Erosive Gastritis - Symptoms, Diet And Treatment

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

Erosive gastritis

Content:

• What is erosive gastritis?
• Symptoms of erosive gastritis
• Erosive-hemorrhagic gastritis
• Treatment of erosive gastritis
• Diet and menu for erosive gastritis

What is erosive gastritis?

Erosive gastritis is a type of inflammatory processes of the gastric mucosa of acute and chronic origin, a distinctive feature of which is the formation of small defects (erosions) on its surface.

This means that erosive gastritis:

• It differs from simple gastritis by the presence of multiple eroded areas of the mucous membrane against the background of its hyperemia (redness) and inflammation. Sometimes they can spread over the entire surface of the stomach;
• It can occur, both acutely, when poor-quality food and toxic compounds enter the stomach cavity, or wear a chronic course in violation of the normal secretory-motor mechanisms of the digestive system;
• May be caused by H. pylori infection;
• Prone to lingering current;
• It is treated for a longer time and more difficult in comparison with other types of gastritis;
• Can cause stomach bleeding of any severity. This feature can be a real problem if bleeding occurs simultaneously from the entire eroded surface of the stomach.

The pathogenetic mechanisms of the development of erosive gastritis can be:

• In acute erosive gastritis, mucosal damage occurs as a result of its direct contact with aggressive media (poor quality food, acids, alkalis, chemicals, drugs, etc.). In this case, a kind of burn occurs, which is accompanied by inflammation during its healing;
• At the heart of chronic erosive gastritis are disturbed secretory processes. They can be associated with both a violation of the nature of nutrition, and with internal failures of the body. In this case, there is a violation of microcirculatory processes, blood circulation in the stomach and an increased release of aggressive components of gastric juice. Naturally, the ischemic mucous membrane is not able to resist them, which leads to its inflammation with further ulceration and the formation of erosions.

Symptoms of erosive gastritis

It is extremely difficult to suspect the erosive form of gastritis only by clinical signs and complaints of the patient. The exception is those cases when gastric bleeding occurs against the background of confirmed gastritis. In such situations, the fact of the formation of erosion becomes obvious. All other symptoms are typical for any type of gastritis and can only indirectly indicate its erosive appearance with its strong severity and persistence.

Symptoms of erosive gastritis include:

• Pain in the projection of the stomach (epigastric region of the upper abdomen). With erosive gastritis, it may not be intense, but with a widespread process, it may even require the introduction of strong analgesics to stop it;
• Heartburn. It is most typical for chronic erosive gastritis with impaired gastric motility and reflux of acidic gastric contents into the lower esophagus;
• Dyspeptic disorders in the form of persistent heaviness in the stomach, sour and rotten belching, dryness and bitterness in the mouth, stool disorders;
• Strengthening or the onset of pain after eating or on an empty stomach, when only gastric juice is present in the stomach cavity, irritating pain receptors at the bottom of erosions.

Any suspicion of erosive gastritis should be confirmed or refuted using additional research methods. For these purposes, a visual assessment of the gastric mucosa is used during fibrogastroduodenoscopy. This method allows you to reliably assess the degree of structural changes caused by the inflammatory process, determine its prevalence and, if necessary, make a biopsy. In this case, a fragment of the mucous membrane is taken along the edge of the erosion for its examination under a microscope.

To assess the secretory activity of the stomach and acidity during endoscopic examination, appropriate studies and measurements are made. In case of hyperacid erosive gastritis with high acidity, a test for Helicobacter pylori infection is performed, which affects the volume of therapeutic measures.

Erosive-hemorrhagic gastritis

Due to its persistent and prolonged course, erosive gastritis often ends in complications. One of them is gastric bleeding from eroded mucosa. Such gastritis is called erosive-hemorrhagic. The mechanism of their development is associated with the size, depth and localization of erosion. Superficial defects in the region of the anterior, posterior walls and fundus of the stomach rarely bleed. The most dangerous in this regard are extensive and multiple erosion, spreading to great depths. Their most dangerous localization is the area of lesser curvature due to the location of large vessels in this area and the high intensity of the general blood flow.

For the transition of erosive gastritis to erosive-hemorrhagic erosion, the depth of the vascular bed must be reached. In each person, small vessels have different features of their branching, structure and level of pressure in them. Therefore, persons with the same diagnosis have a different degree of risk of erosive-hemorrhagic gastritis. To a greater extent, these are patients with any form of arterial hypertension and diseases of the blood coagulation system. The risk group also includes patients taking anticoagulant drugs (aspirin and its analogues, warfarin, heparin), nonsteroidal pain relievers and anti-inflammatory drugs (diclofenac, ibuprofen).

Symptoms of the transition from erosive gastritis to erosive-hemorrhagic gastritis are quite bright. All of them indicate the presence of gastric bleeding of varying severity.

These signs include:

• Reducing the intensity of pain. This symptom is more pronounced, the more intense the bleeding. This phenomenon is due to the fact that erosion destroys sensitive receptors behind which the vessels are located. Therefore, the pain first decreases, then bleeding occurs;
• Vomiting is a mandatory sign of erosive-hemorrhagic gastritis. Its nature depends on the intensity of bleeding, the diameter and number of bleeding vessels. If vomit is presented with bloody contents, this indicates active ongoing bleeding. The presence of brown contents in the vomit is evidence of sweating of blood from the vessels into the stomach cavity or slight bleeding;
• Symptoms of anemia - a decrease in the amount of blood in the vascular space. Their severity depends on the amount of blood loss: skin pallor, dizziness, decreased blood pressure, acceleration of the pulse;
• Dark color of feces. Sometimes erosive-hemorrhagic gastritis is accompanied by so little bleeding that vomiting does not occur. But, destroyed by acid, blood elements, getting into the intestines, cause a dark color of feces.

Treatment of erosive gastritis

To get rid of erosive gastritis, the following directions in its treatment should help:

• Elimination of excess secretion of gastric juice. It is achieved by using drugs with an antisecretory mechanism of action. These can be either histamine receptor blockers or a proton pump. Of the first group, famotidine, ranitidine, and quamatel are most widely used. From the second - omez, lansoprazole, controllers, proxy;
• Neutralization of aggressive hydrochloric acid. For these purposes, antacids are shown: Rennie, Maalox, Almagel, Phosphalugel, Venter. They not only eliminate excess acidity, but also form a protective film over inflammatory mucous membranes and erosions. This contributes to their rapid healing;
• Facilitation of digestive processes in conditions of blocked gastric secretion. Different generations of enzyme preparations are used: Creon, Mezim, Festal, Panzinorm, Pangrol;
• Restoration of normal motility of the stomach and duodenum. In most cases of erosive-hemorrhagic gastritis, its violation occurs. It is possible to eliminate this pathogenetic component with the help of metoclopramide, cerucal, motilium, domperidone;
• Hemostatic drugs. They are used only in case of erosive-hemorrhagic gastritis. It is better to administer intramuscularly or intravenously: ethamsylate, dicinone, vicasol, thioctic acid;
• In case of confirmation of the Helicobacter pylori nature of erosive gastritis, the use of anti-Helicobacter drugs is indicated: clarithromycin, metronidazole, ornidazole, amoxicillin, de-nol or ready-made combined preparations (pilobact neo, clatinol);
• Treatment with alkaline mineral waters. It is better to carry it out in a specialized sanatorium.

On the subject: prevention of gastritis

Diet and menu for erosive gastritis

Acute and chronic erosive gastritis in the acute stage cannot be cured without following certain dietary recommendations. They must be adhered to for the prevention of the disease. In the active stage of the inflammatory process, diet number 1 is prescribed. As it subsides, the patient is gradually transferred to the fifth dietary table. Their general characteristics are as follows:

• Do not eat foods that increase gastric secretion and irritating mucous membranes (spices, smoked meats, fried and fatty foods);
• Food must be fresh, steamed or boiled;
• Fractional and frequent meals. Small portions are preferred;
• Cooked meals should be warm, preferably liquid or mushy. High and low temperatures are equally dangerous for inflamed and eroded mucous membranes.
• As for specific products and indicative menus, they should be as follows:
• Prohibited foods: fresh bread and buns made from rich flour, biscuits, chocolates, fatty animal products (pork, bacon, bloodworm, homemade sausage with spices);
• Allowed foods: stale white and black bread, crackers, bran, mashed potatoes or as part of a soup, various cereals from any cereals except wheat and barley, butter and a small amount of vegetable oil, diet type meat (rabbit, chicken, fresh young beef), fish, fermented milk dishes.

Details about the diet: what can and can not be eaten with gastritis?

An approximate daily menu and the correct distribution of dishes should look like this:

Baked cottage cheese dish, cocoa drink
	Weak sweet tea and uncomfortable yesterday's bun with butter
	Kefir, fermented baked milk or yogurt

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.