Gastritis - this word means a number of diseases of the digestive tract. A common feature of them - inflammation of the inner walls of the stomach. Gastritis can manifest itself in a person completely unexpectedly (acute) or slowly worsen over time (chronic). If this disease is not treated, there is a risk of ulcers and an increased risk of malignant tumors of the stomach. Fortunately, for many people, chronic gastritis is not particularly dangerous; If you follow certain safety rules, it does not deliver strong discomfort and practically does not affect the quality of life.

What is chronic gastritis?

Gastritis in general is an inflammation of the inner wall of the stomach. If the smooth musculature of this organ is weakened, and the protective cover of mucus, which is formed by the cells on the inner surface of the stomach, is damaged, then caustic digestive acids damage the walls and cause inflammation. The risk of developing gastritis can increase a variety of factors - from infectious diseases to individual intolerance to certain foods. Gastritis is called chronic, when inflammation of the inner surface of the stomach occurs regularly or symptoms persist for a long time.

Causes of chronic gastritis

Chronic gastritis develops for many different reasons. Among them are infectious:

Helicobacter pylori. Surprisingly, the main “culprit” of chronic gastritis around the world, the bacterium Helicobacter pylori (according to the latest data, 50% of the world’s population is infected with it) was discovered quite recently - in 1982. In addition to chronic gastritis, it is also “responsible” for the occurrence of human peptic ulcer, adenocarcinoma and primary lymphoma of the stomach. This spiral gram-negative bacterium, having got into the stomach and having survived without action for itself the action of digestive acids, passes through the protective cover of mucus, which is created by the cells of the epithelium of the stomach, and settles on its inner surface. The products of her vital activity lead to intense inflammation in the places of her “residence”. Although the extent of H. pylori infection is striking, it is only a few that have chronic gastritis. Doctors believe that the cause of vulnerability to bacteria may lie in genetics or it is influenced by bad habits - alcohol, smoking, drugs. If other risk factors are present, then the vital activity of H. pylori in the patient's stomach can cause the appearance of peptic ulcers, lymphomas and a malignant tumor of the stomach.

Parasitic infections. Also, chronic gastritis can be a consequence of infection with parasites. Nematode worms that live illegally in nature in the digestive tract of marine life, can live in the human body, if the fish was not well processed - poorly salted or roasted.

Severe infectious diseases. Fortunately, infectious granulomatous gastritis is extremely rare and, as a rule, is the result of a serious illness, such as tuberculosis. The effect of the virus causes the appearance of caseous granulomas on the inner surface of the stomach — a curd-and-white formation of dead tissue. Sometimes the same picture can be observed in patients taking immunosuppressants - usually it is associated with a fungal infection.

Weakened immunity. Accepting immunosuppressants in a patient can cause an undesirable consequence in the form of chronic gastritis if a person is infected with cytomegalovirus, herpes simplex virus, or mycobacterial infections. The inner walls of the stomach in the areas of the lesion become inflamed, and if the disease goes into a severe stage, tissue necrosis may contribute to the formation of ulcers.

Non-infectious:

A number of non-communicable diseases, such as Crohn's disease and sarcoidosis. Crohn's disease causes gastritis in about a third of the cases - granulomas form on the inner surface of the stomach, which leads to the appearance of chronic granulomatous gastritis.

Autoimmune diseases. In some autoimmune diseases, it happens that the patient's t-cell lymphocytes penetrate the gastric mucosa and attack his own epithelial cells. Fortunately, this disease develops quite rarely; people with autoimmune disorders, including Hashimoto disease or type I diabetes, are susceptible to it. Also, autoimmune gastritis can develop against the background of vitamin B-12 deficiency.

Take some medication. If a person has regularly used analgesics on a regular basis for a long time (for example, aspirin, ibuprofen, naproxen), then there is a possibility that he has earned himself chronic gastritis. The fact is that the action of these drugs suppresses the release of a substance that is intended to protect the inner walls of the stomach; the mucous membrane becomes thinner, and the delicate tissues begin to eat away at the stomach juices.

Celiac disease about one-tenth of patients with celiac disease develops lymphocytic chronic gastritis; when using a gluten-free diet, it goes into a mild form and has virtually no effect on human well-being.

Intestinal reflux. In this disease, the contents of the intestine with bile enters the stomach. Bile acids destroy the mucous membrane that protects the walls of the stomach, and damage the cells of its inner surface. Inflammation in this type of chronic gastritis is small.

Alcohol and drug use. Alcohol irritates the inner walls of the stomach, which opens them to the harmful effects of digestive acids. Excessive single use of alcohol can lead to acute gastritis, but even and abundant is fraught with the development of chronic gastritis. People who use cocaine may develop sarcoid granulomas in the stomach.

Radiotherapy. Fortunately, gastritis caused by radiation, passes for 2 to 9 months after the end of radiation therapy. Small doses of radiation (up to 15 Gy) cause reversible damage to the mucosa and lead to chronic gastritis, but higher doses lead to irreversible damage — cells undergo degenerative changes. If the dose of radiation is even higher, then permanent damage to the mucous membrane, its erosion and hemorrhage occurs.

Elderly people are especially at risk for chronic gastritis - over time, the protective mucous membrane of the stomach becomes thinner. Also, older people are more likely to be affected by H. pylori or suffer from autoimmune diseases.

Symptoms

Pain. Almost all occasionally have bouts of stomach pain. They usually pass quickly and do not require urgent medical care. However, if the discomfort, feeling of heaviness or pain in the stomach does not disappear for a long time (a week or longer), it is recommended to consult a doctor. In chronic gastritis, pain is often localized in the upper abdominal cavity or in the upper left part of the stomach and sometimes gives back and chest.

Nausea, vomiting. In chronic gastritis (especially associated with high acidity), the patient may feel sick, sometimes to vomiting. Vomiting can be both transparent and yellow, and greenish. If vomiting with blood - it is necessary to urgently run to the doctor.

Bloating, flatulence. Combined with pain, these symptoms are likely to indicate some type of gastric infection.

Loss of appetite, unusually fast satiety. In chronic gastritis, the patient may unconsciously lose or gain weight.

Change the color of the chair. If the stool is dark, almost black, it means there is blood in it. When this symptom occurs, you should immediately consult a doctor.

Establishing diagnosis

Tell your doctor exactly when stomach pain occurs - perhaps after a certain food, or after taking medication (either prescription or not), or dietary supplements, or herbs. Describe in detail the symptoms you are experiencing, even those that do not seem to be associated with the stomach. If your relatives suffered from any gastrointestinal diseases, tell us about them too. Although according to the results of a patient survey and after a physical examination, the doctor may already suggest the presence of chronic gastritis, however, he may suggest that you undergo several examinations to determine the cause of gastritis and prescribe treatment.

Physical inspection. Although, as a rule, in chronic gastritis, it is of little effect, however, according to some signs, it is possible to determine whether Helicobacter pylori caused it or not. If the abdominal wall is strained and the abdomen is swollen, this can be a symptom of a bacterial lesion. Also, a physical examination helps to determine what, perhaps, the patient suffers from an autoimmune disease, which was the cause of chronic gastritis.

Texts on Helicobacter pylori. Bacteria can be detected by analyzing blood, planting feces on microorganisms, as well as breathing test - when a patient is given a liquid containing a radioactive element to drink, and then, after a while, exhale air into a tight bag. If there are bacteria in the stomach, then there will be traces of this very radioactive element in the air.

Endoscopy. An endoscope is used to study the condition of the upper part of the digestive tract. It is a long flexible tube with a miniature camera at the end. The doctor inserts this tube into the patient’s throat, then the esophagus, stomach, and, if necessary, into the small intestine. In this way, the doctor can determine exactly which state of the inner surface of the stomach, where there is inflammation and what it is. If the damaged tissue looks suspicious, the doctor can pinch off small pieces of tissue (since the inner part of the stomach does not have pain receptors, it is completely painless), then examine them in the laboratory. This is called a biopsy. It can also be used to determine the presence of an infection in the stomach, be Helicobacter pylori, helminites or viruses. Also, a histological examination of the material obtained can determine whether the patient’s autoimmune disease caused a complication in the form of chronic gastritis.

X-ray examination of the upper part of the digestive tract (it is the barium test). Here the patient will be offered to drink a white liquid containing a tiny amount of radioactive substance (barium), and after a while the doctor will take a series of pictures of the esophagus, stomach and small intestine. Barium is needed to make the image contrast better; with its help it is possible to see previously imperceptible damage to the gastric mucosa.

Forecast

If untreated, gastritis can lead to stomach ulcers and internal bleeding. In rare cases, some forms of chronic gastritis may increase the risk of stomach cancer, especially if the gastric mucosa is thin by nature or due to age.

Whether it is possible to cure chronic gastritis or not depends primarily on the cause of the disease. If gastritis is caused by H. pylori, then with the eradication of the bacterial population, the patient's life is getting better - the mucous protective barrier is again safe and sound, and the inner walls of the stomach stop inflaming. As for atrophic changes in the tissue of the stomach, the data here are contradictory. Some scientists report that they cannot be reversed; others happily report on the improvement of the condition of the tissues after the disappearance of harmful occupants. Much more depends on whether the bacteria had time to cause complications - peptic ulcer or even a malignant tumor. Fight them already to be other methods.

Diet

Treatment of chronic gastritis is impossible without proper nutrition. By following a few simple rules, you can reduce the likelihood of a relapse to a minimum.

Eat less, but more often. Small portions do not provoke the release of excess acid, they are easier to digest, they are less irritating to the stomach wall.

Chew food thoroughly. Food moistened with saliva will be easier to digest, and chopped food will not be able to injure the affected areas of the inner surface of the stomach.

Drink plenty of water. Every day you need to drink from 6 to 8 glasses of water - it not only helps the body to clean itself, but also helps to digest food.

Observe the time of eating and going to bed - so you train your stomach to excrete acid only when it is required to digest food. Dinner is recommended for a couple of hours before bedtime.

Try to avoid foods that arouse appetite, or stimulate the release of acid, or can irritate the affected tissue of the stomach. This includes spicy, sour, fried (especially with a hard crust) dishes, snacks (crisps, dry crispy biscuits), and alcohol.

Eat well thermally processed foods. This will not only reduce the risk of a parasitic infection, but will also help the stomach digest food better - after all, all the hard fibers are already destroyed. Give preference to boiled or baked foods, and when boiling broths, remove the skin. It is better to chop large pieces.

Meals should not be too cold nor too hot. Large temperature drops can slow down the treatment and recovery of the affected gastric tissue.

Wash your hands often. It is not yet clear how exactly Helicobacter pylori is distributed, however, there is evidence that they can be transmitted from person to person through bodily contact, as well as by eating contaminated water and food. Thus, you can protect yourself against infection if you often wash your hands with soap and eat foods that have been previously washed and have been heat-treated.