Atrophic Gastroduodenitis - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Atrophic gastroduodenitis

The consequence of chronic inflammation of the mucous membrane of the stomach and duodenum 12 can be atrophic gastroduodenitis. A characteristic feature of this disease is the destruction of the secretory glands that produce gastric juice. Instead of juice, the degenerated glands produce mucus. This form of gastroduodenitis is considered a precancerous condition and develops against a background of low acidity. Approximately 90% of all cases of atrophic gastroduodenitis are associated with the introduction of the bacteria Helicobacter pylori into the patient's body.

After infection of the body with the bacterium Helicobacter, the concentration of gastric juice changes, which protects the gastrointestinal tract from dangerous infections. The pathological process from the stomach very quickly passes into the duodenum, due to which the process of digestion of the food lump is disrupted. During progressive inflammation of the gastric mucosa, secretory, or parietal, glands are lost, metaplasia of individual areas occurs.

If the atrophic process occupies at least 20% of the entire area of the stomach, we can say with absolute certainty that there is cancer. According to medical research, every eighth case of atrophic gastroduodenitis ends with an oncological pathology, while in other forms of gastritis this probability is 5 times lower.

With timely diagnosis of the disease after 5 years of high-quality treatment, the metaplasia areas are significantly reduced, and the mucous membrane of the stomach and duodenum is restored.

Content:

• Causes of atrophic gastroduodenitis
• Symptoms of atrophic gastroduodenitis
• Diagnostics
• Treatment of atrophic gastroduodenitis
• Prevention and prognosis

Causes of atrophic gastroduodenitis

There are two main reasons leading to atrophy of the mucous membrane of the stomach and duodenum:

• An autoimmune process in which the G cells of the secretory glands are damaged by their own immune antibodies;
• Prolonged stay in the digestive tract of the bacteria Helicobacter pylori.

During the autoimmune process, antibodies are mistaken for foreign tissue by the cells of their own secretory glands. The acidity of the gastric juice gradually decreases, the parietal glands begin to produce mucus instead of hydrochloric acid. These processes lead to the impossibility of absorption of iron and vitamins by the walls of the stomach and duodenum, the development of anemia. Attachment of the Helicobacter bacteria accelerates the formation of areas of metaplasia.

The introduction of infection leads to damage to cells, due to which free radicals penetrate into them. The glands change their structure, their cells become precancerous. This is how intestinal metaplasia develops, when areas of the gastric mucosa acquire the properties of the small intestine and large intestinal epithelium. These transformations increase the likelihood of gastric adenocarcinoma.

Factors contributing to the development of the disease:

• Physical and mental stress;
• Hereditary predisposition to gastrointestinal diseases;
• Side effects of drugs;
• Stress;
• Alcohol abuse;
• Occupational diseases;
• Chronic somatic diseases.

Symptoms of atrophic gastroduodenitis

The disease develops slowly, starts from the bottom of the stomach, gradually moving to other parts of the mucous membrane. Vivid symptoms of the disease may not manifest themselves at first, which creates obstacles to early diagnosis and timely treatment.

Signs of anemic syndrome due to impaired absorption of vitamins and iron:

• Weakness;
• Fast fatiguability;
• Drowsiness;
• Pallor of the skin and mucous membranes;
• Burning and pain in the tongue;
• Lacquered tongue surface;
• Dry hair;
• Brittle nails;
• Stitching pains in the heart;
• Shortness of breath with any exertion.

Signs of dyspeptic syndrome associated with indigestion:

• Heaviness in the stomach;
• Aching pain in the projection of the epigastrium;
• Heartburn;
• Belching;
• Nausea;
• Vomiting of recently eaten food, mucus, and bile;
• Decreased appetite;
• Alternating constipation and diarrhea;
• Bad breath and bad taste in the mouth in the morning;
• Gray coating on the tongue, teeth marks on it.

Indigestion leads to a sharp decrease in body weight, in advanced cases - to dystrophy. Obstacles to the absorption of vitamins cause a decrease in immunity, frequent colds and infectious diseases.

Diagnostics

The most informative modern method for determining the shape and stage of gastroduodenitis is the hematological diagnostic panel. This study helps to establish the degree of damage to the secretory glands and the level of metaplasia of the epithelium of the mucous membrane.

The parameters determined by the study:

• Gastrin level-17;
• Pepsinogen-1 and pepsinogen-2 levels;
• Histamine level-17;
• The ratio of indicators.

Another informative study is FGDES with methylene blue staining of the mucosa to assess the area of epithelial metaplasia. During the endoscopic examination, a biopsy of the tissues of all altered areas of the mucous membrane is taken.

Additional methods for diagnosing atrophic gastritis:

• Gastrography;
• Intragastric ph-metry;
• Daily measurement of acidity;
• MSCT (multislice computed tomography) - if stomach cancer is suspected;
• Determination of the presence or absence of the bacteria Helicobacter pylori (breath test, ELISA test, PCR reaction).

Treatment of atrophic gastroduodenitis

The goal of treatment of atrophic gastroduodenitis is to prevent the further development of intestinal metaplasia, destruction of the epithelium and its transformation into atypical cells (cancerous transformations). This goal can be achieved within 5 years of careful therapy.

A prerequisite for full treatment is dietary nutrition. Food should be gentle in composition, temperature, and mechanical structure. After a short period of time, it is allowed to include in the diet low-concentrated lemon, cranberry, cabbage juice. Bananas are the only acceptable fruits for this diet. Food should be neither cold nor hot, the diet should be frequent meals, small portions. It is absolutely unacceptable during and after treatment to smoke or consume alcohol in any dose.

Medicines for the treatment of atrophic gastroduodenitis:

• Antibiotics for the eradication of the bacteria Helicobacter pylori;
• Proton pump inhibitors;
• Bismuth preparations;
• Glucocorticosteroids;
• Iron preparations;
• Vitamins;
• Enzymes;
• Mineral waters with a high mineral content;
• Gastroprotective agents;
• Antacids;
• Cellular regeneration stimulants;
• Peristalsis stimulants.

Additionally, physiotherapeutic treatment is used (electrophoresis, magnetotherapy, thermal procedures), sanatorium treatment at a balneological resort.

Prevention and prognosis

To prevent atrophic gastroduodenitis, acute and chronic diseases of the gastrointestinal tract should be promptly treated, and the principles of rational nutrition should be followed. An early visit to a gastroenterologist and quality treatment will help prevent complications.

For elderly patients, the prognosis for the development of the disease is worse than for younger patients. At the age of over 50, mucosal atrophy most often ends with malignancy. If one course of treatment has not cured the disease, it should be repeated.

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.