Chr erosive gastritis mcb 10. Chronic erosive gastritis: signs of this disease and its treatment

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, ICD-10 code

Erosive gastritis is a pathology of the gastrointestinal tract that has arisen as a result of an inflammatory lesion of the gastric mucous membranes. At the same time, 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 the 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 proceed sluggishly or asymptomatically. Such gastritis is considered the longest 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 tissues begin to break down, defects and bleeding occur.

Forms

Erosive type gastritis is 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, adverse living conditions, etc. Secondary erosive gastritis occurs against the background of pathologies of an infectious nature.

Depending on the localization of the inflammatory erosive process, the pathology is of the antral type. With this form, reflux-erosive gastritis is usually diagnosed. With advanced forms, the exfoliation of the mucous membranes begins and their removal to the outside along with 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 is usually formed against the background of burn or traumatic injuries. With such an inflammatory lesion, the patient releases blood in the feces and vomiting.

Symptoms

The erosive form of inflammation almost does not differ in symptoms from other gastritis - only the occurrence of blood impurities in the feces and vomit indicates a similar nature of the pathology.

The main gastritis manifestations include the following conditions:

Painful spastic sensations in the stomach area - at the initial stages of the pathology are of a weak nature, but with the formation of ulcerative lesions, pain symptoms increase;
Feeling of heaviness in the stomach;
Severe heartburn, which has nothing to do with meals;
Frequent diarrhea and constipation, with blood in the stool;
Noticeable weight loss of the patient;
Unpleasantly smelling belching with a sour (hyperacid form) or rotten (hypoacid type) taste;
Feeling of bitterness in the mouth and dryness;
Absence or pronounced;
Bleeding in the stomach, as indicated by black feces;
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. Usually they are seasonal and occur mainly in autumn and spring. Patients feel quite strong stomach pains, localized in the epigastric zone.

Most of all, such pain occurs after eating, especially after eating spicy or acidic foods. Also, patients complain of frequent heartburn and nausea, belching or vomiting reactions, stool disorders and other discomfort.

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

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

Diagnostics

To identify erosive gastritis, the doctor prescribes:

General analysis of blood, urine and feces;
Blood chemistry;
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, their size and location. If this method is contraindicated, it is prescribed with the introduction of a contrast agent.

Carefully! This video shows gastric EGD with hemorrhagic erosive gastritis (click to open)

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How to treat erosive gastritis?

According to the symptoms, erosive inflammation of the stomach resembles a peptic ulcer, therefore, the therapy for these conditions is similar.

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

Great help with erosive gastritis are home remedies such as agave juice, alkaline mineral water, etc.

Medications

Drug therapy of erosive gastritis requires an integrated approach.

With excessive secretion, proton drugs like Omez or Lansoprazole, Controdlock, 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.
With the Helicobacter pylori origin of the inflammatory process, the use of antibiotics such as Metronidazole, Clarithromycin or Amoxicillin is suggested.
To restore motility of the duodenum and gastric muscles, drugs such as Cerucal or Motilium, Metoclopramide, etc. are prescribed.
To stop bleeding in the case of erosive-hemorrhagic gastritis, Vikasol, Etamzilat or Dicinon are prescribed.

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

To normalize acidity, it is also required to take drugs from the group of antacids and hydrochloric acid blockers. But all drugs should be taken exclusively on medical prescription.

Diet and menu

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

At the same time, patients are forbidden to eat food that provokes an increase in the secretion of gastric juice and irritates the mucous membranes (fermented and fried, smoked or fatty, salty dishes or heavily seasoned with spices).

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

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

You can eat crackers or dried yesterday's bread, potatoes and a variety of cereals, lean meat and fish. Also on the menu should be non-acidic dairy products, a little oil, fruits and vegetables, drinks like tea, herbal decoctions, weak coffee.

Fruits

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

From these fruits and berries, you can cook compotes 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 in a small spoonful twice a day before the main meals. The course of oil therapy is 30 days.
The celandine is crushed 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 in a small spoon about 60 minutes before food enters the stomach. After the end of the course, a 10-day break is taken, and then a monthly treatment is carried out again.
It is useful to drink half a glass and only freshly squeezed.

Useful for erosive gastritis and various gastric preparations that can be prepared independently, as well as purchased ready-made in pharmacies. Such fees usually include herbs like marshmallow or valerian, celandine or, cumin 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 it on a spoonful on an empty stomach. Propolis strengthens the immune defense and renews the mucous membranes that have undergone inflammatory damage.

Gastritis is a pathology in which there is inflammation of the gastric mucosa. Modern medicine knows different forms of this pathological condition, which are accompanied by characteristic symptoms in children and adults. The disease is more often encountered by people who do not eat right, have addictions, and are constantly exposed to stress. For the convenience of classifying the disease, specialists use the ICD coding.

Classification

ICD10 is an international classifier of diseases that is used to assess the quality of medical care, as well as for general epidemiological purposes. Gastritis according to ICD 10 is assigned code 29, and its varieties are determined by additional numbers:

		Type of pathology
		Acute hemorrhagic
		Acute stage of various types of illness
		Alcoholic
		Superficial gastritis mcb 10
		Chronic (atrophic disease)
		Chronic (fundal and antral ailment)
		Chronic forms of other gastritis, ICD code 10
		Unspecified types of disease
		Duodenitis
		Gastroduodenitis

special shapes

Modern medicine identifies special types of pathological conditions that have different names, and therefore they can be assigned a different coding according to the international classifier:

Atrophic form of the pathological condition. Due to the nature of the course of this disease, other names may be assigned to it. For example, stomach polyps, which, according to the ICD, have code 31.7. Also, with such a pathological condition, patients can be diagnosed with neoplasms in the stomach, which are of a benign nature. In this case, the disease will be listed under the number 13.1 in the international classifier.
Ailment "Menetrie". This pathology is a hypertrophic type of gastritis. In the international classifier, she was assigned the code 29.6. A distinctive feature of the pathological condition is the hypertrophy of epithelial folds on the gastric mucosa.

It is worth noting that lymphocytic pathology is considered a special type of disease, with the development of which lymphocytes begin to accumulate in the epithelial layer of the gastric mucosa. Some varieties of the disease have an infectious etiology, which is why the international classifier will be taken into account in the appropriate section.

The diagnosis of gastroduodenitis is made in the presence of inflammatory processes in the inner lining of the duodenum and the pyloric part of the stomach. Previously, this disease and its types did not have its own group in the classification of diseases of the international level (ICD), giving way to two separate diseases - gastritis (K29.3) and duodenitis (K29).

Today, a common combination of two pathologies has its own code in ICD 10 - 29.9 and is referred to as "gastroduodenitis, unspecified." Let's understand the concept of gastroduodenitis code according to the 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 the level of acidity.
The main impetus for the appearance of inflammatory processes is the decrease in the totality of the protective systems of the human body.
Both diseases have other identical 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 a patient, or vice versa.

Therefore, during the 10th revision of the ICD, it was decided to create a separate code - K29.9, referring to the grouping K20 - K31 (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 happens:

Primary and secondary pathology, taking into account the causes and conditions of the 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 inflammatory processes, as well as swelling and redness of the affected organ, with atrophy and metaplasia of the stomach.
The symptomatology of the disease divides it into 3 phases - exacerbation, partial or complete remission.
When examining a patient with an endoscope, it is possible to identify the main types of the disease, on which the subsequent treatment scheme 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 12 duodenal ulcers. This may be improper and malnutrition, experienced stressful situations, constant stay in nervous excitement, causing exhaustion, as well as past diseases of the gastrointestinal tract, which affected the protective functions of the body. It is impossible to accurately diagnose at home; this requires an examination by a qualified gastroenterologist and a series of examinations.

Gastroduodenitis is divided into 2 forms:

Acute.
Chronic.

Acute gastroduodenitis

Acute gastroduodenitis according to ICD 10 can occur for a number of reasons: unbalanced, malnutrition, nervous strain, past infectious diseases, including pathologies of the liver, gallbladder and pancreas, hereditary predisposition.

Symptoms in acute form of gastroduodenitis:

The presence of acute chaotic pain in the region of the stomach and upper abdomen.
Feeling unwell, apathy, feeling tired. Dizziness.
Nausea, the presence of vomiting and other dyspeptic disorders (heartburn, bad taste in the mouth, bad breath, belching, etc.).

Inflammatory processes occurring in the stomach and duodenum eventually lead to impaired motor functions and normal functionality of the organs, so it is important to identify the disease in time. The symptomatology of acute gastroduodenitis is suitable for a number of other diseases of the digestive system, so you should not self-diagnose. It is necessary to consult a doctor in time and start 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 seen in the spring and autumn periods and are caused by a decrease in the protective functions of the body due to climate change, violations of the diet and diet, the presence of viruses and infections in the air. And the period of the course of the disease with a noticeable weakening or complete disappearance of symptoms.

Symptoms in the chronic form of gastroduodenitis:

Usually, during an exacerbation, the patient experiences acute cramping pain in the abdomen in the region of the stomach. Spontaneous and chaotic pains disappear on their own after 10 days, and pains with physical palpation of the patient disappear after 21 days (approximately 3 weeks).
General weakness, lethargy, dizziness and headaches, drowsiness or sleep disturbances, rarely fainting.
Paleness of the skin, caused by a lack of a complex of vitamins in the blood.
Feeling of nausea, gag reflexes and other dyspeptic disorders.
Sensation of full stomach. Constipation or diarrhea may occur.

As in the case of acute gastroduodenitis, the chronic form cannot be determined without examination in the hospital. In addition to an external examination and listening to complaints about the patient's state of 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 diagnostics (a biopsy will help to identify the presence or absence of atrophy), examination of gastric juice and other endoscopic examinations, ultrasound, PH-metry. Indications of surveys will help the gastroenterologist to identify the disease, determine the form and stage of the course of the pathology. Only after accurately establishing the type and stage of the disease, the doctor will be able to prescribe a qualified treatment, the main thing is to seek help when the first symptoms are detected.

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

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

Definition and code of the disease according to ICD-10

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

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

Reasons for development

Provoke the development of acute gastritis inflammation can be enough reasons, among which are:

Abuse of alcohol and coffee, which are quite aggressive on the gastric mucosa, increasing their permeability;
Unhealthy diet with frequent consumption of hot meals or hard to digest foods, too many spices like horseradish, vinegar or mustard;
Penetration into the digestive system of toxins such as alkali, alcohols or acids, heavy metals, etc.;
Tendency to allergic reactions to various products, for example, with or bronchial asthma. In this situation, gastritis may well occur in combination with allergic reactions;
Infectious pathologies of the gastric cavity like or staphylococcus, as well as viral pathologies;
Excessive drug abuse, long-term drug therapy with a violation of the treatment regimen. Sometimes drugs even cause internal bleeding, as they greatly thin the walls of the organ;
A history of serious pathologies such as heart attacks, stroke, or severe burns, surgery or traumatic injuries;
material exchange violations;
Radiation exposure, for example, in 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 the symptoms, causes and degree of damage to the mucous tissues. In general, 4 types of pathology are distinguished: fibrinous and catarrhal, phlegmonous or corrosive.

fibrinous gastritis is formed against the background of severe infectious pathologies such as scarlet fever or, as well as when affected by mucous acid or alcohol. This form of pathology proceeds with necrotic lesions of 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 the 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 mucosa, hemorrhages and small flat-type erosions (with erosive gastritis).
Phlegmonous type is a purulent inflammatory process that covers all gastric layers. Traumatic and oncological factors, ulcerative processes lead to such a lesion. Gastric mucosa becomes thicker due to fibrin overlays. The course of the disease is quite difficult 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 erosion and ulcerative defects are formed. There is a high risk of developing peritonitis, kidney or myocardial insufficiency, gastric perforation, etc.

Also, acute gastritis is 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. In order for the pathology to manifest itself in full force, a few hours after infection are enough.

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

In addition, they provoke the development of infectious gastritis and Helicobacter pylori microorganisms with neglect of personal hygiene.

Pathology is accompanied by severe nausea, up to indomitable vomiting, hyperthermic reactions and general malaise, severe epigastric pain.

Symptoms

Usually, 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:

A sharp decrease in appetite;
The occurrence of pain in the epigastrium;
Development of a nausea-vomiting reaction;
The appearance of an unpleasant aftertaste in the oral cavity;
Problems with the stool like diarrhea, bloating, etc.

Vomiting reactions provoke, dark circles around the eyes appear in patients, diuresis decreases, the skin turns yellow, severe weakness appears, etc.

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

Diagnostics

If symptoms occur, the patient should contact the doctor, who will examine and collect anamnestic data, prescribe laboratory and instrumental diagnostics. Usually assigned:

General blood test aimed at assessing the number of leukocytes, hemoglobin and neutrophils;
A study of urine, where acetone and urates are found in acute gastritis;
A coprogram that involves the study of fecal masses for occult blood, as well as to assess the functionality of the gastrointestinal tract;
Bakposev feces to determine pathogens;
Biochemistry to detect possible comorbidities such as dysfunction of the gallbladder and liver, pancreatic structures, etc.;
, detection of antibodies to Helicobacter pylori.

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

Treatment of acute gastritis in children and adults

Therapy of an 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 bowel cleansing is also necessary. On the first day, the patient is on a starvation diet, and on the second day he is allowed to drink warm water.

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

Medications

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

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

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 is improving.

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

Diet

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

The principle of diet therapy is:

Exclusion of foods rich in fiber, salt, seasonings, yeast, flavorings;
Refusal of alcohol;
Portions should be minimal;
The basis of the menu, lean poultry meat, minced fish, pureed cereals or soups in the form of mashed potatoes;
Food is best steamed, stewed or simply boiled;
All food must be ground to a puree state;
The serving temperature is 50-55 degrees, because hot or cold food irritates the stomach.

Consequences

If proper therapy is not received, acute gastritis becomes chronic, and rather 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 the contents into the peritoneal cavity, peritonitis or shock, etc. If chemical burn damage occurs, then the restoration of the mucous membranes can become difficult and even impossible.

Forecast and prevention

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

Acute infectious gastritis can threaten patients with a weak immune status, elderly patients, and those with comorbidities. 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 forecasts 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 inflammation, it is necessary:

Exclude low-quality products from the diet;
Contact specialists in time for the treatment of intraorganic pathologies;
Eliminate unhealthy addictions;
Take pharmaceuticals strictly according to the doctor's prescription;
Observe strict personal hygiene standards;
Regularly undergo a gastroenterological examination if there is a history of acute inflammation of the gastric mucosa.

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

Causes of erosive gastritis include non-steroidal anti-inflammatory drugs, alcohol, stress and, less frequently, radiation, viral infection (eg, cytomegalovirus), vascular disorders, and direct mucosal trauma (eg, nasogastric tube).

Erosive gastritis is characterized by superficial erosion and point damage to the mucous membrane. They can develop up to 12 hours after the initial injury. Deep erosions, ulcers, and sometimes perforation may occur in severe cases or if left untreated. Injuries are usually localized in the body of the stomach, but the antrum may also be involved in the process.

Acute stress gastritis, a form of erosive gastritis, develops in approximately 5% of critically ill patients. The likelihood of developing this form of gastritis increases with the length of the patient's stay in the ICU and depends on the time the patient does not receive enteral nutrition. The pathogenesis likely involves hypoperfusion of the gastrointestinal mucosa, leading to destruction of the mucosal protective factor. In patients with traumatic brain injury or burns, an increase in acid production is also possible.