disappearing after eating;
• Frequent diarrhea;
• Heartburn after eating acidic foods;
• Frequent urge to pass gas from the mouth - belching.

Symptoms with low acidity

The most common signs of low or no acid gastritis are:

• A persistent bad taste in the mouth;
• Heaviness in the stomach after eating;
• '' Belching of "rotten eggs";
• Rumbling;
• Nausea in the morning;
• Problems with the regularity of bowel movements;
• Disgusting breath.

Symptoms of exacerbation of gastritis

Relapse of chronic gastritis is characterized by a variety of symptoms, the following symptoms are most common:

• Constant or intermittent pain in the solar plexus, which intensifies immediately after eating, or vice versa, with prolonged fasting;
• Belching with air, burning in the sternum, heartburn after eating, metallic taste in the mouth;
• Nausea, morning vomiting of half-digested food with a characteristic sour taste, sometimes vomiting of bile;
• Increased salivation, thirst, weakness;
• Manifestations of dyspepsia (constipation, diarrhea);
• Dizziness, palpitations, headache.

Symptoms of an exacerbation of erosive (severe) forms of gastritis are supplemented by vomiting with blood clots, sometimes vomiting with a dark color of vomit. Gastric bleeding during bowel movements is manifested by black feces. Sometimes gastric bleeding can only be determined by laboratory methods. Massive internal bleeding is manifested by pallor of the skin and mucous membranes and is easily identified by the color of the sclera of the eyes, dizziness, and tinnitus.

Stomach pain with gastritis

Gastralgia - pain in the abdominal wall (cavity) - is an important symptom of gastritis. Meanwhile, pains accompany other diseases of the abdominal organs, which are collectively called the `` acute abdomen ''. Unpleasant sensations are manifested in the form of cuts, as well as stabbing, pressing, shooting, burning and other types of pain.

Acute abdominal syndrome - it can be appendicitis, cholecystitis, pancreatitis, stomach cancer, refluxes, intestinal blockage and other pathologies. All pains in the above diseases are in one way or another combined with other symptoms characteristic of gastritis - vomiting, nausea, belching, constipation, diarrhea, changes in body temperature.

Pains resembling gastralgia can be a symptom of myocardial infarction, inflammation of the membranes of the heart and lungs, and rib fractures. Pain in the stomach can be observed with viral, bacterial and parasitic pathologies in the intestines, specific female problems, neuroses, diabetes mellitus.

At home, you can recognize the pain caused by gastritis. The most characteristic of gastritis and distinguishing it from other pathologies of the "acute abdomen" are pains that intensify after:

• Eating food, especially spicy and smoked food;
• Consuming alcohol or certain drugs, in particular non-steroidal anti-inflammatory drugs;
• Long break from eating.

The rest of the options for the occurrence of pain in the stomach in the absence of clinical skills and the ability to use laboratory and instrumental research methods can be easily confused with symptoms of other ailments.

Causes of gastritis

Of greatest interest are the causes of the chronic form of gastritis. There are external and internal factors that provoke the development of the disease. Interestingly, in some people, gastritis develops much more slowly and does not have a significant effect on the body. That is, most likely, the causes of gastritis are hidden behind many factors and their combinations.

The most significant external causes of gastritis:

• Exposure to the stomach walls of Helicobacter pylori bacteria, less often other bacteria and fungi. In about 80% of patients diagnosed with gastritis, acid-fast bacteria are secreted, which actively invade the wall of the gastric mucosa, secrete specific substances that irritate the mucous membrane, and stimulate a local change in the wall pH and inflammation. The final answer as to why some people these bacteria cause significant harm, while others do not, is still unknown;
• Eating disorders. It has been established that poor nutrition is a common cause of gastritis. The statement is true both in cases of overeating and malnutrition. You should diversify your diet with plant foods rich in vitamins and plant fiber, which normalizes peristalsis. However, with the development of the initial stages of gastritis, it is necessary to avoid foods containing coarse vegetable fiber, as well as fatty, spicy, canned and pickled foods;
• Alcohol abuse is identified as a separate cause of gastritis of the stomach. Ethanol in small amounts is an important component of biochemical processes in the body, however, large amounts of alcohol provoke an acid-base imbalance in the body. In addition, alcohol in large doses with regular use significantly harms other digestive organs - the liver, pancreas, and also has a detrimental effect on metabolic processes in the body;
• It is noted that some drugs widely used in medicine as anti-clotting (antiplatelet), pain relievers and anti-inflammatory drugs have serious side effects - they irritate the gastric mucosa. Most often, gastritis is caused by non-hormonal anti-inflammatory drugs (aspirin, analgin) and glucocorticoid hormones (prednisolone). These medicines are recommended to be used strictly according to medical prescription, fractionally, in small doses, after meals;
• Some researchers note the influence on the development of gastritis of helminthic invasions, chronic stress, aggressive chemicals, accidentally or intentionally swallowed.

The main internal (related to the violation of homeostasis) causes of gastritis:

• Congenital human predisposition to gastrointestinal diseases;
• Duodenal reflux is a pathological injection of bile from the duodenum into the stomach. Bile, getting into the stomach cavity, changes the pH of the juice and irritates the mucous membrane. Initially, inflammation of the antrum part of the stomach develops, and then other parts of it are involved;
• Autoimmune processes, damage at the immune level of the protective properties of the cells of the gastric mucosa. As a result, the cells stop normal functioning and lose their original properties. This phenomenon triggers a cascade of small reactions that change the pH of the juice and leads to constant irritation of the stomach walls. Endogenous intoxication and impaired resistance of the mucous membrane to the aggressive environment of gastric juice occurs;
• Disorders of hormonal and vitamin metabolism, the reflex effect of the pathogenesis of organs adjacent to the stomach.

Types of gastritis:

With the help of instrumental and functional methods, many variants of gastritis have been diagnosed. However, everyone is divided into gastritis with:

• Normal or high acidity;
• Zero or low acidity.

Symptoms of gastritis with low or high acidity can generally be distinguished, however, the final diagnosis is made on the basis of a study of gastric juice obtained by probing, as well as intragastric pH-metry using special sensors inserted into the stomach. The latter method is convenient in that long-term monitoring of gastric juice parameters is possible. In some cases, the pH of gastric contents is determined by an indirect method, in the study of urine pH.

Acidic gastritis

It is characterized by severe pain in the solar plexus or in the navel, usually paroxysmal in nature. The pain subsides after eating a dietary meal, and intensifies between meals. Pain in the right hypochondrium is evidence of gastric juice entering the duodenum. The pathology is characterized by heartburn, morning nausea, rotten belching, rumbling in the abdomen, diarrhea (constipation is more common for gastritis with low acidity), metal taste in the mouth.

In some cases, the disease proceeds subclinically, with periodic exacerbations after the use of alcohol, drugs of the NSAID group, cardiac glycosides (digitalis), potassium preparations, hormones (prednisolone, dexamethasone, hydrocortisone). An attack can be triggered by eating "heavy" food. The type of gastritis is determined by medical examination.

Low acid gastritis

The acid in the stomach is involved in the primary breakdown of coarse food fibers.

A pH level of 6.5-7.0 is a low acidity of gastric juice. With a decrease in the level of acidity, there is a slowdown in denaturation and breakdown of proteins, and, as a result, intestinal motility. Therefore, along with pain, important symptoms of anacid gastritis (with low acidity) are constipation, halitosis, and putrefactive, fermentative processes in the stomach.

Gastritis with low acidity is more often manifested by heaviness in the abdomen, rapid satiety after eating, increased formation of intestinal gases. In some cases, the disease can be corrected by taking digestive enzymes (festal, gastal). You can treat anacid gastritis at home, it is very simple. Since gastric juice has reduced properties, you should chew food for a long time. Thorough grinding of a food coma in the oral cavity and processing it with saliva is an effective non-medical method for treating gastritis.

Acute gastritis

Catarrhal gastritis develops under the influence of aggressive drugs (aspirin, other NSAIDs), harmful drinks (alcohol, carbonated lemonades with frequent use) and heavy foods (fatty, salty, smoked, pickled). There are also known acute gastritis against the background of toxic infections (salmonellosis and others), as well as against the background of renal and hepatic failure. Acute forms of gastritis can be provoked by pathologies that are not directly related to the gastrointestinal tract (pneumonia, frostbite). This is due to the accumulation of under-oxidized products in the blood during severe pneumonia, which causes inflammation of the stomach walls. They also describe acute gastritis against a background of stress.

Fibrinous and necrotizing gastritis develops with special or accidental ingestion of strong acids (acetic, hydrochloric, sulfuric) or alkalis. The disease is accompanied by excruciating pain.

Phlegmonous gastritis is a consequence of deliberate or accidental injury to the walls of the stomach (swallowed pins, glass, nails). The disease is manifested by purulent fusion of the walls of the stomach.

Symptoms of catarrhal (simple) acute gastritis appear 5-8 hours after exposure to the crisis factor. Pathogenesis begins with a burning sensation in the epigastric region (synonyms: under the spoon, in the solar plexus). Pain develops in the indicated area, nausea, vomiting, metallic taste in the mouth. Toxic-infectious gastritis is complemented by fever, persistent vomiting and diarrhea. A serious condition is characterized by bloody vomiting - it is corrosive (necrotic) gastritis. Phlegmonous gastritis is manifested by the phenomena of peritonitis: a tense abdominal wall, a state of shock.

Chronic gastritis

In the initial stages, the disease proceeds without vivid symptoms. Periodically, hypersensitivity to certain types of food appears in the form of heartburn and bloating. Often there is a feeling of heaviness with a full stomach, plaque and a peculiar pattern are found on the tongue.

The chronic form of gastritis can develop at any age: from 20 to old age. The disease is characterized by periods of exacerbation and remission. During an exacerbation, the signs of chronic gastritis do not differ from the symptoms of an acute form of the disease - pain combined with nausea, sometimes vomiting. The unpleasant sensations increase after eating certain types of food. Usually this is a certain set of foods that should be remembered and try to exclude from the diet or limit use.

The most dangerous consequence of chronic gastritis is gastric bleeding. It is manifested by black feces, pallor of the mucous membranes and skin of the patient.

The pallor of the mucous membranes can be a sign of another disease - atrophic gastritis. It proceeds against the background of a deficiency of vitamin B ₁₂ in the body. This vitamin is very important for blood formation. Atrophic gastritis may have no other striking signs other than pallor. The danger of the disease is that it is a harbinger of the development of cancer cells in the epithelium of the stomach. The detection of anemia against the background of signs of gastritis is a reason to take a closer look at the state of health.

On the subject: diet for gastritis with high and low acidity

The human body has large-scale protective resources, therefore, lifestyle changes, adherence to a dietary regimen and properly prescribed complex treatment significantly increase the likelihood of cure for any form of gastritis.

How to help yourself at home?

A common cause of gastritis is excessive consumption of the following two substances:

• Aspirin (acetylsalicylic acid);
• Alcohol (ethyl alcohol, ethanol).

Aspirin and its analogues are prescribed by cardiologists for long-term daily and mandatory use in order to prevent myocardial infarction and strokes. Tens of thousands of people daily take aspirin as a means of inhibiting the formation of blood clots in the bloodstream, which makes the problem of the safe use of NSAIDs very urgent.

Acetylsalicylic acid preparations have excellent antiplatelet properties, that is, they prevent the development of blood clots in the vessels. Blood clots are the main cause of myocardial infarction and cerebral strokes. However, aspirin and other NSAIDs have unpleasant side effects - they irritate the mucous membranes of the gastrointestinal tract. Hypertensive patients use these drugs in combination with other drugs on a daily basis. Excessive intake of aspirin and its analogues can provoke an additional problem for a sick person - gastritis. This is true for all people of the older age group suffering from hypertension, angina pectoris, who have undergone or are at risk of developing myocardial infarction.

Alcohol widely consumed by certain categories of citizens. In people predisposed to diseases of the gastrointestinal tract, even moderate consumption of ethanol can provoke an exacerbation of gastritis. Alcohol is alkaline. Regular neutralization of the acidic environment of the stomach with ethanol creates a condition for irritation of the walls.

Meanwhile, there is no reason to exclude aspirin and other important drugs (iron, potassium, hormones, others) from the list of useful drugs. Read the medication annotations carefully and take them according to the regimen recommended by your doctor.

In particular, you can reduce the side effects of aspirin in the following ways:

• Reducing a single dose (consult your doctor);
• Taking the drug on the eve of a meal;
• Drinking with large volumes of water;
• Transition from aspirin to modern coated analogues (TROMBO-ASS).

When prescribing aspirin and other NSAIDs, caution should be exercised if the patient has:

• Erosive and peptic ulcer disease in the acute stage;
• Individual intolerance to acetylsalicylic acid preparations;
• Tendency to gastrointestinal bleeding;
• Bronchial asthma;
• Renal failure;
• Pregnancy in women.

Always inform your doctor if you have any restrictions on the use of aspirin. This will help the doctor navigate, choose the correct dosage of the drug, replace it with more suitable analogues or drugs of a different pharmacological group, adjust the methods of use, and reduce the frequency of aspirin use.

In some cases, antacids are prescribed to reduce the side effects of aspirin and other NSAIDs - drugs that neutralize the acidity of gastric juice.

Inappropriate use of any drug can have negative consequences and make it difficult for other prescribed drugs to be absorbed. Antacids containing aluminum in large doses cause constipation, potassium-containing medicines - a decrease in stomach acidity (in some cases, this is a useful property). Potassium is also beneficial for women during menopause.

In case of intolerance to certain groups of drugs, they are replaced by others. For example, histamine H2 blockers can become such substitutes. Drugs in this group (Cimetidine, Ranitidine) are non-prescription drugs. These tablets are prescribed as a means of regulating the acidity in the stomach, and, as a consequence, reducing pain in hyperacid gastritis.

On the subject: a list of effective foods and other remedies for gastritis

As for alcohol, you should stop using it during an exacerbation of gastritis and the use of pharmacological agents that have an aggressive effect on the gastrointestinal tract. Regular alcohol consumption is a real threat to the development of gastritis of the stomach.

Medicines for gastritis of the stomach

In the arsenal of gastroenterologists for the treatment and prevention of gastritis, there are several pharmacological groups of drugs, including:

• Detoxifying drugs (antidotes) - activated charcoal, smectite, specific antidotes;
• Antacids (adsorbents) - activated carbon, alum (diamondilate, aluminum phosphate, bismuth subnitrate, bismuth tripotassium dicitrate), hydrotalcite, diosmectite, sucralfate, Antareit;
• Antiseptics and disinfectants (bismuth subnitrate);
• Antidiarrheal drugs (diosmectitis);
• Tetracycline antibiotics (doxycycline);
• Antihistamines (H2 subtype) - famotidine, cimetidine.

The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist

Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.