Chronic superficial atrophic gastritis. Superficial focal gastritis

Atrophic gastritis is a chronic progressive inflammatory pathological condition characterized by decreased function glandular epithelium. A characteristic feature dystrophy of cells that synthesize hydrochloric acid and enzymes that have a proteolytic effect is considered. Pathomorphologically chronic atrophic gastritis forms a thinning of the walls of the stomach due to the atrophic process that affects the surface and deep layers of the wall of the organs of the digestive system.

The inflammatory process in protracted pathology - chronic atrophic gastritis - is induced by various factors. The main and common microorganism is Helicobacter pylori (H. pylori). Pathogenic bacteria inhabits the mucous membranes of the stomach. Its toxic waste products destroy the mucus that protects the walls of the stomach.

Under the influence of Helicobacter pylori toxins, glandular cells are destroyed. It changes the level acid balance contents of the stomach and causes the development of a superficial pathological process. Gradually, superficial atrophic gastritis transforms into moderately severe atrophic gastritis.

Atrophic processes in the thickness and on the surface of the mucous membrane lead to the formation of a connective tissue scar in place of the glandular epithelium or the growth of cells characteristic of the intestinal epithelium. The result of the transformation will be the inability of the stomach to produce required quantity digestive enzymes, hydrogen and chlorine ions. Level indicator acid-base balance significantly increases and food processing processes in the stomach become worse. As a result, the food bolus moves forward in an unprocessed form. The main ones are listed.

Atrophic gastritis is usually considered to be precancerous conditions, modern researchers have come to this conclusion. However, not enough attention is paid to the diagnosis of atrophic gastritis. Patients do not always pay attention to discomfort, making subjective complaints. Carrying out an FGDS without taking a tissue sample for a biopsy will not achieve the desired result. diagnostic value. The procedure will not allow the doctor to identify existing changes in the epithelium of the stomach and timely detect the beginning of cancerous degeneration. Mostly, the diagnosis of the increasing atrophic process occurs on late stages. This explains why atrophic gastritis and cancer often occur and “go hand in hand.”

Focal atrophic gastritis

This chronic gastritis classified as precancerous conditions of the stomach. Epithelial cells undergo malignant degeneration in the absence of timely diagnosis and proper therapy.

The chronic pathological process is accompanied by a decrease in the secretory activity of the stomach and a significant decrease in the thickness of the mucous and muscular lining of the stomach. refers to focal. Not the entire mucous membrane is completely subject to atrophy, only certain areas. This course of the disease is characterized by great diversity clinical manifestations. It is easy to determine a list of symptoms that are considered specific.

The risk group for the development of atrophic gastritis of the stomach consists of elderly and elderly people. After a person reaches 45 years of age, the risk of developing chronic atrophic gastritis doubles. Let us note that for recent years atrophic gastritis has become significantly “rejuvenated”; cases of the disease affecting children and adolescents have been recorded.

Another factor increased risk considered to be already developed gastritis, prolonged disturbances in the quality and diet, eating large quantities of fast food, alcohol abuse and smoking cigarettes. Provoke acute atrophic gastritis in at a young age overwork and chronic protracted psychotraumatic situations are capable of. These circumstances influence the symptoms and treatment of atrophic gastritis and determine the further prognosis. The incidence rate in men and women has no obvious differences.

Clinical symptoms

Symptoms of atrophic gastritis depend on the stage of development and form of the process. In particular, superficial atrophic gastritis occurs without subjective sensations.

The main signs of atrophic gastritis:

A reliable diagnosis can be made with fibrogastroduodenoscopy and biopsy. Taking a sample of the material histological examination– an indispensable condition correct diagnosis. Malignancy – main danger gastritis.

Remember, with chronic atrophic gastritis, symptoms can for a long time be of an erased or non-pathognomonic nature for the disease, which will delay and complicate the detection of the disease.

Principles of treatment

Treatment of atrophic gastritis is carried out using medications and surgical interventions.

Treatment of chronic atrophic gastritis must be complex and multi-stage. Drugs are prescribed to help protect the mucous membrane and stimulate the secretion of gastric juice. To normalize digestive processes, enzymes, mineral and vitamin complexes are prescribed.

If not treated in time, the disease will lead to either malignancy or a decrease in secretory activity. Reducing the production of hydrochloric acid in the stomach will lead to digestive problems in general. The growth and transformation of elements is disrupted gastric epithelium, on same place the intestinal epithelium grows.

Standard treatment regimen

In order to competently draw up a treatment regimen for atrophic gastritis, it is necessary to deeply understand pathogenetic mechanisms its development and carry out treatment taking into account the existing clinical symptoms. Symptoms vary across categories of patients.

Symptomatic treatment of atrophic gastritis is prescribed for each patient individually, taking into account the condition and existing complaints. The attending physician should give recommendations.

Features of therapy for older people

The human body undergoes aging, age-related changes touch the mucous membranes of the body, including gastrointestinal tract. The changes are expressed in atrophy of the epithelial layer of the mucous membranes of the digestive system. The muscle fibers of the stomach begin to degenerate, and the glandular cells atrophy. This leads to a deterioration in the quality of digestive processes and difficulty in evacuation. food bolus. Patients suffering from diabetes mellitus and other metabolic disorders.

In older people, the incidence of acute processes decreases, but the frequency increases chronic processes and complications. The atrophied epithelium is replaced by scar tissue and leads to a decrease in motor functions of the stomach.

When starting therapy for elderly patients, it is necessary to approach the issue taking into account the nature of the pathology and the prevalence of the process. The treatment plan must be developed with absolute precision and certainty. Older people are often exposed to multiple chronic conditions at the same time; it is important to prevent polypharmacy. This is the name given to the simultaneous prescription of excessive amounts of drugs. Only the doctor decides how to treat atrophic gastritis of the stomach.

During the remission stage, it is very useful to take an approach such as treatment folk remedies. Allowed to use herbal infusions and drink juices from vegetables, which relieve pain and inflammatory process in the stomach.

General groups of drugs

1. Drugs to stimulate production active substances and pepsin for atrophic gastritis. According to practicing specialists, the effectiveness of such drugs is low and they require very long-term use. Their effect is usually short-lived.
2. Replacement drugs. The necessary agent for therapy is a complex of hydrochloric acid with pepsin. You should drink it immediately before you start eating. In addition, Creon, Mezim, Festal, and peppermint tincture are prescribed for replacement purposes. In general, the prescription of replacement therapy depends on what acidity of gastric juice is determined in the patient in each specific case of gastritis.
3. Drugs for protecting the mucous membrane and its regeneration are called gastroprotectors in medicine. This group includes solcoseryl, Actovegin, Venter, de Nol. Most often, these drugs are used for ulcerative and erosive processes in the stomach, accompanied by subsequent atrophy of glandular cells.
4. Astringents and enveloping drugs, which have a pronounced anti-inflammatory effect. This group includes preparations based on aluminum and bismuth for the treatment of gastritis.
5. To stimulate gastric motility and peristaltic activity, medications such as domperidone are used. For the treatment of trophic gastritis, complexes of these drugs are selected.

Active atrophic gastritis requires hospitalization. If foci of tissue necrosis develop at the site of atrophy, surgical treatment is required. In this case, the patient undergoes gastric resection. Drug treatment after surgery consists of prescribing replacement therapy.

Diet for atrophic gastritis

To maintain normal digestive function food should be gentle. It is necessary to exclude heavy spicy and salty foods, alcohol and strong coffee from the diet. Meals must be taken in fractions, small portions and often. The diet should be balanced and contain all the necessary proteins, fats and vitamins.

It is preferable to boil or steam the products; it is acceptable to bake them in the oven. It is not recommended to eat hot or excessively cold foods.

Atrophic gastritis is a chronic disease of the stomach, which is classified as a precancerous condition, since according to statistics, the probability of cancer with this disease is close to 15%.

In addition to the threat of a malignant tumor, this pathology brings the patient a lot of inconvenience associated with impaired digestion and absorption of vitamins and other important chemicals. In view of this, gastric atrophy must be treated by combining drug therapy and a special therapeutic diet.

What is it?

Atrophic gastritis is chronic pathology, characterized by thinning of the gastric mucosa and severe secretory insufficiency. There are many reasons that can lead to atrophy of the mucous membranes, but most often this occurs due to infection Helicobacter pylori.

Causes

There is no consensus among experts about the reasons that provoke the development of this disease. Among the factors contributing to the occurrence of atrophy of the gastric mucosa are the following:

• consumption of rough foods and insufficient chewing of food;
• carbonated drinks, coffee, alcohol;
• smoking;
• constant overeating;
• eating large quantity hot, spicy and other products with an aggressive taste;
• excessively hot or cold food;
• long-term use of medications;
• reflux (reflux of intestinal contents into the stomach).

All of these factors affect the mucous membrane irritant effect, eventually leading to the occurrence of atrophic processes in it.

Symptoms of atrophic gastritis

The main manifestations of atrophic gastritis are caused by functional impairment stomach, developing against the background of changes in the mucous membrane. Among these symptoms are:

• pain syndrome- stupid aching pain, worse after eating, due to overstretching of the stomach walls;
• dyspeptic syndrome (indigestion syndrome) – decreased or complete absence loss of appetite, belching of air or rotten food, nausea, feeling of heaviness and fullness in the epigastric region, putrid smell from the mouth, bad taste in the mouth;
• anemic syndrome – characteristic changes in a general blood test in combination with rapid fatigue, deterioration in tolerance to usual physical activity, drowsiness, apathy;
• excess syndrome bacterial growth– rumbling in the stomach, increased gas formation, unstable stool;
• dystrophic syndrome is the result of impaired absorption of vitamins and digestion of nutrients.

At first, all these signs are subtle, but as the pathological process progresses, it develops quite quickly. complete exhaustion body.

Chronic atrophic gastritis

This is a sluggish illness, during which thinning of the gastric mucosa occurs, a decrease in the amount of gastric juice production due to a decrease in the number of glands.

In approximately half of the cases, such a disease is necessarily accompanied by a change in the structure of the membrane, i.e., its metaplasia. This is caused by a decrease in the number of normal cells and glands and the formation of hybrids that have a combination of characteristics that should not normally exist.

Gastric cells are often replaced by intestinal cells. In addition, the disease is distinguished by the fact that as it progresses, it involves anatomically located nearby areas in the inflammatory process. internal organs Gastrointestinal tract, as well as disruption of the functioning of the circulatory and nervous systems.

Often the chronic form is manifested by such symptoms as:

• pain in the stomach - usually dull in nature and occurs on an empty stomach or some time after eating food;
• discomfort – determined by pressure, bloating, a feeling of heaviness and rapid saturation;
• severe heartburn;
• belching with a sour, unpleasant odor;
• flatulence;
• increased sweating;
• discomfort in oral cavity associated with the appearance of a whitish coating on the tongue and a metallic taste;
• significant reduction in body weight, which is caused by aversion to food;
• pale skin;
• increased fragility of nail plates and hair loss;
• the occurrence of an inflammatory process in the gums;
• weakness and lethargy of the body.

In addition, there are specific signs for some types of atrophic gastritis.

Diagnostics

Correct diagnosis of atrophic gastritis consists of methods such as x-ray, FEGDS (fibrogastroduodenoscopy), histological examination, general analysis blood, ultrasound, assessment of stomach functionality.

1. Ultrasound can detect smoothing of folds along with a decrease in the size of the organ.
2. FEGDS shows thinning of the mucosa, a change in its color to gray or pale pink, smoothness of folds, and an increase in the vascular pattern. It is possible to identify areas of metaplasia into the intestinal epithelium.
3. Grade functional activity stomach is to measure the pH of gastric juice in order to assess the acidity of atrophic gastritis in this patient and determine the activity of pepsin.

Interesting: initial information about this disease appeared in 1728, but the real beginning in the study of atrophic gastritis is the activity of a doctor from France named Brousse. During autopsies, he found in almost every case changes in the gastric mucosa and identified them as inflammation. At that time, his thoughts were incorrect, since they represented only changes on the part of a non-viable organ.

Subsequently, Kussmaul's version arose, explaining atrophic gastritis of the stomach from the point of view of violation nervous regulation organ, but it turned out to be erroneous. In the period from 1900 to 1908, Faber proposed a method of fixing a stomach preparation with formalin, which saved scientists from the problem of post-mortem defects and clearly showed the presence of changes like gastritis.

How to treat atrophic gastritis

The traditional treatment regimen for atrophic gastritis in adults includes the eradication of Helicobacter pylori, if acid-fast bacteria have a significant effect on the pathogenesis. Helicobacter pylori eradication methods are constantly being improved.

Eradication objectives:

• suppressing the development of bacteria and preventing the formation of their resistance to antibiotics;
• reduction of treatment duration;
• use of inhibitors proton pump to improve well-being;
• reducing the number of medications, which significantly reduces the number of side effects from treatment;

Three- and four-component eradication schemes are usually used:

1. The drugs Omeprazole, Lansoprazole, Esomeprazole, Rabeprazole, Pantoprazole, Ranitidine, bismuth citrate and others are used as proton pump inhibitors.
2. Antibiotics (tetracycline, penicillin series), as well as the antibacterial drug metronidazole (Trichopol). The dosage and frequency are indicated by the doctor.

We have not yet fully learned how to influence the development of autoimmune processes in atrophic gastritis. Application hormonal drugs and other immunocorrectors are not justified in most cases.

Pathogenetic therapy of atrophic gastritis involves complex use medicines various groups, among them:

• in cases of vitamin B12 deficiency, appropriate vitamin preparations in the form of parenteral injections.
• means to facilitate gastric digestion– preparations of hydrochloric acid and gastric juice enzymes.
• agents that reduce inflammation - plantain juice or granulated pharmacological drug from plantain (Plantaglucid).
• agents that influence the production of hydrochloric acid in the form of mineral waters (Essentuki 4.17 and others). Although they are not drugs, in some cases they show high therapeutic activity.
• To protect the mucous membrane, bismuth or aluminum preparations are used (Bismuth nitrate basic, Vikalin, Vikair or Rother, Kaolin).
• means regulating the motor function of the stomach. Among the drugs of this pharmacological group, Domperidone and Cisapride are most often used.
• In recent years, Riboxin has become more often used in the treatment of gastrointestinal inflammation. This drug has properties useful in the treatment of atrophic gastritis.

In addition to etiotropic treatment, treatment is carried out in several other areas:

• diet therapy in compliance with the principles of mechanical, thermal and chemical sparing;
• replacement therapy with hydrochloric acid preparations, enzyme preparations;
• stimulation of hydrochloric acid secretion ( mineral waters, medicinal fees, lemon and succinic acids etc.);
• protection of the gastric mucosa with gastroprotectors;
• the use of regenerants and reparants to restore the mucous membrane;
• the use of enveloping and astringent drugs;
• increased gastric motility (prokinetics);
• physiotherapeutic treatment.

All of the above drugs are prescribed during active phase inflammation of the stomach with symptoms of atrophy. During remission main principle treatment – ​​replenishment of substances missing for proper digestion.

Alternative treatment of atrophic gastritis

Increase the secretion of gastric juice in atrophic gastritis with low acidity possible using traditional methods of treatment:

1. Drink half a glass of beet juice before meals.
2. Potato juice – grate the potatoes on a fine grater, strain through cheesecloth. Drink the resulting juice 1/3 glass 3 times a day. The duration of the course of treatment is 10 days, after which you need to take a break for 10 days.
3. St. John's wort will help increase the acidity level - pour 2 tablespoons of crushed flowers into a glass of boiling water and leave for 2 hours. Drink the resulting infusion three times a day, 20 minutes before meals.
4. Brine sauerkraut– enhances the production of gastric juice. Strain the cabbage infusion and drink 1/3 glass 3 times a day before meals.
5. Rose hip decoction without sugar - drink freshly brewed tea before meals.
6. White cabbage juice - the cabbage is grated or chopped using a meat grinder, the juice is filtered through cheesecloth. The resulting juice should be stored in the refrigerator and drunk 30 minutes before meals, 1/3 cup. It must first be warmed to body temperature.

Following a diet during the treatment of gastritis is very important! During the subsidence period acute form Due to the inflammatory process, the patient must also adhere to dietary restrictions.

Diet and proper nutrition

Diet for atrophic gastritis is one of the the most important moments affecting the effectiveness of treatment of this disease. As with other types of gastritis, normalization of nutrition, adherence to a regimen and exclusion of certain foods are required to improve and facilitate the functioning of the stomach.

Prohibited products include:

• smoked, salted and pickled products;
• fatty and fried foods;
• alcohol;
• tea, coffee, carbonated drinks;
• sweets
• spicy seasonings.

In case of exacerbation of the disease, diet No. 1a is prescribed. In this case, food is allowed only in liquid form, as well as in pureed or mashed form. It must be steamed or boiled. The menu consists of nine main dishes, these are mainly puree soups, and the consumption of dairy products is also acceptable.

Such a diet for atrophic gastritis at the acute stage is short-lived until eliminated acute symptoms. Then meals follow diet menu No. 1. Limits include hot and very chilled foods, as well as foods rich in fiber.

When stable remission is achieved, the patient is transferred to basic diet No. 2. The diet becomes more varied, but gentle methods should be followed heat treatment and steam, boil, bake, while light frying of food is allowed. The consumption of vegetables and fruits, meat, fish, and dairy products is allowed. You should not eat chilled food with a rough texture.

Forecast

With timely complex treatment the prognosis is favorable. In 2002, Japanese scientists proved the possibility of reversing the development of precancerous changes in the gastric mucosa after eradication (destruction) of Helicobacter pylori bacteria. Using chromoscopy, it was established that within five years after successful anti-Helicobacter therapy, the size of the foci of intestinal metaplasia decreased by almost 2 times compared to the initial ones.

Complete restoration of the structure of the mucous membrane in severe atrophy requires a long time, and in some cases is most likely impossible. If pretumor processes are not subjected to reverse development, but, on the contrary, progress, apply radical methods treatment up to resection of the gastric mucosa.

Any violations in digestive system may lead to serious consequences for the health of the whole body.

The appearance of gastritis in the early stages requires immediate treatment, dieting.

Gastritis with mucosal atrophy can cause significant harm to the entire gastrointestinal tract, since it is one of the most dangerous diseases chronic stage illness.

The consequences of the disease can be cancer, which often results from the disease.

What atrophic gastritis is like, symptoms and treatment of the disease, more about this.

Description of the disease

A dangerous sign of this disease is the absence of symptoms at the first stages of the pathological process.

The patient does not experience any symptoms, which makes the situation worse. Gastritis with signs of mucosal atrophy is characterized by atrophic degeneration of the cells of the stomach walls.

In this state, they are not able to fully produce gastric juice, losing their functional abilities.

At the first stage, the secretory glands are transformed into simple formations. Instead of gastric juice, they produce mucus. Gastritis with mucosal atrophy develops with low stomach acidity.

The main danger of the pathology is the risk of oncological neoplasm in the stomach.

It is impossible to completely cure the atrophic cells of the stomach walls. You can only reduce the risk of cancer.

This requires a special drug therapy, special dietary meals and a regular diet.

Symptoms

The first stages of atrophic gastritis do not manifest themselves in any way. Many patients note the absence of pain.

The absence of pain can accompany all stages of the development of the pathological process.

The main symptoms include those characteristic of all types of gastritis. Patients often complain of a feeling of heaviness in the area solar plexus after eating.

The amount of food consumed is not of fundamental importance. What other symptoms accompany the disease:

• general malaise;
• nausea;
• gagging;
• belching;
• unpleasant odor from the mouth;
• bloating;
• flatulence;
• stool disorders;
• weight loss;
• manifestations of hypovitaminosis;
• disturbances in hormonal metabolism.

Development of the disease

Atrophic gastritis develops in two forms:

• acute;
• chronic.

Both options are characterized by a large loss of the gastric mucosa, and the synthesis of gastric juice is significantly reduced.

The incoming food is not able to be properly digested and absorbed.

Acute form

The disease is in the acute stage. It is characterized by various signs, including pronounced pain syndrome, nausea, vomiting, stool disorders, elevated temperature body, weakness, general malaise, loss of consciousness.

When the irritated gastric mucosa is exposed to aggressive pathogenic substances, serious consequences are possible.

Death can occur due to severe intoxication of the body. How does this form of gastritis manifest:

• the walls of the stomach swell;
• leukocytes come out vascular boundaries;
• the vessels become overfilled with blood;
• epithelium is disrupted, and erosions are sometimes observed.

Chronic form

At chronic form Gastritis atrophy progresses over a long period of time. This is an independent disease in which the main role is played not by inflammatory processes, but by dystrophic ones.

During development of this disease The gastric mucosa is affected, motility and gastric secretion are impaired. There is a violation of the suction function.

At further development gastritis affects the duodenum, esophagus, liver and other important digestive organs.

Pathological process affects the circulatory and nervous system due to intoxication. How does the disease manifest itself during diagnosis:

• the walls of the stomach become thinner;
• the appearance of wide pits;
• the epithelium becomes flat;
• mucous membranes have a smoothed surface;
• weak secretion;
• leukocytes extend beyond the vascular boundaries with moderate intensity;
• glandular cells undergo changes.

Classification of atrophic gastritis

When the first signs of the disease appear, you need to see a doctor as soon as possible.

An experienced specialist will conduct a set of diagnostic studies, based on which he will make an accurate diagnosis.

The disease comes in several types, and by determining which, the doctor can prescribe the correct treatment.

Atrophic gastritis is divided into:

• focal;
• surface;
• moderate;
• antral;
• diffuse;
• erosive;
• mixed.

Each type of pathology requires careful laboratory and diagnostic studies and properly selected therapy.

Focal gastritis

The disease is manifested by foci of changes in the epithelium of the stomach walls. Atrophic focal gastritis often occurs against the background increased acidity gastric juice.

This may be due to compensation for the work of the affected areas by increasing acid production. Other signs of the disease are similar to other types of gastritis:

In the subclinical course of the disease, atrophic focal gastritis occurs against the background of poor tolerance to certain foods.

Superficial gastritis

This stage is initial stage in the development of a chronic inflammatory process.

Superficial gastritis is presented in the form of unexpressed lesions. Patients do not experience any clinical manifestations.

To make an accurate diagnosis, a diagnostic study is required. The results will be revealed during endoscopy.

Superficial gastritis is characterized by moderate disturbances tissue structures, normal thickness stomach walls, slight increase cellular secretions.

Moderate gastritis

The pathological process can cause moderate inflammation. With this course of the disease, the cells of the affected organ undergo minor changes. Only histological examination can determine pathology. Analysis determines the quantity healthy cells, reveals changes in the tissues of the stomach.

This form of the disease is similar to dyspeptic disorders. The usual pain syndrome that accompanies acute stage gastritis may be absent.

Patients often feel discomfort in the digestive organs, especially after meals.

Pain sensations may occur after heavy foods: spicy, sour, salty, smoked, fatty, fried foods, marinades.

Antral gastritis

The pathology is characterized by scarring lower section stomach located in the area duodenum.

It has the following manifestations:

• dull pain localized in the solar plexus;
• morning sickness;
• lack of appetite;
• belching appears after eating;
• weight loss;
• weakness;
• malaise.

Ulcerative lesions often appear in the antrum.

Diffuse gastritis

The disease occurs without pronounced degenerative processes. It is an intermediate stage between superficial and dystrophic.

The main manifestation of the disease is the appearance of foci of degenerated glands of the organ, immature cells with symptoms of impaired secretion.

The pathology is represented by the following symptoms:

• ridges appear on the walls of the organ;
• the pits deepen;
• cellular microstructures are disrupted.

Erosive gastritis

Erosive atrophic gastritis is characterized by the formation of erosions on the surface of the walls of the affected organ.

The clinical picture is not enough to identify the disease. But atrophic erosive gastritis often causes the following symptoms:

• pain syndrome in the affected organ;
• heartburn;
• heaviness in the stomach;
• manifestations of belching;
• stool disorders;
• pain on an empty stomach or after eating.

Mixed gastritis

With this course of the disease, several forms of atrophic gastritis may occur at once.

Hypertrophic, superficial and erosive atrophic gastritis are often combined simultaneously.

Experts say that a patient can develop and experience up to 4 forms of gastritis at the same time.

Classification of focal gastritis

The disease is manifested by inflammation of the gastric mucosa with manifestations of lesions on the surface of the affected organ.

It is diagnosed very often and affects patients of different age categories. Patients feel pain in the stomach, heartburn, nausea, and vomiting appear. There can be many such foci.

Gastritis with focal atrophy of the gastric mucosa is divided into several types:

• Focal chronic gastritis. It develops due to improper treatment acute form of the disease or its complete absence. The disease occurs against a background of symptoms similar to oncology. For these reasons, it is very important to consult a specialist in time for a complete diagnosis and comprehensive treatment.
• Focal atrophic gastritis. In the first stages it manifests itself as subatrophic damage to the stomach. Next, necrosis of individual cells develops. Affected areas appear in which cells are replaced connective tissues. Atrophy of the mucous membranes develops.
• Focal superficial gastritis. This initial stage diseases. The pathological process has not yet penetrated into the deep layers of the mucosa. Often the pathology is a special form of antral disorder.
• Focal erosive gastritis. It is manifested by inflammation of the mucous membrane of the stomach walls. Lesions with ulcerative or erosive formations form. Timely and comprehensive therapy is required.

Treatment

For effective therapy gastritis, all the causes that led to the development of the disease should be identified.

The acute stage requires immediate hospitalization. Relapse of the chronic stage requires outpatient treatment prescribed by a physician or gastroenterologist.

To achieve maximum results, you should adhere to certain rules:

• Compliance special diet and provision proper nutrition– deposit healthy stomach And wellness. It is important to exclude all products containing harmful substances, food colors, emulsifiers, preservatives and other additives. The food consumed should not be hot, cold, spicy, sour, salty, smoked, fried, or fatty. Avoid marinades and heavy foods in favor of a healthy diet.
• If pathogenic bacteria (Helicobacter) are detected, they are prescribed antibacterial drugs to achieve normal condition microflora.
• If acidity is increased, medications are taken that suppress secretion production. Histamine blockers are often used.
• If there is insufficient production of enzymes by the pancreas, a complex of auxiliary enzymes is prescribed.
• To reduce the severity of painful manifestations and speed up the process of emptying the gastric cavity, prokinetics are prescribed.
• To reduce acidity and block the unpleasant symptoms of heartburn, take antacids.
• They often resort to traditional medicine. It is famous for various medicinal herbs, from which decoctions and infusions are made.

When the first unpleasant symptoms, characteristic of atrophic gastritis, immediately consult a doctor.

It is important to go through as quickly as possible full diagnostics And laboratory tests body.

Based on the results obtained, an accurate diagnosis will be established. The specialist will be able to prescribe treatment.

Such manifestations cannot be left unattended; the consequences can be disastrous. Self-medication is contraindicated.

Useful video

Atrophic gastritis is an insidious disease. It does not always cause any pain or noticeable discomfort, and people usually do not understand the danger of metabolic disorders that develop due to the death of normal stomach cells.
So little by little, if treatment for atrophic gastritis is not carried out, this pathology, without any obvious symptoms, turns into cancer. But all that can help is taking two or three medications and long-term adherence.

The mucous membrane of the stomach with atrophic gastritis resembles depleted and lifeless earth

Types of treatment

For atrophic gastritis, only conservative treatment is carried out:

• It makes no sense to remove anything, since areas of atrophy are located in larger or smaller foci;
• before the cells degenerate into cancer, they can (and should) be brought back to life;
• only with the help conservative methods it is possible, by gently inducing the gastric mucosa to recover, to feed into further lying sections digestive tract food needed to improve metabolism.

Conservative treatment of chronic atrophic gastritis is based on “three pillars”:

1. Diet: foods must be specific and also prepared in a special way so that the intestines not only do not suffer from the fact that they were not properly treated with hydrochloric acid, but can also take from them everything that the exhausted body needs.
2. Drug treatment. In this case, the doctor decides how to treat atrophic gastritis of the stomach based on the results of the studies:
   • fibrogastroscopy (possibly with biopsy);
   • determining the presence of gastritis as the cause (the test is usually performed simultaneously with FEGDS);
   • probing the stomach to determine its acidity.
3. . They, being selected by a doctor who is familiar with the “picture of the stomach,” help achieve treatment goals without overloading the body with chemical compounds.

Is it possible to cure atrophic gastritis? It is possible if minimal changes have occurred in the stomach focal changes. If a person seeks help already at the stage of diffuse atrophy, then with the help of a long-term diet he can only restore some areas of the mucous membrane and stop further progression of the disease.

Drug therapy

The spiral-shaped bacterium Helicobacter pylori is fixed in the gastric mucosa and begins to dissolve its cells with the help of its enzymes and its own hydrochloric acid

Treatment of both focal atrophic gastritis and its diffuse variant is carried out as follows:

1. Medicines are prescribed to improve the movement of food from the stomach to the intestines. They also effectively fight nausea.
2. If there is a decrease in the production of hydrochloric acid, medications containing natural gastric juice are prescribed.
3. Since a reduced amount of hydrochloric acid reduces the production of pancreatic enzymes necessary for digestion, such enzymes are prescribed in the form of synthetic preparations.
4. Impaired processing of food in the stomach leads to vitamin deficiency. The metabolism of B12 and folic acid, due to which the hemoglobin level also decreases. To correct this condition, not only vitamin complexes are used, but also cyanocobalamin and folic acid separately.

Specifics of therapy for atrophic-hyperplastic inflammation

Treatment of atrophic depends on the cause of the disease:

1. Most often, such an inflammatory process on the gastric mucosa is caused by the Helicobacter bacterium, so it is immediately prescribed specific therapy. It consists of two antibacterial agents, as well as products that protect the stomach from hydrochloric acid. This treatment is carried out for 7 days, after which it is repeated to check for the presence of Helicobacter in the stomach.
2. To eliminate stomach pain, a combination of antispasmodic and anticholinergic drugs is used.

Warning! Drugs of these two groups are prescribed only by a gastroenterologist after examination and other studies.

3. If there is an increase in the pH of the stomach, drugs that stimulate the production of hydrochloric acid are prescribed. If acidity is high, blockers of its production are prescribed.
4. It is necessary to take medications that improve the regeneration of the gastric mucosa.

How to eat with atrophic gastritis

The diet for atrophic gastritis of the stomach is called 1A, with a gradual transition to table No. 2. These numbers indicate that the food should be such as to prevent mechanical, thermal and chemical injury to the gastric mucosa. In addition, there should be no stomach overfilling copious amounts food, so you need to eat little and often, while the total energy value(number of calories) must be at least 2500 kcal/day.

Nutrition for atrophic gastritis of the stomach should be carried out according to the following rules:
Diet basis:

Exclude:

• spicy dishes;
• food prepared by frying;
• pickled products;
• alcohol;
• coffee;
• chocolate;
• cakes;
• candies;
• breaded fish;
• legumes;
• canned food;
• mushrooms.

A diet for focal atrophic gastritis allows a person to eat:

• chicken broth with noodles;
• meatballs;
• baked pumpkin with honey;
• cottage cheese casserole;
• omelette;
• mashed potatoes;
• boiled fish;
• egg and milk sauces;
• cocoa;
• weak tea;
• boiled veal;
• rabbit cutlets;
• mousses, jelly, honey;
• sandwiches from a dried piece of bread (up to 400 g/day) with low-fat cheese and butter(up to 25 g/day).

What does traditional medicine offer?

The doctor prescribes herbal decoctions that stimulate the production of gastric juice

Treatment of atrophic gastritis with folk remedies includes the use of the following recipes:

1. Drink 100 ml of warmed freshly squeezed white cabbage juice half an hour before meals.
2. Take 30 ml potato juice three times a day, before meals. This remedy has been successfully used for treatment by more than one generation of supporters. traditional medicine. Read the article about and learn about all of it medicinal properties, about the nuances of preparation, as well as contraindications.
3. For breakfast, eat a grated raw green apple (200 g), mixed with grated raw pumpkin(600 g), ¼ cup lemon juice and 1 tsp. honey After this, do not eat anything for 3-4 hours.
4. Eat 1 teaspoon of fresh blueberries, grated with sugar, before breakfast.
5. In equal parts, 50 g each, take trifoliate leaves, immortelle, sage leaves, mint, St. John's wort, angelica root, eyebright herb, calamus rhizome, dill seeds, wormwood herb, mix dry. Then take 1 tbsp. mixture and pour a glass of boiling water over it, leave for 3 hours, strain and drink before eating. This should be done three times a day.
6. Take a decoction of chamomile purchased at a pharmacy, prepared according to the recipe indicated on the box.
7. Take 50 g of calamus root, dandelion, sage, peppermint, calendula flowers, St. John's wort, chamomile, plantain leaves, chop everything, mix. 4 tbsp. pour a liter of boiling water, take 100 ml three times a day.

Thus stopping the progression