The upper membrane of the walls of the stomach, which protects it from various injuries, is the mucosa. The state and ability of an organ to perform its functions depends on its integrity. Some diseases of the gastrointestinal tract lead to a violation of the morphological structure of the protective layer and cause impaired functionality of the digestive system. Such diseases include gastritis, which occurs with the formation of erosion. The lack of treatment for this pathology leads to serious consequences for the whole organism.
What is erosive gastritis
In 11-18% of patients who went to the doctor complaining of pain in the epigastric region (the center of the abdomen between the hypochondria), inflammatory-dystrophic changes in the mucous epithelium lining the stomach were found. In relation to the inflammatory process, which leads to atrophy of epithelial cells and replacement of the affected tissue with fibrous, the medical term is used – gastritis.
Depending on the defects visualized during endoscopy, several forms of the disease are distinguished, one of which is erosive, which is characterized by the presence of ulcers (erosion) on the gastric mucosa. Due to the fact that the internal organs contain a small number of nerve endings, the morphological signs of the pathology may not have clinical manifestations, and the disease makes itself felt only in the late stages, when large sections are involved in the pathological process.
The main characteristics of the erosive form of the inflammatory disease are:
- the presence of eroded areas (single or multiple) on the surface of the inflamed gastric mucosa;
- tendency to a protracted course;
- may lead to gastric bleeding;
- asymptomatic course in the initial stages of the disease;
- worse treatable compared to other forms of pathology.
Morphological changes in the mucous membrane can occur under the influence of exogenous or endogenous factors that determine the clinical picture of the disease. The main significant external reason, due to which the majority of registered cases of the development of the inflammatory process occur, is the infection of the body with the gram-negative bacterium Helicobacter pylori. Other exogenous factors that can trigger the development of inflammation of the gastric mucosa include:
- non-compliance with the principles of proper nutrition;
- exposure to the body of toxic substances (radiation, chemicals, etc.);
- uncontrolled or prolonged use of drugs that irritate the gastric mucosa (glucocorticosteroids, acetylsalicylic acid, non-steroidal anti-inflammatory drugs);
- the use of harmful substances that damage the protective mucous barrier of the epithelium of the stomach (alcohol, drugs, nicotine);
- infection of the body with parasites, bacteria or fungi;
- prolonged exposure to stress, psycho-emotional stress, physical or mental overwork.
Factors of an endogenous (internal) nature are the processes occurring in the body that directly or indirectly contribute to the development of inflammatory-dystrophic changes in the mucous layer of the gastric epithelium. Possible causes of gastritis are the following conditions:
- predisposition due to genetic characteristics;
- hormonal imbalance;
- violation of metabolic processes;
- oncological pathologies of the stomach or other organs;
- hypo- and vitamin deficiencies;
- diabetes and other endocrine dysfunctions;
- reverse flow of the contents of the duodenum into the stomach (duodenogastric reflux);
- reduced blood oxygen (hypoxemia);
- intoxication with substances whose production occurs in the body (endogenous toxins);
- autoimmune disorders;
- chronic and systemic diseases.
Symptoms of erosive gastritis
The clinical course of gastritis of the ulcer form differs little from the picture of other types of this disease. The fact of the occurrence of erosive formations can be accurately ascertained only in the presence of gastric bleeding against the background of previously diagnosed inflammation of the mucosa. Acute erosive gastritis develops rapidly – after 7-8 hours after exposure to a mucous epithelium of the stomach, the symptoms become most pronounced. In this case, the obvious signs indicating the presence of erosion are:
- complete lack of appetite;
- persistent nausea;
- frequent bouts of vomiting (first consumed food, then bile);
- in the vomit, the presence of blood is detected (in complicated cases, the disease immediately manifests itself as bloody vomiting);
- in the epigastrium there is a strong discomfort, a feeling of bursting, internal pressure;
- palpation of the epigastric region causes pain, irritates the patient.
Chronic erosive gastritis is manifested by less severe symptoms. Indirect signs indicating the formation of erosion is the stability and the enduring intensity of clinical manifestations. Erosive form of the disease can be expressed in the following:
- pain, localized in the epigastric region (sensations are not always intense, but it is difficult to stop them);
- burning behind the sternum (heartburn) – more often occurs with impaired gastric motility;
- constant feeling of heaviness in the stomach;
- belching with sour or rotten aftertaste;
- drying out of the oral mucosa, bitterness in the mouth;
- painful cramps often appear after eating (erosive areas are irritated by particles of food consumed) or on an empty stomach (ulcers are irritated by gastric juice);
- upset stool (diarrhea or constipation);
- the presence in the language of plaque white-gray or white-yellow.
In the absence of treatment, ulcerative gastritis as the erosive process spreads leads to gastric bleeding. If the erosive mucosa begins to bleed, this process is called erosive-hemorrhagic, and the following symptoms are characteristic of it:
- a decrease in the severity of pain (associated with the destruction of sensitive receptors by erosion);
- the presence in the vomit of bloody (active, prolonged bleeding) or brown (bleeding of low intensity or sweating of blood from the vascular bed into the stomach) contents;
- the symptoms inherent in anemia are pale skin, frequent dizziness, an increase in heart rate with a decrease in blood pressure;
- a change in the consistency and color of feces – feces becomes darker, due to the ingestion of blood-damaged acid elements into the intestines.
If a gastroenterologist suspects that there is an erosive form of inflammation of the gastric mucosa, additional diagnostic methods are mandatory. It is possible to identify structural changes in the epithelium and assess their prevalence by visualizing the organ, which is performed during fibrogastroduodenoscopy (HDF).
During an endoscopic examination, the doctor with the help of a gastroscope (a special device equipped with a video camera) studies the morphological structure of the upper sections of the gastrointestinal tract. If erosive defects are detected, a biopsy is performed (a small piece of the mucous membrane is taken for microscopic examination). In addition to assessing the condition of the inflamed organ, the localization and vastness of the affected areas, the volume of prescribed therapeutic measures is influenced by the results of such diagnostic methods as:
- blood test – signs of anemia, infection by bacteria or other pathogens are determined;
- coprogram (fecal analysis) – helminthic infestations are detected;
- radiography – an x-ray is prescribed to detect tumor neoplasms that may cause the development of the disease;
- breath tests – performed to determine the presence of the Helicobacter pylori bacteria;
- ultrasound (ultrasound) – through ultrasound, the state of other organs is evaluated, the diseases of which can affect the stomach;
- measurement of gastric acidity – shown to determine the state of secretory activity and assess the functionality of secretory glands;
- electrogastroenterography – the purpose of this method is to determine duodenogastric reflux (one of the causes of erosion on the gastric mucosa).