Erosive Gastroduodenitis - Causes, Symptoms And Treatment

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

Erosive gastroduodenitis

The main difference between erosive gastroduodenitis from other forms of this pathology is the presence of ulcers and erosions against the background of inflammation of the mucous membrane of the stomach and duodenum. At the same time, the normal functioning of the glands of the gastrointestinal tract is preserved.

Erosive gastroduodenitis is diagnosed mainly in young women and men. With this disease, surface defects appear on the mucous membrane. Ulcers and erosions do not penetrate into the submucosa and muscle layer; they can be single or multiple. Erosive gastroduodenitis is accompanied by bleeding from mucosal defects, which eventually leads to anemia.

Content:

• Causes of erosive gastroduodenitis
• How is erosive gastroduodenitis manifested?
• Diagnostics
• Treatment of erosive gastroduodenitis
• Prevention and prognosis

If the patient does not receive adequate treatment, the pathological process is complicated by the development of gastric and upper intestinal ulcers, cholecystitis, and pancreatitis. This form of gastroduodenitis is the most common among all pathologies of the gastroduodenal zone, the disease can be both acute and chronic. Compared with ordinary gastritis, erosive gastroduodenitis does not go into remission for a long time, it is difficult to treat.

Causes of erosive gastroduodenitis

The pathological process is based on the aggressive influence of hydrochloric acid against the background of its excessive secretion. The epithelial layer of the mucous membrane is unable to regenerate, as a result of which erosion and ulcers appear on it.

Negative factors provoking the development of erosive gastroduodenitis:

• Hereditary predisposition;
• Helicobacter pylori infection;
• Poor nutrition;
• Frequent stress and psycho-emotional shock;
• Intestinal infections;
• Poisoning by poor quality products;
• Diseases of neighboring organs of the gastrointestinal tract (liver, pancreas);
• Reflux (reverse throwing) of acid from the duodenum 12 into the stomach;
• Side effects of drugs from the group of NSAIDs, antibiotics, glucocorticosteroids;
• Eating spicy, rough, too hot or too cold food;
• Alcoholism.

Infection with the bacterium Helicobacter pylori is the most common cause of the development and progression of the disease.

How is erosive gastroduodenitis manifested?

The clinical picture of the disease depends on the form in which it proceeds. Acute erosive gastroduodenitis occurs most often due to poisoning with toxins or poor quality food. The chronic form is the result of an imbalance between damaging factors and the protective function of the mucous membrane.

The main and most striking symptom is constant or recurrent pain in the epigastric region. It occurs immediately after eating or after a few hours.

Other symptoms:

• Sour belching;
• Nausea;
• Heartburn;
• Bloating;
• Frequent constipation;
• Decreased appetite;
• Vomiting of mucus with blood clots or acidic contents (with exacerbations);
• Loose stools of black color (with internal bleeding);
• Deterioration of general health (weakness, headache, insomnia).

With frequent gastric and duodenal bleeding, the patient develops anemia.

Symptoms of anemia against the background of chronic gastroduodenitis:

• Dizziness;
• Tachycardia;
• Fast fatiguability.

In the chronic form of pathology with mild changes in the mucous membrane, the symptoms are muted. Patients notice that they have a serious disruption of the gastrointestinal tract only when they see black feces.

Diagnostics

The best method for diagnosing erosive gastroduodenitis is esophagogastroduodenoscopy, or EGDS. The study is carried out using an endoscope armed with a microscopic camera. The purpose of EGD is to determine changes in the mucous membrane associated with the inflammatory process, as well as to assess the size and location of erosion.

What the doctor sees during the study:

• Hyperemia and edema of the mucous membrane of the stomach and duodenum;
• Looseness of the mucous membrane and increased sensitivity to touch;
• Bleeding in the area of erosion;
• Minor hemorrhages;
• Gray coating on erosions in the form of a film;
• The size of the defects is 0.3-0.5 mm.

During EGDS, the doctor performs a biopsy of the mucosal area for histological examination and clarification of structural changes.

Diagnostics of the presence of Helicobacter pylori:

• Microscopic examination of a biopsy sample from the stomach and upper intestine;
• PCR test - search for bacterial DNA by the presence of DNA polymerase;
• Breath test - collection of air exhaled by the patient before and after exercise;
• ELISA method is a study of blood serum for the presence of antigens to a bacterial agent.

Anemia is diagnosed with a complete blood count. When hemorrhagic anemia is confirmed, the color indicator sharply decreases, the level of hemoglobin and erythrocytes falls.

Treatment of erosive gastroduodenitis

Diet food, a rational regimen of food intake is an indispensable condition for effective therapy of this pathology. The diet and the filling of the menu are of particular importance during exacerbations of the disease.

Diet requirements:

• Exclusion of fatty and fried foods;
• Refusal from hot spices and herbs;
• Food should not contain coarse fiber, be too hot or cold;
• The daily amount of food is divided into 5-6 meals.

If Helicobacter pylori is detected, it is eradicated using first and second line therapy:

• The first line is a complex of drugs, including Clarithromycin, Amoxicillin and proton pump inhibitors (Omeprazole, Rabeprazole).
• The second line (used when the first is ineffective) is a complex of drugs, including Tetracycline, Metronidazole, bismuth preparations, antisecretory agents.

Additional medications:

• To protect the mucous membrane - alginates, antacids;
• To create a film over erosions that protects against the action of gastric juice - cytoprotectors;
• To improve regeneration - reparants, vitamin preparations;
• To reduce pain - antispasmodics (papaverine, drotaverine hydrochloride);
• To relieve stress - sedatives.

Prevention and prognosis

To avoid the development of the disease, you need to carefully compose your menu, adhere to the correct diet, do not eat too hot or cold food. Taking NSAIDs and glucocorticosteroids, you must strictly observe the dosage and follow the doctor's recommendations. When the first symptoms of the disease appear, you need to contact a gastroenterologist and be tested for the presence of Helicobacter pylori.

The prognosis of erosive gastroduodenitis is favorable with timely treatment. Otherwise, there is a high risk of developing gastric and duodenal ulcers in a patient.

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.