Difference between erosion and gastric ulcer. Erosion of the stomach - damage to the mucous membrane with dangerous consequences

The gastric mucosa may be subject to various damages. Quite often conditions such as mucosal erosion and... Let's tell you what the differences are between these diseases.

Erosion is the name given to superficial damage to the gastric mucosa. The defect develops only in upper layers without affecting the submucosa.

The formation of an ulcer is the appearance of a defect not only in the mucous membrane, but also in the muscular layer of the stomach wall.

Development mechanism

The mechanisms of development of erosion and gastric ulcers are the same. In case of erosion pathological process stops earlier. For an ulcer to form, longer exposure to damaging factors is required.

Reasons that can cause erosion of the gastric mucosa:

constant exposure to too cold or too hot food and drinks;
food with big amount spices;
taking medications that irritate the mucous membrane;
Availability foreign body in the stomach;
increased production of hydrochloric acid;
irregular nutrition and irritation of the mucous membrane with gastric juice.

Under the influence of these factors, mucosal cells begin to collapse, and this area loses its protective properties. Formed wound surface called erosion. The process can stop at this stage, and when proper treatment the erosion is completely healed. If the impact continues causal factors and there is no treatment, erosion turns into an ulcerative defect.

In addition to the above reasons, the following contributes to the formation of ulcers:

These reasons contribute to an increase in erosion and penetration of the defect into muscle layer gastric wall, and an ulcer develops.

Symptoms

Clinical manifestations for erosion and gastric ulcer will vary. The ulcerative process is more serious condition than erosive, and can lead to the development of dangerous complications.

If there is erosive damage, the person will be bothered discomfort while eating. The development of dyspeptic symptoms in the form of nausea and unstable stools is possible.

On examination there were no pathological changes not detected. There are no complications with erosion.

At peptic ulcer The clinic will be more extensive:

pain occurs not only during eating, but also several hours after it;
heartburn, nausea develops, loose stools appear periodically;
when viewed at height pain attack muscle retraction can be detected abdominal wall in the stomach area.

Ulcers are characterized by the development of complications. They can appear almost immediately after the ulcer forms or after several years.

Perforation and penetration of the ulcerative defect. These two complications involve the destruction of the muscle layer of the gastric wall and the formation of a through hole. In this case, the contents of the stomach enter abdominal cavity and causes peritonitis.
Stenosis of the gastric outlet. This late complication, develops several years after the formation of the ulcer. It is caused by deformation of the muscle wall around the ulcerative defect. As a result, the opening leading to the duodenum narrows, resulting in the passage of food being disrupted. Food bolus remains in the stomach and undergoes rotting.
Stomach bleeding. This complication develops when the ulcerative defect damages a large blood vessel. In this case, the patient exhibits signs internal bleeding: pale skin, drop in blood pressure, increased heart rate. Characteristic for stomach bleeding symptoms include vomiting "coffee grounds" ( Brown) and tarry stools (loose and black).
Malignization of ulcers is the most dangerous complication. This is the degeneration of a peptic ulcer into a cancerous tumor.

With erosion, symptoms are observed regardless of the time of year. The ulcer is characterized by seasonality, exacerbations appear in spring and autumn.

Diagnostics

A diet is prescribed that involves the exclusion of alcoholic and carbonated drinks, fast food, and heavily seasoned foods. The temperature of the food should be moderate. If possible, food should be of uniform consistency.
To relieve discomfort during meals, antacid medications are prescribed - Almagel, Gaviscon. They cover the area with erosion with a protective film, thanks to which it is not irritated by food.
To restore the mucous membrane, drugs with a regenerating effect are used, for example Methyluracil. Using a gastroscope, you can apply Methyluracil or Solcoseryl directly to the damaged area.

Treatment of peptic ulcer disease is more complex and takes longer:

Treatment may take several months or even years, but does not provide a 100% recovery. Stomach ulcer has chronic course and is prone to recurrence.

Consequences:

Typically, erosion full treatment disappears without a trace.
The ulcer takes a long time to heal, and relapses of the disease often occur.

For some reason, various types of damage can occur in the stomach. In some cases they are minor, in others they are very dangerous. Let's look at two types of serious defects, or rather, let's find out how erosion differs from an ulcer.

Definition

Gastric erosion– a pathology that affects the mucous membrane of the corresponding organ.

Ulcer- a defect that is characterized by deep penetration into the stomach tissue.

Comparison

The two phenomena in some cases represent stages of a single destructive process. Moreover, the difference between erosion and ulcer is that the first of them is formed on early stage, and the second – after some more time.

Initially occurs negative impact one or more factors. Abnormalities in the stomach can occur, for example, due to irregular eating habits, constant use hot liquids or taking irritating medications. All this, and much more, can lead to the destruction of mucosal cells and the occurrence of erosion.

It represents more light form diseases, since they only affect surface layer. The damaged area has a round or jagged shape and differs in color from the surrounding healthy tissue. The integrity of the mucous membrane during erosion can be impaired in several places at the same time, which aggravates the situation.

The development of erosion is indicated by spasms, discomfort when food is ingested, as well as bloody inclusions in stool or vomit. Fortunately, such a defect does not always degenerate into an ulcer. The pathogenic process may stop at this stage, especially if it has been necessary treatment. Fabrics at favorable outcome are completely restored, not even a scar remains.

But if provoking factors continue to operate and the person is in no hurry to see a doctor, there is a risk of earning more dangerous defect- ulcer. With it, in addition to the mucous membrane, the deeper layers of the organ are also corroded. Unlike erosion, this damage is detected not only by endoscopic examination, but also by x-ray examination.

What is the difference between erosion and ulcer regarding symptoms? The fact is that the latter, for obvious reasons, is felt stronger. Pain occurs here both during and after eating. The stomach may not accept the food consumed, and vomiting occurs. The ulcer is often accompanied severe heartburn, periodic bowel disorders.

The disease takes a long time to treat and tends to periodically worsen. The diet is prescribed in both cases, but with an ulcer it is more strict. In case of successful healing, a scar remains at the site of such a deep defect.

The therapeutic drug OMEZ, belonging to the group of inhibitors proton pump, prescribed for non-infected diseases gastrointestinal tract, as well as in the system complex therapy when the gastrointestinal tract is infected with the bacterium Helicobacter Pylori.

Main indications for use of the drug Omez

Prescriptions of drugs from the group of proton pump inhibitors are made only after a thorough diagnosis of the patient’s condition. In case of a confirmed diagnosis, the drug Omez is prescribed. Indications for the use of medicinal medication, are the following diseases:

with reflux esophagitis;
ulcerative-erosive damage to the walls of the stomach caused by taking non-steroidal anti-inflammatory drugs (hereinafter referred to as NSAIDs);
erosive and ulcerative lesion 12- duodenum caused by taking various drugs, including chemicals;
stomach and intestinal ulcers resulting from stressful situations;
when diagnosing Zollinger-Ellison syndrome;
as prophylactic during aspiration of gastric contents with pronounced acidity during general anesthesia, or Mendelssohn's syndrome;
with an infected bacterial infection gastric flora Helicobacter Pylori, but only as part of complex therapy.

Prescription of Omez for reflux esophagitis

Reflux esophagitis is best treated with a combination of complex anti-secretory therapy in combination with proton pump inhibitors (hereinafter referred to as PPIs). A significant increase in the sensation of heartburn caused by reflux esophagitis is provoked by the action of over-the-counter antacids. Their impact progresses due to the complex use of H2-blockers, as well as NSAIDs, which have always needed to be replaced with a drug with a lowering effect on gastric acidity. Since the cost of PPIs has decreased with the advent of Omez, use of NSAIDs drugs are not effective and economically profitable. PPIs are considered as safe as H2 blockers but are more effective. Until PPIs were first introduced into the Omez formula (omeprazole, Prilosec AstraZeneca, Wilmington, DE), the safety of use antiulcer drugs was a problem.

The result was that Omez (omeprazole) plays a large role in profoundly reducing acid secretion gastric juice. The cells responsible for the stimulating secretory properties of producing the appropriate amount of acid increase the release of the stimulating hormone gastrin. Gastrin levels tend to be elevated in patients taking NSAIDs, but they are generally not clinically significant.
Animal studies, especially using mice as a clinical trial model, PPI data have shown the proliferation of gastrin-secreting cells, and even the development of gastrinomamia as a specific condition of the body. Increased level gastrin (hypergastrinemia) is often observed in patients as an allergic reaction to PPIs, which over time poses a danger for this category of patients with the development of Gastrinomas.

Hypergastrinemia, or Zollinger-Ellison disease (ZES), is the most terrible diagnosis, caused allergic reaction on IPP. Normal level Gastrin in blood serum on an empty stomach is usually 110-150 mcg/ml. Antisecretory drugs can moderately increase gastrin levels in the range of 200-400 mcg/ml. However, in some study groups, approximately 5% of total number In patients taking PPIs, gastrin levels could exceed 400 mcg/ml. The only case recorded in the studies was in a patient with ZES with a fasting serum level of more than 1000 mcg/ml. But it is also necessary to take into account that about 10% of patients diagnosed with ZES have serum gastrins levels below 100 mcg/ml.

Prescription of Omez for peptic ulcer

Zollinger-Ellison disease (ZES), as a rule, represents a sublimation of recurrent multiple lesions of the mucous membrane of a peptic ulcer, as a result of hypersecretion of the gastrointestinal tract. Approximately 90% of patients develop multiple ulcers. For most, these ulcers are located in the first part duodenum.

Zollinger-Ellison disease may be accompanied by diarrhea as the main symptom of the disease, since secretory excess acid in the gastric juice can lead to inactivation of pancreatic enzymes as a result of malabsorption and steatorrhea. Signs indicating acid hypersecretion, such as disseminated recurrent peptic ulcers, diarrhea, or a history of multiple endocrine neoplasia type I, should prompt the body to send out ZES. This includes fasting serum concentrations of gastrin while taking a PPI, and secretin as a stimulation test for gastric acid secretion.

Method of diagnosing the disease

In practice, two methods are used to facilitate the most accurate diagnosis of the disease, the location of ulcers, and to determine further methods of prescribed treatment. The first step is to measure fasting gastrin levels, excluding PPI use, for at least one week. As mentioned above, gastrin readings greater than 1000 mcg/ml are usually a direct symptom of ZES. This, however, is not accurate diagnosis diseases, as in patients with pernicious anemia, where a similar indicator may also have serum gastrin levels in the same range. It is therefore important for the patient's clinical picture to be evaluated for gastrinoma.

For patients with serum gastrins levels greater than 1000 mcg/ml, only with gastric tube and gastric pH levels, may help distinguish between chronic atrophic gastritis from other reasons.
The second step is to measure the pH level. Elevated pH levels may be a precursor pernicious anemia. For patients with gastrin levels between 110 µg/ml and 1000 µg/ml, a secretin stimulation test can help guide further diagnosis and therefore therapy. This test is based on the fact that normal gastrin secreting cells will inhibit the formation of infustion secretin (usually an inhibitor of gastrin secretion).

Patients diagnosed with Zollinger-Ellison disease in the presence of gastrinoma, there is uncoupling of the secretin inhibitory receptor. Thus, these patients should have a persistent and significant increase in serum gastrin levels. After stimulation of secretin production, patients with other causes of hypergastrinemia do not experience an increase in serum gastrin levels. A decrease in any level should be recorded in the description of the progress of treatment of the patient’s disease and assessed clinical picture the patient's condition.

If the patient's body does not respond to secretin-inhibiting methods, imaging should be performed to try to localize the tumors. This can be done by scanning using the OctreoScan parting, or using endoscopic ultrasound (EUS). OctreoScan shows more accurate results studies of metastatic disease or lymph nodes. EUS endoscopy provides a more accurate image of the pancreas. The device is capable of showing the location of metastasis with great accuracy, and can allow finer tuning for the diagnosis of micro formations on the walls of the mucous membranes, which gives more full diagnostics during research.

Endosonographic studies show how total weight tumors consistent with islet cell tumors. Also, the data are the main indicator of the presence of gastrinsecreting cells in the immunostain, and how consistent they are with the level of gastrinoma. The most the right decision for the patient, this is to perform an endoscopy to evaluate his reflux and determine the diagnosis: his condition is associated with gastritis, or he still develops a stomach ulcer. CT scan, magnetic resonance imaging and EUS should be performed for imaging when gastrinoma is suspected.

Peptic ulcer as a result of psychological stress

Peptic ulcer disease has always been considered a classic example of psychosomatic interaction. But ulcers can be caused by household stress. Diagnosis in this area suffers from methodological limitations: insufficient documented diagnoses, as well as a lack of information about the main known risks and factors for the occurrence of ulcers.

“There are multiple doubts about the occurrence of ulcers as a disease. The mechanisms that may be associated with distortion and diagnostic bias against the background of the effect of stress, as one of the symptoms of the disease, are still not known and no associations have been found,” said Professor of Psychiatry Dr. Susan Levenstein, MD, Dr. medical sciences Aventino Medical Group clinics in Rome, Italy. Psychological stress increases the risk of peptic ulcer disease, regardless of Helicobacter Pylori infection status or use of nonsteroidal anti-inflammatory drugs.

In an effort to resolve the controversy surrounding the question: how much does it contribute? psychological stress symptoms of peptic ulcer disease, Dr Susan Levenstein and colleagues obtained blood samples to test for the presence of antibodies and bacterial infection Helicobacter pylori. The samples were obtained in addition to psychological, social, behavioral and medical data collected from 3,379 study inpatients and laboratory treatment V medical institutions Denmark. Also took part in the research World organization health (WHO). Her research topic was the study of risk and development peptic ulcers against the background of infection of the gastrointestinal tract. Stress was measured based on specific life stressors and various kinds disasters and accidents using a 10-point stress index.

Ulcer as a diagnosis was confirmed by reviewing radiological and endoscopic reports and searching all participants in the Danish National Patient Registry.

There were a total of 76 confirmed ulcer incidents throughout the study period. The risk of ulcer was reported to have the highest rate of 3.5%, compared with the lowest tertile of 1.6. Adjustments for H. Pylori positivity, alcohol consumption, or insufficient sleep had no effect on the scores. However, the index fell significantly after adjusting for socioeconomic status, and continued to fall after adjusting for smoking, NSAID use, and lack of exercise.

Multivariate analysis showed that stress, socioeconomic status, smoking, H. pylori infections and NSAID use were independent predictors of the disease. From all of the above, brief conclusions can be drawn:

Stress increases the risk of both gastric and duodenal ulcers. In these cases, Omez is prescribed in the form intravenous infusion, avoiding oral administration drug.
When diagnosing Zollinger-Ellison disease, the dosage of the drug is selected individually, but not higher than 120 mg per day.
For Mendelssohn's syndrome, the drug is prescribed before bedtime, but not more than 40 mg once.
For elderly patients, the dose of Omez taken is not adjusted.

You can learn more about gastric ulcers and duodenal ulcers by watching the video:

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Gastric erosion(lat. erosio corrosion) - a superficial defect in the gastric mucosa that does not reach the muscular plate and heals without scar formation. Etiology and E. zh. insufficiently studied. They are often diagnosed with e, ah, e, after various operations (so-called stress injuries). The emergence of E. zh. may be related to intake medicines(acetylsalicylic acid, ibuprofen, indomethacin, corticosteroids, etc.). Sometimes erosive lesions of the stomach (usually the antrum) can be an early stage of peptic ulcer disease. Often E. zh. accompany colon tumors, chronic liver diseases, of cardio-vascular system, respiratory organs, blood secondary erosion). Thus, erosion can be considered the result of a similar reaction of the gastric mucosa to various (general and local) pathological influences. In this case, the main importance is given to ischemia of the gastric mucosa, as well as to disruption of its permeability. It is assumed that increased secretion of hydrochloric acid and pepsin, bile reflux (see. Reflux ), as well as increased autoimmune reactions contribute to the transition of the process to chronic.

Erosion of the stomach is small (up to 10-15 mm in diameter) a defect of the mucous membrane of a round, jagged or triangular shape, not reaching the muscular plate. Erosion can be single (1-3) and multiple (more than three in different departments stomach). Damage to the mucous membrane of the entire stomach or most of it is classified as erosive-hemorrhagic gastritis.

There are acute and chronic erosions. Acute erosions are often located in the fundus and body of the stomach. They are characterized by the absence of surface epithelium, moderate infiltration by lymphocytes and the overlay of fibrin and the area of the bottom of the defect, in the area of the edges - flattening epithelial cells and hyperchromia of their nuclei, the presence of a large amount of DNA in the nuclei. Chronic erosions are most often localized in the antrum of the stomach. At histological examination reveal granulation tissue, dilation of blood vessels in the fundus, dystrophic changes and atrophy of the pyloric glands in the area of the bottom and edges of erosion, as well as focal hyperplasia of the surface epithelium in the area of its edges. With erosive-hemorrhagic e in the mucous membrane, along with e, multiple hemorrhages with rejection of the surface epithelium are noted.

Clinically E. g. often manifest as ulcer-like or hemorrhagic syndromes.

An ulcer-like syndrome can be observed in individuals with acute and chronic migraines. Patients are bothered by pain in epigastric region related to food intake, sometimes “hungry”, nausea, belching, heartburn. Hemorrhagic syndrome observed more often in patients with acute miliary and erosive-hemorrhagic diseases, manifested by gastric bleeding and post-hemorrhagic anemia. The process is often asymptomatic; in secondary cases, the symptoms of the underlying disease may predominate.

The leading diagnostic method is gastroscopy. During endoscopic examination, acute erosions are superficial defects of the mucous membrane (flat erosions), covered with blood, hemorrhagic or fibrinous plaque, chronic erosions look like small bulges with a depression in the center (“full” erosions). In case of infiltration, hyperemia, or changes in the relief of the gastric mucosa around the erosion, a targeted biopsy is performed in order to exclude a malignant tumor of the stomach.

When E. is detected. must be carried out comprehensive examination the patient and monitor him,

to promptly identify the underlying disease (usually the colon, chronic illness liver).

Treatment is basically the same as for peptic ulcer. Patients are prescribed an appropriate regimen, a gentle diet, antacids (precipitated calcium carbonate, magnesium oxide or basic carbonate, almagel), enveloping agents (bismuth preparations, etc.), anticholinergics (atropine), as well as metronidazole, which promotes the healing of defects in the gastric mucosa. Good effect possess the antipsychotic sulpiride. H 2 -histamine blockers - cimetidine, ranitidine, etc., as well as gastrozepine, which reduces the secretion of gastric juice. For E. g., occurring with hemorrhagic syndrome, which is more common in acute E. g., treatment in the surgical department of the hospital is indicated. Patients are transfused with blood and plasma, aminocaproic acid and fibrinogen are administered intravenously, Vicasol is administered intramuscularly, and the stomach is washed. cold water or cold isotonic sodium chloride solution. In case of ineffectiveness conservative treatment Using gastroscopy, diathermocoagulation or laser photocoagulation of bleeding vessels is performed.

At heavy bleeding sometimes they resort to surgical intervention up to gastric resection. For chronic

Often, gastric erosion (EG) begins other, more serious pathologies. The disease can be acute or chronic form, with periods of exacerbations and remissions. As they progress, lesions may bleed and degenerate into malignant formations. However, these consequences can be prevented by starting treatment on time.

General information about the disease

The formation of ulcers on the surface of the gastric mucosa is called erosion or erosive gastritis. The disease, unlike peptic ulcer disease, does not affect muscle tissue . In 10% of cases, the disease is also detected in the duodenum.

Stomach erosion was first discussed in 1759. Private Italian pathologist Giovanni Morgagni revealed erosive defects on the gastric mucosa and was the first to describe this disease.

Approximately 15% of patients complaining of painful sensations in the abdominal area, they suffer from gastric erosion. It's pretty high rate Moreover, every year the figure increases and continues to grow. The disease can occur in people of all ages.

Causes of gastric erosion

Among the main causes of erosions in the stomach are:

One of possible reasons erosion development is considered Helicobacter bacterium pylori, which negatively affects the gastric mucosa. Proof of her guilt is the presence of antibodies to the bacterium in the vast majority of patients with erosion.

Symptoms and signs

All children and adults with erosive gastritis have a painful appearance. The disease may have various symptoms depending on severity. On initial stages patients are tormented by:

the skin takes on a gray tint;
bruises appear around the eyes;
arises bad smell from mouth;
the tongue becomes covered with a white coating;
is decreasing physical activity and mood;
pain in the upper (epigastric, epigastric) region of the abdomen (especially after eating or on an empty stomach);
nausea and vomiting;
heartburn;
belching with a sour taste.

If the disease long time do not treat, then to general symptoms can join:

bleeding - appears in feces and vomit;
anemia in general analysis blood;
pathologies of bile outflow.

If you notice blood in your stool every day, you should urgently visit a doctor. Harmless diseases do not cause such symptoms. However, if blood appears in the stool once, there is no need to panic - this indicates a rupture. small vessel or rectal fissure, which is not dangerous.

Various forms of the disease

EZ has several forms, based on the cause of the disease:

Primary. Appears in the background poor nutrition, alcohol abuse, smoking, etc. Has no connection with other pathologies of the gastrointestinal tract (GIT).
Secondary. It is a consequence of another disease (diseases of the liver, stomach, blood, intestines, as well as various tumors).
Malignant. This form is spoken of when detected cancerous tumors. The cause may be blood cancer and others.

Diagnostic methods

To identify the disease, be sure to carry out:

Endoscopic examination. The main and most informative method. It is carried out using a flexible probe with a camera. The device is inserted through oral cavity into the stomach. Allows you to evaluate and identify defects in the form of ulcers and neoplasms.
Biopsy. Collection of biomaterial from the gastric mucosa for further diagnostics in the laboratory. Performed if cancer is suspected. The method detects the presence cancer cells with an accuracy of up to 99.99%.
X-ray examination with contrast agent. It is carried out after taking barium salts (barium sulfate is mainly used). This mixture is a good contrast. After an x-ray, all defects in the gastric mucosa are clearly visible, since barium tends to accumulate in the lesions.
Ultrasound ( ultrasonography) stomach. It also allows you to evaluate the structure of the stomach and its function, see erosive changes and inflammation. The method is less informative because it does not allow you to clarify finer details.

Besides instrumental examinations, you will definitely need to pass lab tests, including;

general blood and urine analysis;
blood chemistry;
coprogram (identification hidden blood in feces);
analysis for the bacterium Helicobacter pylori.

Based on the results general examination, the doctor may prescribe additional methods if the diagnosis remains in doubt.

Treatment

Treatment of EJ is a long and complex process. During an exacerbation, the patient should be on inpatient treatment. Here the condition of the gastric mucosa is periodically assessed and tests are carried out. Drugs are prescribed according to individual scheme, after the examination results. Mainly used:

antisecretory agents - reduce the production of hydrochloric acid ( ranitidine, kvamatel);
special preparations for the treatment of erosions and stomach ulcers ( Venter);
antacids - temporarily neutralize hydrochloric acid (Maalox, phospholugel).

With absence positive result, the patient is prescribed cauterization of ulcers using an endoscope.

Surgical methods are used in especially severe cases, complicated by massive bleeding or peritonitis. If bleeding in the affected areas cannot be stopped, then the stomach tissue is partially removed.

Taking medications without a doctor's prescription is unacceptable. Often, several drugs do not combine with each other and in combination lead to a worsening of the condition and various side effects.

Nutrition

When prescribing the main treatment, prerequisite is dieting. It is necessary to exclude from the diet all foods that injure the stomach and cause irritation. The prohibited list includes:

alcoholic drinks;
all types of soda;
hot and cold;
pickled cucumbers, tomatoes, etc.;
fatty foods;
herbs, spices;
mayonnaise, ketchup;
tomatoes and all dishes containing them;
sour berries;
some types of cereals (pearl barley, barley, buckwheat, millet);
products containing coarse fiber(bran, beets, greens, etc.);
smoked;
sweets, White bread, baked goods;
coffee Tea;
chocolate and cocoa.

During treatment you should eat:

dairy low-fat foods(milk, kefir, fermented baked milk, cottage cheese);
eggs, in any form, except fried;
jelly from non-acidic berries and fruits;
semolina and oatmeal porridge;
meat and fish products with minimal fat content;
steamed and baked vegetable dishes;
butter and all types of vegetable fats.

Folk remedies for stomach erosion

As aids have proven themselves to be excellent folk recipes, which are prescribed in parallel with the main treatment and diet:

Chamomile flowers. 1 tsp dry chamomile is poured into a glass of boiling water. The product is infused for an hour. You need to take half a glass (for adults) and 1 tbsp. (children), 3 times a day, before meals. The infusion has a powerful anti-inflammatory and wound healing effect.
Celandine. A teaspoon of crushed leaves is poured into 200 ml. boiling water Leave for 1 hour. After this, the broth must be filtered. Drink 1 tsp three times a day. It has wound-healing and bactericidal properties. The course of treatment should not exceed 1 month, because long-term use and exceeding the specified dosages may be harmful to health. After a break of 10 days, the procedure can be repeated.
Propolis. Prepare a tincture from 100 g. propolis and 100 gr. alcohol, shake thoroughly for 20-25 minutes and leave for 3-4 days to mature. Next, the solution is filtered and the resulting mixture is consumed 10-15 drops half an hour before meals. After 2-3 weeks, a pause is made for 10 days and after this period, the tincture continues. The product is very effective in long-term use. In addition, it provides positive influence on digestive tract and the entire body as a whole.

Disease prevention

Sticking to preventive measures, you can significantly reduce the risk of occurrence or exacerbation of the disease. To do this you need:

get rid of bad habits;
timely treat all pathologies of the gastrointestinal tract;
limit consumption of harmful foods;
avoid stress;
perform therapeutic exercises daily;
control physical activity;
get more rest and sleep;
provide the body essential vitamins and minerals;
Do not use medications on your own.

Complications

EJ is a progressive pathology, which, if left untreated, leads to various complications. It could be.