Chronic gastroduodenitis in adults and children. How to cure various forms of erosive gastritis of the stomach? Chronic gastritis ICD 10 in adults

So, knowing what code chronic gastritis has according to ICD 10, you can easily decipher the diagnosis in the medical record and become familiar with the features of the course and the main subtleties of the treatment of this pathology.

Each of the groups of inflammatory diseases of the stomach in the ICD 10 system may have several more detailed classifications. For example, an erosive type that corresponds to cipher 29.0 can be divided into:

• reflux gastritis;
• antral
• spicy;

That is, the international congress, which adopted the ICD 10 classification, maximally generalized all existing pathologies, but each of them can have a significant variety of forms and courses.

Main features of chronic gastritis according to ICD 10

Let's look at each code relating to chronic gastritis separately.

29.0 Inflammation with bleeding. The picture of the disease is characterized by the fact that the first changes occur in the vessels, and not in the mucous membrane. These disorders lead to the formation of hemorrhages, which, in turn, is fraught with the formation of blood clots, inflammation and erosions.

29.1 Acute gastritis. The reason for the transition of the chronic form to this form can be the use of medications, malnutrition, poisoning, etc. Depending on the type of inflammation, the following are distinguished:

• catarrhal form;
• fibrinous;
• corrosive;
• phlegmonous gastritis.

29.2 Alcoholic. Caused by alcohol abuse. As a result of this addiction, the production of protective mucus by the stomach is disrupted, pathological changes in the blood supply occur, and erosions are formed.

29.3 Chronic erosive and superficial. The entire inflammatory process does not extend beyond the boundaries of the upper lining layer of the gastric mucosa.

29.4 Atrophic gastritis. As a result of inflammation, the differentiation (development, maturation) of cells of the mucous layer is impaired, which leads to their failure. The thickness of the membrane decreases, the production of enzymes and gastric juice is disrupted.

29.5 Unspecified. Can be divided into:

• antral;
• fundamental.

In the first case, inflammation affects the lower part of the stomach, which means that the production of gastrin is most disrupted. An insufficient amount of this substance causes an increase in the acidity of gastric juice.

In the second case (fundic form), the inflammation is localized in the middle and upper lobes of the stomach. This leads to a decrease in the activity of gastric juice, because this is where hydrochloric acid is produced.

29.6 Other forms of chronic gastritis. These pathologies most often occur against the background of other diseases: tuberculosis, mycosis, Crohn's disease, as a result of nerve conduction disorders. Also, such gastritis can be provoked by a foreign body that has entered the lumen of the stomach.

Knowing the code, it is very easy to understand the causes and small features of the course of various forms of pathology.

Don’t be afraid of the codes in your medical record; it’s important not to get hung up on the numbers, but to move on to treatment as quickly as possible. After all, by ignoring the symptoms of the onset of the disease, we create the conditions for its long and persistent course. Be healthy!

Today, a frequently encountered combination of two pathologies has its own code in ICD 10 - 29.9 and is designated as “unspecified gastroduodenitis”. Let's understand the concept of gastroduodenitis code according to ICD revision No. 10.

Combining two pathologies into a single combination

The combination of two independent diseases is justifiably combined into a single pathology due to the presence of common pathogenetic mechanisms:

• Both diseases develop against the background of changes in acidity levels.
• The main impetus for the emergence of inflammatory processes is a decrease in the totality of the protective systems of the human body.
• Both diseases have other similar causes of inflammation.

Duodenitis rarely occurs as an independent symptomatic disease. Often both diseases are closely related to each other - duodenitis is a consequence of chronic gastritis in the patient or vice versa.

Therefore, with the 10th revision of the ICD, it was decided to create a separate code - K29.9, related to the K20 - K31 group (diseases of the esophagus, stomach and duodenum).

Classification of gastroduodenitis

Pathological processes occurring in the stomach are interconnected with the processes of the duodenum, due to which the pathologies of these organs are often considered as a single disease.

Gastroduodenitis is classified according to various factors and can be:

• Primary and secondary pathology, taking into account the causes and conditions of origin of the disease.
• Widespread and localized.
• With reduced, within normal limits, or increased acidity, based on the level of secretion produced by the stomach.
• The disease can have mild, moderate and severe forms of inflammatory processes, as well as swelling and redness of the affected organ, atrophy and metaplasia of the stomach.
• The symptoms of the disease divide it into 3 phases - exacerbation, partial or complete remission.
• When examining a patient with an endoscope, the main types of disease can be identified, on which the subsequent treatment plan will depend. There are 4 types in total - superficial gastroduodenitis, erosive, with atrophy and hyperplasia of organs.

Forms of gastroduodenitis

There are a number of causes of diseases of the stomach and duodenum. This may be improper and inadequate nutrition, experienced stressful situations, constant exposure to nervous excitement, causing exhaustion, as well as previous diseases of the gastrointestinal tract, which affected the protective functions of the body. It is impossible to make an accurate diagnosis at home; this requires an examination by a qualified gastroenterologist and a series of examinations.

Gastroduodenitis is divided into 2 forms:

Acute gastroduodenitis

Acute gastroduodenitis according to ICD 10 can occur for a number of reasons: unbalanced, poor nutrition, nervous strain, previous infectious diseases, including pathologies of the liver, gall bladder and pancreas, hereditary predisposition.

Symptoms of acute gastroduodenitis:

• The presence of acute chaotic pain in the stomach and upper abdominal cavity.
• Poor health, apathy, feeling tired. Dizziness.
• Nausea, the presence of vomiting and other dyspeptic disorders (heartburn, unpleasant taste in the mouth, bad breath, belching, etc.).

Inflammatory processes occurring in the stomach and duodenum ultimately lead to disruption of motor functions and normal organ functionality, so it is important to identify the disease in time. The symptoms of acute gastroduodenitis are similar to a number of other diseases of the digestive system, so you should not make a diagnosis yourself. It is necessary to consult a doctor in time and begin treatment so that the acute form does not develop into a chronic one.

Chronic gastroduodenitis

Chronic gastroduodenitis according to ICD 10 is an aggravated and more serious disease that occurs and is provoked by a variety of pathogens and infections that enter the patient’s body.

The chronic form is divided into two stages - seasonal exacerbations, which are noticed in the spring and autumn periods and are caused by a decrease in the body's protective functions due to climate change, disruption of diet and the presence of viruses and infections in the air. And a period of the disease with a noticeable weakening or complete disappearance of symptoms.

Symptoms of chronic gastroduodenitis:

• Usually, during an exacerbation, the patient experiences acute cramping pain in the abdomen in the stomach area. Spontaneous and chaotic pain disappears on its own after 10 days, and pain when physically palpating the patient disappears after 21 days (about 3 weeks).
• General weakness, lethargy, dizziness and headaches, drowsiness or sleep disturbances, less often fainting.
• Paleness of the skin caused by a lack of a complex of vitamins in the blood.
• Feeling nausea, gag reflexes and other dyspeptic disorders.
• Feeling of full stomach. Constipation or diarrhea may occur.

As in the case of acute gastroduodenitis, the chronic form cannot be determined without examination in a hospital. In addition to an external examination and listening to complaints about the patient’s health, the doctor must prescribe a series of examinations to identify the clinical picture.

Among the examinations of gastroduodenitis there are X-rays, excision of a piece of organ tissue for diagnosis (biopsy will help determine the presence or absence of atrophy), examination of gastric juice and other endoscopic examinations, ultrasound, PH-metry. Test results will help the gastroenterologist identify the disease and determine the form and stage of the pathology. Only after accurately establishing the type and stage of the disease will the doctor be able to prescribe qualified treatment; the main thing is to seek help when the first symptoms are detected.

Gastritis and duodenitis (K29)

Excluded:

• eosinophilic gastritis or gastroenteritis (K52.8)
• Zollinger-Ellison syndrome (E16.4)

Acute (erosive) gastritis with bleeding

Excludes: erosion (acute) of the stomach (K25.-)

Mucosal atrophy

Chronic gastritis:

• antral
• fundamental

Giant hypertrophic gastritis

Excluded:

• with gastroesophageal (gastroesophageal) reflux (K21.-)
• chronic gastritis caused by Helicobacter pylori (K29.5)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Gastroduodenitis code according to ICD 10 – disease code 29.9

The accepted three-volume International Unified Classification of Diseases - ICD 10 includes all diseases. Classification in each section with numbers and letters allows you to encode the causes and symptoms of pathology in an understandable language for doctors around the world. Gastroduodenitis code according to ICD 10 is K29.9, duodenitis is K29.8, the main types of gastritis are from 0 to 7. Section ICD 10 means diseases associated with the gastrointestinal tract.

Gastroduodenitis – gastritis + duodenitis

Gastroduodenitis is a mutual disease of two organs: the stomach and the upper bulbous round part of the duodenum. Typically, chronic gastroduodenitis ICD 10 develops in the presence of inflammation in the antral - lower and pyloric compartment of the stomach, usually this is gastritis in a chronic form:

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The localization of the disease may be limited to only one part of the stomach or the inflammation may spread throughout the entire mucous membrane. At the same time, along with processed foods, a large amount of acid and bacteria enters the duodenal bulb. This irritates the walls, causing inflammation of the mucous membrane.

At the same time, a weakened valve and a disturbance in the contractions of the stomach and also the duodenum provokes the reverse release of alkali from the bulbous section into the stomach - reflux.

The lower sphincter, a valve, separates not only two organs: the stomach and intestines, but also juices that are completely different in composition - enzymes. In the stomach, hydrochloric acid and pectin predominate; in the intestines, alkaline enzymes break down the gruel from the stomach and, with the help of intestinal bacteria, sort out nutritional and harmful elements. These are mainly the well-known bifidobacteria and lactobacilli.

Gastroduodenitis ICD 10 – causes and symptoms

Initially, doctors diagnosed only gastritis and attributed duodenitis to additional symptoms. In the new classification, gastroduodenitis ICD 10 - K29.9 in the three-volume classifier of diseases is designated by the generally accepted term - “gastroduodenitis, unspecified.” The diagnosis was placed in the gastritis section and duodenitis ICD 10 - 29.8 was identified as a separate item. It is unspecified because it can accompany different types and forms of gastritis. The reason for combining two inflammations into one diagnosis was the dependence in the development of inflammation of the mucous membranes of two organs and the same pathogenetic mechanisms.

1. Both diseases are provoked by bacteria, in particular, Helicobacter Pylori, which survives in an acidic environment and even produces enzymes that activate the release of hydrochloric acid and increase the level of acidity.
2. The reason for the onset of inflammation in both organs is the weakening of protective functions and the weakening of the body’s immune system.
3. The form of the disease depends on the concentration of hydrochloric acid and Helicobacter Pylori in gastric juice.
4. Duodenitis is extremely rare, approximately 3%, and occurs as an independent disease. Mainly with increased release of bile. In other cases, malfunctions of the duodenal sphincter are provoked by gastritis.

The disease may appear when the immune system is weakened

The cause of the disease is one and the course of treatment is prescribed taking into account the type of gastritis and the condition of the gallbladder. Exacerbation occurs simultaneously in both organs.

Chronic gastroduodenitis ICD code 10 – K29

Chronic gastroduodenitis usually does not have pronounced symptoms or pain. Therefore, it is necessary to monitor signs that may seem insignificant at first glance and that the functioning of the stomach and intestines is disrupted.

Symptoms of gastroduodenitis are similar to most stomach diseases:

• periodic and hungry pain in the navel area;
• nausea;
• belching;
• heartburn;
• feeling of heaviness after eating;
• unstable stool;
• bloating;
• bitter taste in the mouth;
• weakness;
• pallor.

Chronic gastroduodenitis code according to ICD 10 - 29.9 is accompanied by weakness, fatigue, drowsiness and depression. Food is not completely processed; most of the nutrients leave without being absorbed by the body. The result is anemia - low hemoglobin levels. There is a loss of strength, increased sweating without exercise.

Heaviness in the stomach and heartburn

Abdominal pain manifests itself depending on the location and type of gastritis. Basically, with a chronic course of the disease, they are aching and weak. They occur in the area around the navel and can spread along the epigastric region and to the left under the ribs. Sometimes they appear spasmodic, hungry at night and during prolonged fasting. They are similar to the pain syndromes of a stomach ulcer.

Hunger pains disappear after eating a small amount of food. Eating large foods causes aching pain and heaviness immediately or within an hour. Sensation as if there was a stone in the stomach. This is due to inflammation caused by Helicobacter Pylori in the intestinal and stomach mucosa, a reduced ability to process food. It occurs more often against the background of low acidity and with the developing autoimmune and atrophic type of gastritis.

Food stagnates, is not moistened by enzymes, clumps in the stomach and enters the intestines not completely broken down. This causes fermentation and increased gas production. The result is meteriosm and bloating. Disturbances in the intestines are accompanied by unstable functioning of intestinal bacteria. Constipation may occur, but more often with gastroduodenitis, diarrhea is observed.

Bloating and flatulence

When the gallbladder malfunctions, bile is released into the duodenum. As a result of reflux, it enters the stomach, and a bitter taste appears in the mouth.

Chronic gastroduodenitis code according to ICD 10 in adults can be determined only by tests and examination results. Different types of gastritis require their own medications and treatment methods. First of all, the acidity of gastric juice, the concentration of Helicobacter Pylori and the presence of bile are determined.

Acute gastroduodenitis ICD 10 – K29.1

In the chronic form of the disease, exacerbation occurs periodically. Hidden causes cause seasonal relapses and periodic exacerbations against the background of pathology of other organs and changes in hormonal levels. In this case, an examination is carried out, the cause is determined and a course of medications is prescribed. Treatment is carried out on an outpatient basis, with periodic visits to a gastroenterologist.

Exacerbation of gastroduodenitis often occurs through the fault of the person himself and the reasons are known to him. These are, first of all, the following types of acute gastritis:

The reasons that provoke an exacerbation of the disease are external:

• alcohol consumption;
• stress;
• overeating;
• spicy dishes;
• fatty and spicy foods;
• starvation;
• strict diets for weight loss;
• hypothermia;
• sedentary lifestyle;
• excessive physical activity.

Causes of exacerbation - constant overeating and fatty foods

If you follow a diet, temperature regime, and moderate physical activity, after a few days the painful symptoms associated with exacerbation of gastroduodenitis disappear without taking medications.

Alkaloids irritate the mucous membrane, promote tissue death and block their regeneration. As a result, tissue inflammation increases, smooth muscles contract worse and food stops moving, and enzymes are released from the bulbous section and the entire duodenum into the stomach, from the stomach into the esophagus. Symptoms of alcoholic gastritis:

• severe spasmodic pain in the epigastrium;
• nausea;
• heartburn;
• weakness;
• vomit;
• dizziness;
• white coating on the tongue;
• bitterness in the mouth;
• high blood pressure;
• pale skin;
• heaviness in the stomach.

Often after an attack of vomiting, temporary relief occurs, the heaviness in the stomach goes away, and the pain decreases. Overeating causes similar symptoms, but the most obvious symptoms are heaviness in the stomach, nausea, and subsequently constipation. Hypothermia and stress cause spasmodic contraction of smooth muscles, disrupting the movement of food through the stomach and intestines. The result is flatulence, diarrhea, fever, vomiting and heartburn.

Abdominal pain, heaviness in the mouth and vomiting are symptoms of alcoholic gastritis

Fatty foods and large feasts load the stomach with indigestible foods, proteins and fiber of animal origin. As a result, food stagnates in the stomach, heaviness, aching pain in the epigastrium, constipation and diarrhea replace each other.

Treatment methods and diet when acute gastroduodenitis is diagnosed ICD 10 - K29-1

Treatment methods for acute gastroduodenitis against the background of alcoholic gastritis include several types of drugs:

• antacids;
• antidotes;
• adsorbents;
• disinfectants;
• antiseptics;
• antihistamines;
• tetracyclines.

First of all, you need to cleanse your stomach. To do this, drink 2 liters of water colored with manganese to a faint, slightly noticeable pink color and induce vomiting. Then take steps to remove toxins.

On your own, before consulting a doctor, you should drink 5–6 tablets of activated carbon or another adsorbent drug. It binds in the stomach and removes toxins and alkaloids. You can take tetracycline if the temperature has increased, chamomile decoction with mint or monastery tea. Herbs will relieve pain and inflammation and improve the condition. You can drink brine and other acidic drinks only if you are sure that the acidity is low or neutral.

Activated carbon - first aid

The same should be done when overeating, eating spicy foods, fatty fried meats and cakes.

Poor food and strict diets can also provoke exacerbation of gastroduodenitis. Lack of proteins and carbohydrates, lack of irreplaceable amino acids, fasting leads to irritation of the walls of the stomach and intestines with juice and enzymes.

Chronic gastroduodenitis ICD 10 - 29.9 - treatment and diet

Chronic gastroduodenitis does not cause constant pain and unpleasant symptoms. But he needs to be treated. Atrophic gastritis is a transitional form to oncological formations. Any advanced gastroduodenitis poses an increased risk of the formation of a perforated ulcer and cancer.

If gastritis is superficial, it can be cured with folk remedies if you eat right. To clarify the treatment and monitor the condition of the organs, it is necessary to conduct an examination and constantly consult a gastroenterologist. First you need to reduce, or better yet completely eliminate, alcohol, fatty foods, and fried foods. Eat in small portions, several times a day. Switch from strong coffee to green and monastery tea, chamomile decoction with mint.

The condition will be improved by moderate physical activity and walking. You need to dress for the season, don’t get cold, and try not to get nervous.

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Chronic gastroduodenitis: signs and treatment in the acute stage

Chronic gastroduodenitis is a dangerous disease that can significantly reduce the quality of life. They speak of a chronic form when symptoms persist for 6 months, and sometimes longer.

Concept of disease

With chronic gastroduodenitis, a cumulative inflammation of the mucous surfaces of the stomach and intestinal area occurs. The disease occurs among adults and among children.

A feature of the chronic form is that damage to the mucous membrane leads to disruption of the pancreas and autonomic disorders. Therapeutic tactics require the mandatory addition of B vitamins to the treatment regimen.

According to ICD-10, the disease belongs to class XI diseases. Block number K20-K31, code K29.9.

Varieties

All chronic gastroduodenitis is divided into several types:

• Etiology: primary or concomitant type.
• Changes in the mucosa: superficial, erosive, atrophic, hyperplastic.
• Histology: with varying degrees of inflammation, with atrophy, tissue transformation.
• The clinical picture is in the acute stage, remission.

Most often we are talking about the following forms:

1. Atrophic. Develops against the background of reduced acidity. Found in people with a genetic predisposition.
2. Helicobacter. Characteristic for people with high acidity. It develops due to the entry of Helicobacter pylori into the stomach.
3. Surface. Inflammation affects only the mucous membrane.
4. Erosive. Characterized by the formation of a large number of small ulcers on the mucous membrane.
5. Hypertrophic. It is a dangerous type of disease. It is a benign tumor.

Reasons

Various agents lead to pathology. Endogenous includes a malfunction of the immune system. In this case, the production of antibodies actively begins, which infect one’s own tissues. Hormonal disorders can lead to a chronic form.

Because of them, the protective function of the mucous membrane is reduced. Endogenous factors include stress and disorders in the nervous system. They cause stomach cramps. The result is the creation of favorable conditions for the development of inflammation.

There are also exogenous factors:

• Infectious pathogens. They can reproduce in any environment, including an acidic environment. This leads to the development of an inflammatory process.
• Overeating. The same reason includes overeating and poor chewing of food.
• Eating foods that stimulate the production of gastric juice. This can be fatty, fried, spicy and smoked foods.
• Alcohol abuse. Inexpensive wines and beer cause particular harm.

Symptoms of pathology

Chronic gastroduodenitis leads to:

• Feeling of heaviness and discomfort in the abdominal area.
• Sharp pain that intensifies when eating food.
• Constant nausea.
• Periodic bouts of vomiting.

These signs are combined with lack of appetite, belching and constipation, as well as sleep disturbances. A white coating may appear on the mucous membrane. A person with this form of the disease does not always feel unwell. The terrible state of health is replaced by periods of remission.

Chronic gastroduodenitis in children

In recent years, there has been a steady upward trend in gastroduodenitis.

Gastroduodenitis in chronic form often occurs in children who have a genetic predisposition or have suffered serious somatic illnesses.

Symptoms in children are similar to those observed in adults. Weakness, sleep disturbances, and headaches appear.

Vegetative-vascular dystonia is often observed. The pain syndrome is accompanied by a feeling of fullness and heaviness in the stomach. Sometimes vegetative crises occur as dumping syndrome. Then drowsiness and weakness appear. Heart rhythm disturbances may occur.

Diagnostics

Laboratory and instrumental examinations are carried out. Gastroduodenoscopy with biopsy is mandatory.

Using a special tube, the doctor examines the condition of the mucous membrane. Then pieces of fabric are taken from some areas. If necessary, the study is repeated several times. Inflamed and atrophied organ walls become visible.

To determine the presence of Helicobacter Pylori, the HELIC breathing test is used. First, the patient is given a special solution to drink. Then after 30 minutes you need to breathe into a tube that is connected to a special device. This is one of the most optimal methods for detecting bacteria, but due to the high cost of the equipment, only some hospitals have it.

Laboratory methods examine a general blood test with a leukocyte formula. Elevated leukocytes indicate the presence of an inflammatory process. If eosinophils predominate, then most likely there are worms. This is an important indicator in differential diagnosis.

Treatment of the disease

Treatment of the chronic form can last from several months to 2 years. All this time it is necessary to adhere to the rules of a healthy diet. In the acute period, bed rest is required for 7-8 days. If you do not adhere to these rules, then it is unlikely that you will be able to reduce the frequency and severity of pain syndromes.

Drugs

Treatment is carried out in several directions at once:

• Anti-inflammatory and immunomodulatory therapy.
• Normalization of the secretory functions of the digestive organs.
• Optimizing bile production.
• Restoring the balance of the nervous system of the gastrointestinal tract.

Thanks to modern treatment methods, it is possible not only to eliminate symptoms, but also to restore the health of the gastrointestinal tract, normalize digestion and absorption of food. Treatment is often carried out against the background of eliminating concomitant diseases.

If chronic gastroduodenitis is caused by a bacteria, then antibacterial drugs must be included in the treatment regimen.

For diseases with high or normal acidity, proton pump inhibitors are used. These include Omeprazole, Rabeprazole, Neximum. There are other drugs that reduce the production of hydrochloric acid, reducing the acidity of gastric juice. Usually, one medication is chosen for treatment.

If there is low acidity, instead of antisecretory drugs that are aimed at producing hydrochloric acid. Regardless of the form, antacids are prescribed: Phosphalugel, Almagel, Maalox. For vomiting and flatulence, prokinetics are prescribed (Cerucal, Motilium). They restore the movement of the food bolus, eliminating painful symptoms.

Folk remedies

Among the folk methods to get rid of a chronic disease, a collection of viburnum, chaga, aloe and honey can be used.

Propolis is also effective. It has a pronounced anti-inflammatory effect. For a speedy recovery, drink juices. Including sea buckthorn and cabbage. But even the most effective traditional medicine does not lead to a lasting effect. Therefore, they are used as an additional treatment.

Diet

Foods that are too hot, cold, salty or spicy are prohibited. Food should be small and chewed thoroughly. It is recommended to diversify the menu with pureed soups in low-fat broths. Fish, lean meat, and egg dishes have a positive effect on the gastrointestinal tract. It is possible to use cream, cheese, kefir.

First courses should be well ground to reduce the damaging effect on the mucous membrane. If you want to pamper yourself with juices, it is better to dilute them with water in a 1:1 ratio. Avoid excessive hunger or overeating.

The disease is in the acute stage: symptoms and treatment

During an exacerbation of chronic gastroduodenitis, symptoms characteristic of the acute form may appear. These include:

• dizziness,
• vomit,
• general malaise,
• severe pain in the stomach area.

Heartburn and belching, as well as bowel dysfunction, are often accompanying this phase. If these signs appear, you should quickly consult a doctor. in children in the acute stage, symptoms of endogenous intoxication appear. These include emotional lability, headaches and fatigue.

Treatment necessarily consists of diet. The menu should include vitamins B1, B2, PP, C. Meals should be 5-6 times a day. De-nol and Metronidazole are prescribed for 1-2 weeks. Omepazole and Clarithromycin are taken for 7 days. To correct treatment, a second consultation with a gastroenterologist may be required.

To prevent relapses, sanatorium or balneological treatment and various physiotherapeutic measures are often prescribed.

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The issue is resolved after diagnostic measures have been carried out. According to category “B” of the conscription rules, a disease with rare exacerbations may make a young man partially fit for service.

K29 Gastritis and duodenitis

GASTRITIS - inflammation of the gastric mucosa. Gastritis can occur in acute or chronic (slowly developing over several months or years) form.

The cause of gastritis is most often the bacterium Helicobacter pylori, which affects the gastric mucosa. Also, chronic gastritis can occur against the background of an inflammatory disease - Crohn's disease, characterized by inflammation of the digestive tract. Long-term use of alcohol, aspirin or NSAIDs can also lead to chronic gastritis.

One form of gastritis, known as atrophic or autoimmune gastritis, is a consequence of a pathological reaction of the immune system (antibodies are produced that destroy the tissue of the gastric mucosa).

Chronic gastritis often occurs without significant symptoms, but as a result of chronic gastritis, gradual damage to the gastric mucosa can occur, which will ultimately manifest itself in symptoms similar to those of acute gastritis. Symptoms of acute and chronic gastritis are:

• pain or feeling of comfort in the stomach, often after eating;
• nausea and vomiting;
• loss of appetite;
• stomach bleeding (may not appear until anemia develops); In case of severe bleeding due to gastritis, vomiting of blood or dark, tar-like stools may be observed.

Atrophic gastritis often occurs without pain, and the only symptom of atrophic gastritis may be pernicious anemia, leading to a deficiency of vitamin B 12 in the body. With atrophic gastritis, the stomach is unable to produce sufficient quantities of intrinsic factor Castle, a protein necessary for the absorption of vitamin B12. Patients suffering from atrophic gastritis have an increased risk of developing stomach cancer.

Gastritis usually resolves with lifestyle changes, for example, by reducing the amount of alcohol consumed. If chronic gastritis is caused by Helicobacter pylori infection, complete recovery usually occurs after taking a course of antibiotics and antiulcer drugs.

DUODENITIS - inflammation of the duodenum.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RF

"On approval of the standard of medical care for patients with chronic gastritis, duodenitis, dyspepsia"

In accordance with clause 5.2.11. Regulations on the Ministry of Health and Social Development of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 30, 2004 N 321 (Collected Legislation of the Russian Federation, 2004, N 28, Art. 2898), Art. 38 Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens of July 22, 1993 N (Vedomosti of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 33, Art. 1318; Collection of acts of the President of the Russian Federation and the Government of the Russian Federation, 1993, N 52, art. 5086; 1998, no. 1143, no. 6289, no. 4740; Art. 805; No. 1, Art. 2704, No. 2711)

1. Approve the standard of medical care for patients with chronic gastritis, duodenitis, and dyspepsia (appendix).

Deputy Minister V.I. Starodubov

to the order of the Ministry of Health and Social Development of the Russian Federation

medical care for patients with chronic gastritis, duodenitis, dyspepsia

1. Patient model

1.2. Treatment based on 14 days

Nosological form: chronic gastritis, duodenitis, dyspepsia

ICD-10 code: K29.4, K29.5, K30

Complication: no complications

Condition of provision: outpatient care

Types of chronic gastritis and ICD-10

Any branch of healthcare has its own statistical and methodological standards, as well as a system according to which gradation is carried out. In the section that combines the diseases described to date, this is the International Classification of Diseases, 10th revision. In daily clinical practice, for convenience, this classification is usually called ICD-10. It is international in nature and designed to provide common starting points for diagnostic criteria for known diseases.

The system is adopted for the work of practicing specialists in the field of medicine. This normative document is reassessed every 10 years. The complete edition of the classification consists of three volumes. This includes instructions for use, the classification itself and a short alphabetical index.

In the classification, the names of the disease are encrypted with a special code consisting of Latin letters and Arabic numbers. Acute or chronic gastritis according to ICD-10 reveals a number of varieties in morphology and severity of clinical manifestations. Acute gastritis according to ICD-10 is assigned code K 29.1

Classification of chronic gastritis

ICD 10 classifies any chronic gastritis under the Latin letter K, which includes diseases of the digestive system.

Chronic superficial gastritis

According to ICD-10, the form has code K 29.3. The disease is an easily occurring type of chronic process. The prevalence of the disease is high. In the absence of timely detection and treatment, the disease can develop into a severe form and lead to serious complications.

Inflammatory phenomena in a similar form of the disease, called superficial gastritis, affect only the upper layer of the epithelium lining the inside of the stomach. The submucous and muscular membranes of the stomach are not affected. Chronic gastritis according to ICD-10 is coded under the heading of digestive diseases and in a number of other headings, implying infectious, autoimmune or oncological diseases.

Main symptoms

Characteristic clinical manifestations are sensations of pain and discomfort, which are localized in the upper floor of the abdominal cavity. The appearance of pain is associated with a violation of diet and nutrition. Prolonged fasting or, conversely, excessive overeating can cause pain.

After eating, the feeling of pain, bloating and discomfort in the abdomen increases significantly. With focal gastritis, the pain is point-like in nature. Inflammation at the outlet of the stomach forms the clinical picture of antral inflammation. If the inflammation is diffuse, the entire lining of the stomach is affected. If soups and first courses are completely absent from a person’s menu, the patient abuses fatty and spicy foods, the disease becomes chronic and aggravation is regularly observed in the spring and autumn months, including moments when the regime and diet are violated. In addition to abdominal pain, the patient complains of heartburn, nausea, belching and stool disorders. In the absence of proper treatment and adherence to diet and nutrition, the superficial form turns into erosive gastritis.

Atrophic gastritis

Chronic atrophic gastritis is an independent nosological unit. Atrophic gastritis according to ICD-10 should not be confused with a chronic acute process. Some clinicians call the disease in remission, or inactive.

Pathogenesis

The distinctive features of chronic atrophic gastritis are considered to be a long course and progressive atrophic processes in the mucous membranes of the stomach. Atrophy affects the gastric glands, and dystrophic processes begin to prevail over inflammatory ones. Pathogenetic mechanisms ultimately lead to disruption of absorption, gland secretion and motility of the gastric muscles. Inflammatory and atrophic processes begin to spread to neighboring anatomical formations that have a common functional purpose with the stomach.

With gastritis, symptoms of general intoxication develop, and the nervous system is involved in the process. Weakness, fatigue, lethargy and headache develop. Absorption disorders lead to the development of iron and folate deficiency anemia.

Clinic

Clinically, the picture corresponds to gastritis with a reduced level of gastric acidity.

1. The stomach wall is thinner and sometimes stretched.
2. The mucous membrane in the stomach shows a smoothed appearance and the number of folds decreases.
3. The gastric pits are wide and deep.
4. The epithelium in microsection has a flattened appearance.
5. The glands of the stomach secrete a much smaller amount of secretion.
6. Outside the blood vessels supplying the stomach, leukocytes infiltrate into the walls.
7. Glandular cells degenerate.

This form of gastritis requires constant replacement therapy.

Unspecified gastritis

This type of disease is coded in ICD-10 as K. 29.7. The diagnosis is made in the medical documentation when the diagnosis contains the word Gastritis and no longer contains additional clarifications. The situation arises when the documentation was not maintained correctly enough.

Perhaps the lack of information content of the diagnosis was due to the presence of objective difficulties in the diagnosis. The doctor’s capabilities could be severely limited by the patient’s condition, financial situation, or categorical refusal to undergo examination.

Special forms of chronic gastritis

In the international classification of diseases, other forms of chronic inflammatory process in the stomach are also coded. According to the current classification, they act as syndromic conditions in other common diseases. Typically, types of gastritis are coded in other subheadings and are related in meaning to the underlying disease that caused their development.

The following nosological units are usually considered as special forms of inflammation:

1. The atrophic-hyperplastic form of gastritis is called warty or polypous. The disease can be classified in other sections of ICD 10. In particular, the polypous form of inflammation is mentioned under code K 31.7 and is considered a gastric polyp. In addition to the heading denoting diseases of the digestive system and coded with the Latin “K”, the form is considered in the section of neoplasms as the diagnosis “Benign neoplasms of the stomach” and is coded D13.1.

In the latter case, the ICD-10 code is assigned according to the underlying disease that caused the inflammatory process in the gastric mucosa.

Other classifications

In addition to the international classification of diseases, ICD 10, a number of different classifications have been developed that are widely used throughout the world. They are sometimes more convenient for clinical use than ICD-10, which is primarily aimed at statistical recording.

For example, in the 90s of the last century the “Sydney Classification” was developed. It includes two criteria by which diseases are classified. The histological section includes etiological factors, morphology and topographic criteria. According to the classification, all chronic inflammatory processes in the stomach are divided into Helicobacter, autoimmune, and reactive. Endoscopic classification considers the severity of mucosal edema and hyperemia of the stomach walls.

In recent years, a fundamentally new gradation of inflammatory processes in the stomach has been developed. The division of pathological conditions is carried out taking into account the severity of morphological changes. The advantages include the fact that it becomes possible to determine the extent of the spread of the pathological process and determine the severity of atrophy based on the results of the therapy.

Gastroduodenitis code according to ICD-10

When it comes to inflammation of the mucous membrane of the duodenum and the pyloric part of the stomach, a diagnosis of gastroduodenitis is made, its types are classified according to the endoscopic picture. Until recently, this pathology was not classified as a separate group. The International Classification of Diseases (ICD-10) includes a diagnosis of “gastritis” (K29.3) and a diagnosis of “duodenitis” (K29). Now gastroduodenitis also has a code according to ICD-10. A possible combination of gastritis and duodenitis is highlighted in ICD-10 by paragraph K29.9 and is designated by the phrase “gastroduodenitis, unspecified”; we will tell you what it is in the article.

In ICD-10, unspecified gastroduodenitis was identified only recently. Doctors are still debating whether the combination of two pathologies (inflammation of the mucous membrane of the stomach and duodenum) is justified. Those who vote “for” pay attention to general pathogenetic mechanisms:

1. The development of both diseases depends on the level of acidity of the environment.
2. Inflammation begins against the background of an imbalance in the body's protective functions.
3. The causes of the inflammatory process are also the same.
4. It is very rare for duodenitis to occur as a separate symptomatic disease. It often happens that it becomes a consequence of chronic gastritis, and vice versa. Therefore, it was decided to allocate gastroduodenitis into a separate group, ICD-10 classifies it as a disease of class XI, block number K20-K31, code K29.9.

Domestic medicine, taking into account that pathological processes in the stomach determine and support pathological processes in the duodenum, considers the disease as a single whole. A disease such as gastroduodenitis is classified taking into account various factors, so it makes sense to list them all.

Detailed classification of gastroduodenitis:

• Taking into account the etiological factor, the disease is divided into primary and secondary pathologies.
• By prevalence - widespread and localized.
• Depending on the level of acidity, there is gastroduodenitis with low acidity, with increased and normal secretory function.
• According to histological indicators - for a mild form of inflammation, moderate, severe, for the degree of inflammation with atrophy and with gastric metaplasia.
• Based on symptomatic manifestations, the following types are distinguished: exacerbation phase, complete remission phase and incomplete remission phase.
• Based on the endoscopic picture, superficial, erosive, atrophic and hyperplastic types of the disease are distinguished. Depending on the type, treatment regimens are determined.

For example, superficial gastroduodenitis is diagnosed if inflammation affects only the walls of the gastric mucosa, while the walls of the intestine simply thicken, its vessels become overfilled with blood, and this causes swelling. In this case, the pastel regime and therapeutic diet will be effective.

The erosive type is accompanied by the appearance of painful scars, erosions and ulcers throughout the gastrointestinal tract. They can form for various reasons: due to insufficient mucus secretion, the presence of reflux, or the penetration of infections. Treatment should help eliminate the root cause of the disease. It is this stage that ICD 10 distinguishes; gastroduodenitis in this case can provoke the development of peptic ulcer.

Catarrhal gastroduodenitis is diagnosed during an exacerbation, when the inflammatory process affects the walls of the stomach and the initial part of the duodenum. It can be caused by poor diet or overuse of medications. And here a therapeutic diet becomes the right lifeline.

The erythematous variety is diagnosed when inflammation of the gastrointestinal mucosa is of a focal nature. In this case, a large amount of mucus is formed, which causes swelling of the walls. Such a clinical picture signals that the disease is entering a chronic stage. Treatment in this case will be complex.

Chronic gastritis

In the system of statistical recording of all nosological units, the code of chronic gastritis according to ICD 10 is of great importance.

This classification, which is revised every 10 years with the introduction of certain additions, allows for the following actions on a global and local scale:

• assess the incidence of gastritis;
• keep statistics on mortality from gastritis;
• develop more effective treatments for the disease;
• assess the etiological factor in the development of pathology and, accordingly, successfully carry out preventive measures;
• draw up risks and prognoses for this disease.

Thanks to the international classification of diseases, doctors all over the world can use the same data and share their own.

What is chronic gastritis

Acute gastritis in the urolithiasis is an inflammatory process involving the gastric mucosa, digestive disorders and damage to important layers of the gastric wall.

However, gastritis most often has a chronic course with exacerbations. Moreover, according to theories about the pathogenesis of the disease, inflammation is immediately long-lasting, which makes it possible to distinguish it as a separate nosology even in the ICD. There are three main types of the inflammatory process: A, B and C. The clinical picture of the morphological forms will be the same, but the treatment will be radically different.

Gastritis often occurs in combination with a pathology such as duodenitis, that is, inflammation of the duodenum. Even in the ICD, these pathologies are located in the same section next to each other. The combined inflammatory process is identified as a separate pathology – gastroduodenitis. The ICD 10 code for chronic gastroduodenitis is represented by the following symbols: K29.9, which is one of the items in the extensive section on inflammation of the stomach.

Position of the disease in the ICD system

Diseases in the international classification of diseases are in most cases divided into subsections according to etiology.

Thanks to this coding, it is possible to develop and use the latest types of pathology treatment.

For example, different types of gastritis require fundamentally different therapy. If the patient experiences a significant increase in secretion, then proton pump inhibitors must be used. If acidity is reduced, then the use of these drugs is unacceptable.

The first division in the ICD is in accordance with the lesion system. Gastritis belongs to the class of diseases of the digestive organs. The gastritis code in ICD 10 is presented as follows: K29. However, this section has 9 more subparagraphs, each of which is a separate nosological unit.

That is, K29 indicates that the patient has gastritis or duodenitis, but this is not enough to make a correct, complete diagnosis. The doctor finds out the etiology and understands the pathogenesis of the disease as much as possible, after which the final coding is carried out.

Options for the location of gastric inflammation in the ICD system:

• K29.0 - is an acute inflammatory process with the obligatory presence of bleeding (in its absence, code K25 is set, that is, ordinary erosion);
• K29.1 - this is how any acute gastritis is coded, except for the above;
• K29.2 – inflammation of the stomach caused by alcohol consumption is isolated separately;
• K29.3 - in ICD 10, erosive gastritis or superficial chronic gastritis is coded as follows;
• K29.4 – this is how chronic inflammation of an atrophic nature is written;
• K29.5 - represents a whole group of chronic nosologies, when it is not possible to clarify the etiology or type;
• K29.6 – this includes a giant hypertrophic inflammatory process or a granulomatous lesion;
• K29.7 - simply unspecified inflammation of the gastric membranes;
• K29.8 – inflammation of the mucous membrane of the duodenum or duodenitis;
• K29.9 – combined pathology in the form of gastroduodenitis.

In addition to the listed nosological units in the International Classification of Diseases, 10th revision, there are two exceptions that are in the same class, but in different sections.

These include: eosinophilic gastroenteritis and Zollinger-Ellison disease. This disease belongs to the pathologies of the pancreas and is an oncological process.

Medical terms can often confuse patients very easily. Moreover, when faced with a mysterious encoding, the patient’s imagination immediately paints a tragic picture. Chronic gastritis is no exception to such situations. How to interpret and decipher incomprehensible numbers and letters in your own medical history?

For the common man, ICD 10 and K29.1-9 are a set of incomprehensible letters and numbers, but for a specialist this combination speaks volumes. The ICD should be understood as the international classification of diseases. Its system of statistics of all diseases is adopted as a basis in our healthcare.

The number 10 indicates the frequency with which statistical information was collected, that is, these data were obtained over a period of 10 years.

As for the next combination K29.1-9, it indicates a type of chronic pathology of the stomach.

The main types of chronic gastritis according to ICD 10

Acute hemorrhagic (erosive) Code 29.0

Pathology is a type of inflammatory process on the surface of the stomach cavity. The peculiarity of the disease is that the beginning is not the formation of an inflamed area, but microcirculatory disorders in the vessels of the submucosal surface. Next, they provoke hemorrhages, gradually permeating the upper layer of the cavity. As a result of disturbances in the vessels of the stomach wall, blood clots can occur, which causes acute gastritis, inflammatory processes and erosion. This disease is also called hemorrhagic erosive gastritis.

Other types of gastritis (acute type) Code 29.1

This type of pathology is caused by short-term exposure to an aggressive environment, which can be poor quality food, medications, etc.

Depending on the type of damage to the mucosa, as well as the characteristics of the clinical signs, gastritis can be:

• catarrhal;
• fibrinous;
• corrosive;
• phlegmonous.

Alcohol Code 29.2

In accordance with ICD10, such gastritis does not occur against the background of an inflammatory process. Acute gastritis, in which there is damage to the inner lining of the stomach, is formed as a result of prolonged alcohol intake and is often accompanied by erosions.

Under the influence of ethanol, the production of hydrochloric acid increases, which gradually corrodes the walls of the stomach, thus disrupting their structure and making it impossible to fully carry out their functions.

In this case, the blood circulation process is completely disrupted, the production of protective mucus is inhibited, which prevents the restoration of cells in the gastric mucosa.

Superficial chronic Code 29.3

Pathology is considered the most easily form, which is often diagnosed among patients. Untimely or poor quality treatment threatens this form to develop into a more complex pathology. The superficial type occurs only in the outer lining layer, without destroying the deeper levels of the gastric mucosa.

Chronic atrophic Code 29.4

Chronic gastritis according to ICD 10 is an inflammatory process in the mucous layer of the stomach, which provokes its thinning. As a result of such destruction, the production of gastric secretions decreases, and there are also significantly fewer epithelial cells involved in the regeneration of the mucosa. Against this background, secretory insufficiency of the gastric cavity is formed.

Unspecified chronic Code 29.5

According to the ICD 10 classification, this type of gastritis has two forms:

• antral;
• fundamental

The antral type is characterized by localization of the inflammatory process in the lower part of the stomach, called the antrum. This part contains glands that produce the digestive hormone gastrin. Through it there is a powerful effect on hydrochloric acid. In case of its deficiency, increased acidity occurs, which causes an inflammatory process on the walls of the stomach. The disease in most cases becomes chronic.

Acute gastritis of the antral type most often occurs as a result of food intoxication, severe malnutrition and food or drug allergies.

Fundal gastritis develops in the upper and middle zone of the gastric cavity. It is in this part that the digestive glands are located, the purpose of which is to produce hydrochloric acid. In case of partial loss of the digestive glands of their functions, the antrum retains its structure.

Other chronic types Code 29.6

In addition to the above forms, chronic gastritis can be:

• hypertensive;
• granulomatous giant,

The hypertensive type of gastritis is characterized by increased excitability of the tone of the gastric wall. The cause of this pathology is the excitability of the autonomic nervous system. The acute appearance is to a greater extent an accompanying symptom of diseases such as neurosis, ulcers, stomach cancer or other diseases of the gastric cavity.

A feature of granulomatous gastritis is the lack of ability to develop independently. Most often, diseases such as mycosis, tuberculosis, and Crohn's disease serve as a favorable background. It can also appear due to the entry of a foreign body into the stomach cavity.

Menetrier's disease manifests itself in the form of degeneration of the mucous layer of the stomach. As a result of the destructive process, cysts and adenomas form on its walls. In this case, secretory insufficiency occurs, and acute gastritis is characterized by gastric bleeding.

This list of gastric pathologies also includes unspecified gastritis under code 29.7. This disease is characterized by unclear localization of the inflammatory site.

According to statistics, every person on our planet suffers from various forms of stomach inflammation. About half currently have an acute gastritis form, which is an acute process that primarily affects the superficial part of the mucosa.

Typically, such a pathology is accompanied by reactions and other digestive ailments, disrupting the quality of life of a gastritic patient.

Definition and disease code according to ICD-10

Acute gastritis is called primary inflammation of the gastric mucosa, in which glandular and epithelial structures are involved in the pathological process. At the same time, deeper lesions develop quite rarely, when the pathology becomes advanced.

According to ICD-10, chronic gastritis is assigned the code K29.0 - acute hemorrhagic form, while K29.1 - the remaining acute gastritis forms.

Reasons for development

The development of acute gastritis inflammation can be provoked by a number of reasons, including:

• Abuse of alcoholic beverages and coffee, which have a rather aggressive effect on the gastric mucous membranes, increasing their permeability;
• Unhealthy diet with frequent consumption of hot dishes or difficult-to-digest foods, too many spices like horseradish, vinegar or mustard;
• Penetration of toxins such as alkali, alcohols or acids, heavy metals, etc. into the digestive system;
• Tendency to allergic reactions to various products, for example, with bronchial asthma. In this situation, gastritis may well occur in combination with allergic reactions;
• Infectious pathologies of the gastric cavity such as staphylococcus, as well as viral pathologies;
• Excessive abuse of medications, long-term drug therapy in violation of the treatment regimen. Sometimes medications even cause internal bleeding because they greatly thin the walls of the organ;
• A history of serious pathologies such as heart attacks, stroke, or severe burn injuries, surgical interventions or traumatic injuries;
• Metabolic disorders;
• Radiation exposure, for example, during radiation therapy of tumors.

In general, the etiological factors of acute inflammation of the gastric mucosa are quite diverse and are closely related to the adverse effects of an external or internal nature.

Classification

Acute forms of pathology are classified depending on symptoms, causes and degree of damage to mucous tissues. In general, there are 4 types of pathology: fibrinous and catarrhal, phlegmonous or corrosive.

• Fibrinous gastritis forms against the background of severe infectious pathologies such as scarlet fever or, as well as when the mucous membrane is damaged by acid or alcohol. This form of pathology occurs with necrotic damage to the epithelium, necrotization, up to the muscle layer. A characteristic manifestation of such gastritis is the formation of a fibrous film on the walls of the organ.
• Catarrhal type of gastritis is considered the most common form of pathology, in which inflammation spreads only on the epithelial surface and is accompanied by abundant secretion, swelling of the mucous membrane, hemorrhages and small erosions of a flat type (with erosive gastritis).
• Phlegmonous type is a purulent inflammatory process that covers all gastric layers. Traumatic and oncological factors, ulcerative processes lead to such damage. The gastric mucous membranes become thicker due to fibrin deposits. The course of the disease is quite complex with a very high risk of peritonitis and perigastritis.
• Corrosive gastritis develops against the background of potent chemical intoxication with metal salts or acids. Not only the surface is affected, but also the muscular layer of the gastric walls. In this case, extensive erosions and ulcerative defects are formed. There is a high risk of developing peritonitis, kidney or myocardial failure, gastric perforation, etc.

Acute gastritis is also divided into diffuse and local. In addition, non-infectious and infectious gastritis are distinguished.

Infectious

Acute gastritis of an infectious nature is characterized by a fairly rapid development and rapid course. For the pathology to manifest itself in full force, a few hours after infection are enough.

Such gastritis develops against the background of consumption of low-quality products contaminated with salmonella, etc.

In addition, Helicobacter microorganisms provoke the development of infectious gastritis when personal hygiene is neglected.

The pathology is accompanied by severe nausea, up to uncontrollable vomiting, hyperthermic reactions and general malaise, severe epigastric pain.

Symptoms

Typically, the symptomatic picture of acute gastritis begins to manifest itself approximately 6-12 hours after exposure to the provoking factor. If the etiology is associated with mechanical damage or chemical exposure, then the disease manifests itself much faster.

Early gastritis symptoms strongly resemble dyspeptic disorders and appear in the form of:

1. A sharp decrease in appetite;
2. The occurrence of painful sensations in the epigastrium;
3. Development of a nausea-vomiting reaction;
4. The appearance of an unpleasant taste in the mouth;
5. Problems with stool such as diarrhea, bloating, etc.

Vomiting reactions are provoked, patients develop dark circles around the eyes, diuresis decreases, the skin turns yellow, severe weakness appears, etc.

Sometimes dermatological symptoms such as rash and skin itching, urticaria, Quincke's edema, etc. also appear. And with phlegmonous acute gastritis, purulent contents appear in the vomit.

Diagnostics

If symptoms occur, the patient should contact a doctor, who will perform an examination, collect anamnestic data, and prescribe laboratory and instrumental diagnostics. Usually prescribed:

• A general blood test aimed at assessing the number of leukocytes, hemoglobin and neutrophils;
• Examination of urine, where acetone and urates are detected in acute gastritis;
• A coprogram that involves examining stool for hidden blood, as well as to assess the functionality of the gastrointestinal tract;
• Stool culture to determine pathogens;
• Biochemistry to detect possible concomitant pathologies such as gall and liver dysfunction, pancreatic structures, etc.;
• , detection of antibodies to Helicobacter microorganisms.

Examinations such as gastroscopy, FGDS, radiography, ultrasound diagnostics, etc. are also carried out.

Treatment of acute gastritis in children and adults

Therapy of the acute gastritis form is aimed at eliminating the provoking pathogenic factor that provoked catarrhal processes in the stomach.

When an attack occurs, gastric lavage is usually performed, and sometimes it is necessary to cleanse the intestines with the help of. On the first day the patient is on a starvation diet, and on the second day he is allowed warm drinks.

In case of acute gastropathy, the patient must remain in bed for the first 3 days; it is allowed to sit or walk to the toilet. In general, therapy involves the use of medications and diet therapy.

Medicines

Drug treatment of acute gastritis involves the use of the following categories of pharmaceuticals:

• Enterosorbents and prokinetics that eliminate nausea and vomiting reactions;
• To eliminate pain and spasms, antacids, anticholinergics and antispasmodics are indicated;
• If toxic-infectious gastropathy occurs, then antibiotics are also used;
• In cases of severe dehydration, an infusion of glucose and saline is administered.

With the development of acute catarrhal inflammation, the recovery of patients usually does not take much time; after a week or two, the patient’s gastrointestinal tract activity improves.

In other cases, gastropathy requires longer treatment and recovery, up to 3-4 weeks. After completing therapy, a gastritis patient should be examined by a gastroenterologist every six months.

Diet

Diet therapy is important for acute gastritis. As has already been clarified, for the first 3 days it is better for the patient to fast while sitting on the water. On the 4th day, you can begin the gradual introduction of gentle food into the diet.

The principle of diet therapy is:

1. Exclusion of foods rich in fiber, salt, seasonings, yeast, flavorings;
2. Quitting alcohol;
3. Portions should be kept to a minimum;
4. The basis of the menu, lean poultry, minced fish, pureed porridge or soups in the form of puree;
5. It is better to steam, stew or simply boil food;
6. All food must be ground to a puree;
7. The serving temperature is 50-55 degrees, because hot or cold food irritates the stomach.

Consequences

If proper treatment is not received, acute gastritis becomes chronic, and quite quickly. It can also be complicated by pathologies of the cardiovascular system, kidney or liver failure, gastrointestinal bleeding or complications of a purulent-septic nature.

The acute form of corrosive gastritis sometimes leads to perforation of the gastric walls, penetration of contents into the peritoneal cavity, peritonitis or shock, etc. If a chemical burn injury occurs, then restoration of the mucous membranes can become difficult and even impossible.

Prognosis and prevention

If the pathology is detected in time and the patient immediately receives proper treatment, then the prognosis is quite favorable.

Acute infectious gastritis can threaten patients with a weak immune status, elderly patients, and those with concomitant pathologies. In general, the course and severity of the pathological process depends on the etiological factor, as well as the prognosis for recovery.

Gastroenterologists give the most favorable prognosis for phlegmonous and corrosive forms of inflammation, in which death can occur only in half of the cases.

Mortality is possible already in the first few days after the attack due to acute purulent peritonitis, abdominal abscess, sepsis or shock.

To prevent such acute inflammations it is necessary:

• Eliminate poor quality foods from the diet;
• Contact specialists in a timely manner for treatment of intraorganic pathologies;
• Eliminate unhealthy addictions;
• Take medications strictly as prescribed by your doctor;
• Observe strict personal hygiene standards;
• Regularly undergo gastroenterological examination if there is a history of acute inflammation of the gastric mucosa.

As for the prevention of pathology in children, it is imperative to properly organize a healthy diet for the baby, it is imperative to teach the child to maintain hygiene, protect the baby from psycho-emotional overload, etc.

Gastritis in various forms today affects more than 65% of the population. One of the varieties of this disease is erosive gastritis.

About the disease, code according to ICD-10

Erosive gastritis is a gastrointestinal pathology that occurs as a result of inflammatory damage to the gastric mucous membranes. In this case, multiple or single erosive formations appear on the mucous tissues.

Erosion manifests itself in the form of inflammation of a focal nature and over time can spread over large areas. There are several of these foci, and the degree of their development depends on the severity of the pathology.

Erosive gastritis in the international classification of diseases is listed under code K29.0 and is designated as an acute hemorrhagic pathology. Typically, such gastritis manifests itself in and is complicated by internal bleeding.

But there are also erosive types that are sluggish or asymptomatic. Such gastritis is considered the longest lasting and occurs mainly in adult men.

Causes

The erosive type of inflammation of the gastric mucosa has a lot of factors that provoke its development. These factors can be internal or external.

In fact, erosive gastritis is a stage at which mucous tissue begins to break down, defects and bleeding occur.

Forms

Gastritis of the erosive type can be acute and chronic, and the pathology is also divided into primary and secondary.

Primary inflammation develops in patients who have not previously suffered from gastrointestinal pathologies. Typically, such gastritis occurs against the background of long-term trauma of a psycho-emotional nature, unfavorable living conditions, etc. Secondary erosive gastritis occurs against the background of pathologies of an infectious nature.

Depending on the location of the inflammatory erosive process, the pathology is of the antral type. With this form, reflux-erosive gastritis is usually diagnosed. In advanced forms, the mucous membranes begin to peel off and are expelled through vomiting.

Chronic

The chronic course of erosive gastritis is a complication of chronic pathologies. In this case, remissions are replaced by exacerbations. Often this form has an antral localization and manifests itself in the form of reflux.

Erosive formations usually have a length of up to 0.7 cm.

Spicy

Acute erosive gastritis usually forms against the background of burns or traumatic injuries. With such an inflammatory lesion, the patient releases blood in the stool and vomit.

Symptoms

The erosive form of inflammation is almost no different in symptoms from other gastritis - only the appearance of blood impurities in stool and vomit indicates a similar nature of the pathology.

The main gastritis manifestations include the following conditions:

1. Painful, spastic sensations in the stomach area - in the initial stages of the pathology are mild, but with the formation of ulcerative lesions, pain symptoms increase;
2. Feeling of heaviness in the stomach area;
3. Severe heartburn that has nothing to do with meals;
4. Often alternating diarrhea and constipation, with blood in the stool;
5. Noticeable weight loss of the patient;
6. Unpleasant-smelling belching with a sour (hyperacid form) or rotten (hypoacid type) taste;
7. Feeling of bitterness in the mouth and dryness;
8. Absent or pronounced;
9. Bleeding in the stomach, as indicated by black stool;
10. Increased pain after eating and prolonged fasting.

Chronic forms of erosive inflammation of the gastric mucosa often occur latently.

Exacerbation of the disease

The chronic form of erosive gastritis has acute periods when the disease worsens. They are usually seasonal and occur mainly in autumn and spring. Patients feel quite severe stomach pains localized in the epigastric region.

Such pain occurs most severely after eating, especially after eating spicy or sour foods. Patients also complain of frequent heartburn and nausea, belching or vomiting, stool disorders and other discomfort.

An exacerbation begins against the background of irregularities in the diet and frequent stress, hard work or chronic fatigue.

Helicobacter pylori, autoimmune reactions and concomitant pathologies, intestinal infections or intoxication due to poor-quality food can also provoke an exacerbation. Typically, the symptoms of exacerbation occur very abruptly, although a gradual increase is also allowed.

Diagnostics

To identify erosive gastritis, the doctor prescribes:

• General analysis of blood, urine and feces;
• Biochemical blood test;
• Examination of vomit;
• for Helicobacter pylori infection, as well as ELISA and PCR diagnostics;

But the most significant method is (FGDS) with a biopsy of the material. He carefully detects the source of bleeding, its size and location. If this method is contraindicated, it is prescribed with the introduction of a contrast agent.

Carefully! This video shows FGDS of the stomach with hemorrhagic erosive gastritis (click to open)

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How to treat erosive gastritis?

In terms of symptoms, erosive inflammation of the stomach resembles peptic ulcer disease, therefore the therapy for these conditions is similar.

The doctor selects the necessary medications in accordance with the specific form of the pathological process. Therapy includes diet and medication, folk remedies, etc.

Home remedies such as agave juice, alkaline mineral water, etc. are excellent for erosive gastritis.

Medicines

Drug therapy for erosive gastritis requires an integrated approach.

• In case of excessive secretion, proton drugs like Omez or Lansoprazole, Controdlok, etc. are used.
• Histamine blockers such as Famotidine, Ranitidine or Kvamatel are also prescribed.
• To reduce the negative impact of hydrochloric acid secretion, drugs such as Maalox, Almagel or Phosphalugel are used, which create a protective film over the affected area.
• If the inflammatory process is of Helicobacter pylori origin, the use of antibiotics such as Metronidazole, Clarithromycin or Amoxicillin is suggested.
• To restore motility of the duodenum and gastric muscles, drugs like Cerucal or Motilium, Metoclopramide, etc. are prescribed.
• To stop bleeding in the case of erosive-hemorrhagic gastritis, Vikasol, Etamzilat or Dicynon are prescribed.

To eliminate the root cause of the pathological process, appropriate medications are also prescribed. If antibiotic therapy is intended, then the course must be completed, otherwise the bacteria will multiply again and fill the digestive system.

To normalize acidity, it is also necessary to take drugs from the group of antacids and hydrochloric acid secretion blockers. But all medications must be taken exclusively as prescribed by a doctor.

Diet and menu

Erosive inflammation of the gastric mucosa cannot be cured without specialized diet therapy. Usually, during an exacerbation, patients are prescribed diet No. 1, and after it is relieved - table No. 5.

In this case, patients are prohibited from eating foods that provoke an increase in the secretion of gastric juice and irritate the mucous membranes (fermented and fried, smoked or fatty, salty dishes or heavily seasoned with spices).

The diet should always contain vegetables and fruits. It is better to cook dishes by steaming or boiling.

Meals should become frequent, but portions should be reduced to a minimum. Food should be at room temperature, but it is forbidden to eat fresh bread and pastries, cookies, chocolate and other sweets of this kind.

You can eat crackers or dried day-old bread, potatoes and a variety of cereals, lean meat and fish. The menu should also include non-acidic dairy products, a little butter, fruits and vegetables, drinks like tea, herbal infusions, and weak coffee.

Fruits

For erosive gastritis, you can eat sweet and ripe fruits without skin, peeled tangerines or melons and ripe sweet berries, watermelons and grapes.

You can cook compotes from these fruits and berries or add them to non-acidic cottage cheese.

Folk remedies

Often, to alleviate pathological symptoms, patients use folk remedies against erosive gastritis. These include:

• Sea buckthorn oil. You need to take this product one small spoon twice a day before your main meals. The course of oil therapy is 30 days.
• Celandine is ground in a mortar and a large spoonful of the resulting powder is poured with boiling water. A couple of hours after full infusion, the mixture is filtered and taken for a month three times a day with a small spoon approximately 60 minutes before food enters the stomach. After completing the course, take a 10-day break, and then again carry out a month of treatment.
• It is useful to drink half a glass and only freshly squeezed.

Various gastric preparations are also useful for erosive gastritis, which you can prepare yourself, as well as purchase ready-made in pharmacies. Such collections usually include herbs like marshmallow or valerian, celandine or, caraway and nettle, wormwood, etc.

How to take propolis for treatment?

Useful in the treatment of erosive inflammation of the gastric mucosa and. It is recommended to eat a spoonful of it on an empty stomach. Propolis strengthens the immune defense and renews mucous membranes that have been subject to inflammatory damage.