home Audience 6 Acute hemorrhagic gastritis (K29.0). How to treat hemorrhagic gastritis

Acute hemorrhagic gastritis (K29.0). How to treat hemorrhagic gastritis

This is an inflammation of the gastric mucosa, accompanied by the formation of erosions and bleeding. This is a polyetiological disease that can have acute or chronic course. Patients complain about dull pain in the epigastric region, associated with food intake, dyspeptic disorders; in case of acute gastric bleeding, symptoms of blood loss, vomiting in the form of “coffee grounds” and tarry stools develop. Treatment includes diet, the use of drugs to reduce acidity and restore mucous membranes, and hemostatic therapy. Sometimes required surgery.

Hemorrhagic gastritis is one of the most severe inflammatory lesions of the gastric mucosa. Gastroenterologists believe this pathology quite common, but least studied; According to WHO statistics, over the past 10 years the number of registered cases of the disease has increased 10 times. In patients taking non-steroidal anti-inflammatory drugs, corticosteroid hormones and alcoholics, the erosive process is detected in 50% of cases.

Causes

Errors in nutrition (irregular meals, hot and spicy foods, smoked foods) trigger the formation of defects in the gastric mucosa; action plays an important role high temperatures(food too hot). Quite often, mucosal defects are found in patients after suffering stress, especially against the background of chronic psychotrauma.

An important role in the development of hemorrhagic gastritis under the chronic action of damaging factors is played by impaired vascular permeability and microcirculation, intracellular metabolic processes and the development of cellular degeneration. The occurrence of bleeding is directly due to the presence of multiple erosions, as well as the leakage of blood plasma and cellular elements into the lumen of the stomach.

Classification

Depending on the duration of the course, acute and chronic forms of the disease are distinguished: acute erosions heal in 4-10 days, and chronic ones can exist for quite a long time. Primary and secondary hemorrhagic gastritis are also distinguished. Primary develops in almost healthy people against the background of an intact (unaffected) mucous membrane, secondary - in persons who already have stomach diseases. Depending on location pathological process differentiate erosions of the fundus, body and antrum of the stomach (damage to the antrum is more common).

Symptoms of hemorrhagic gastritis

In most cases, the main signs of pathology are mild dyspeptic complaints. In some cases, hemorrhagic gastritis can manifest itself immediately with gastric bleeding. Most often, patients complain of decreased appetite, dull pain in the epigastrium, a feeling of fullness and pressure in the stomach, nausea, heartburn, sour belching, and an unpleasant, sometimes “metallic” taste in the mouth. Pain occurs immediately after eating. There may be vomiting undigested food, diarrhea followed by constipation.

Palpation of the abdomen reveals pain in the epigastric region, there are no symptoms of peritoneal irritation, however, with acute hemorrhagic gastritis, defence (tension) of the abdominal muscles may occur. Specific to hemorrhagic gastritis are signs of acute or chronic gastric bleeding. When acute process patients complain of general weakness, dizziness, nausea. Vomiting is typical coffee grounds"(vomit turns black due to blood entering the stomach and combining with hydrochloric acid to form hydrochloric acid hematin).

With excessive blood loss, consciousness may be impaired. The skin and visible mucous membranes become pale, tachycardia and decreased blood pressure are detected. Black liquid stools (“tarry stools”) are passed. Chronic bleeding is characterized by complaints of general weakness, headache, fatigue, dizziness, skin becomes pale, dry, nails dull, brittle. Posthemorrhagic iron deficiency anemia develops.

For hemorrhagic gastritis associated with ingestion medicines, almost typical asymptomatic diseases. If changes are caused by other diseases internal organs, then the signs of gastritis are superimposed on the symptoms of the underlying disease (diabetes mellitus, myocardial infarction, thyrotoxicosis). Radiation sickness is accompanied by signs of radiation enterocolitis and infectious complications.

Diagnostics

When examining the patient, the gastroenterologist reveals pallor of the skin, and the abdomen may be painful on palpation. A clinical blood test determines changes characteristic of acute or chronic blood loss (anemia). In order to determine acid-forming function pH-metry is performed in the stomach; to identify Helicobacter, a respiratory urease test and PCR diagnostics are performed.

Most informative method diagnosis is esophagogastroduodenoscopy, which allows you to visually assess the condition of the gastric mucosa, localization pathological changes, their prevalence and source of bleeding. Against the background of the inflamed mucosa, numerous erosions, areas of hemorrhage and bleeding are determined. In the process of endoscopy, a targeted biopsy is performed to exclude the oncological nature of the changes and determine characteristic features inflammation.

Treatment of hemorrhagic gastritis

Therapy can take place in outpatient setting or in a hospital. Patients with signs of gastrointestinal bleeding are subject to mandatory hospitalization. Treatment begins with diet therapy: meals should be frequent, fractional, in small portions, food should be consumed pureed and semi-liquid, warm. If there is bleeding, the Meulengracht diet is prescribed - pureed chilled food. Coffee, rich broths, spicy and fried foods, smoked meats, alcoholic drinks and freshly squeezed juices.

Pharmacotherapy is carried out individually, taking into account the characteristics of the disease. In accordance with treatment standards, acidity correctors are used (H2-histamine receptor blockers - cimetidine, ranitidine; M-anticholinergics - pirenzepine; proton pump inhibitors - omeprazole, pantoprazole; antacids - aluminum hydroxide + magnesium hydroxide, aluminum phosphate). Enveloping, astringent agents are also used medicines(bismuth subcitrate, aluminum hydroxide + sucrose octasulfite), antibiotics (in case of bacterial etiology diseases), mucus formers (licorice root extract, licurazide + quercetin) and reparants (methyluracil, sea buckthorn oil).

In case of bleeding, hemostatic therapy is prescribed: oral solution of aminocaproic acid with adrenaline, tranexamic acid; Vikasol and etamsylate intramuscularly, intravenously. At hemorrhagic shock blood loss is replenished with antishock blood substitutes, sometimes with drugs and blood components. It is advisable to use vegetable oils: sea buckthorn, carotene and rosehip oils. These drugs have anti-inflammatory and reparative effects. In the remission stage, herbal medicine is indicated: a decoction of flax seeds, yarrow, plantain, St. John's wort and chamomile inflorescences.

In some cases, surgical treatment is performed. To this day there is no consensus on what volume surgical intervention is optimal, so the operation is performed only when all possibilities have been exhausted conservative therapy and endoscopic treatment. The methods of endoscopic injection with an alcohol-adrenaline mixture, irrigation with hemostatic solutions and electrocoagulation of the bleeding area, and the method of prolonged hemostasis using a barium-thrombin mixture are quite effective.

Prognosis and prevention

The prognosis for life with hemorrhagic gastritis is in most cases favorable, but for recovery it is doubtful, since this disease takes a long time to be treated and often recurs even after surgical treatment.

Prevention comes down to healthy image life, proper daily routine, regular nutrition and stress prevention, timely treatment of stomach diseases, avoidance of smoking and alcohol consumption. If symptoms of stomach damage appear, it is imperative to contact a gastroenterologist - timely treatment allows you to avoid the progression of the disease and the development of life-threatening complications.

Gastritis is an inflammatory disease of the gastric mucosa (in some cases, even deeper layers), leading to its dystrophic changes and violations in the work of the body itself. Gastritis is accompanied by pain in the upper abdomen and various dyspeptic disorders.

The causes of gastritis are non-compliance with the rules healthy eating, alcohol and smoking abuse, taking certain medications, chronic stress.

It may also occur against the background of other diseases of the internal organs or as a result of infection with certain bacteria and fungi (in particular the bacterium Helicobacter pylori).

Acute form of the disease without timely treatment quickly becomes chronic, which usually occurs with complications.

Chronic gastritis is a term used to refer to long-term inflammatory diseases stomach, which are characterized by persistent structural changes its mucous membrane.

Erosive-hemorrhagic gastritis– this is an acute or inflammation of the gastric mucosa, accompanied by the formation of erosions and hemorrhages (bleeding). Damage affects only the mucous layer, muscle tissue stomach in this disease remain unchanged.

Reasons development erosive gastritis the following factors become:

uncontrolled use of certain medications (analgesics, non-steroidal anti-inflammatory drugs, etc.);
addiction to “unhealthy” foods (smoked meats, marinades, spicy foods, etc.);
systematically eating too hot food;
bacteria: Helicobacter pylori, diphtheria bacillus, salmonella;
chronic stress.

Complications of hemorrhagic gastritis can be repeated stomach bleeding, anemia, formation, in in rare cases shock.

Erosive gastritis is considered one of the most dangerous inflammatory diseases of the stomach!

Symptoms

In most cases erosive hemorrhagic gastritis is manifested by the following symptoms:

pain in the epigastric region (on an empty stomach and late);
feeling of fullness in the stomach;
unpleasant taste in the mouth;
heartburn;
sour belching;
vomiting with blood;
tendency to constipation with “episodes” of diarrhea.

Expert opinion

Irina Vasilievna

Practicing gastroenterologist

Most characteristic symptom This disease, which distinguishes it from other gastritis, is gastric bleeding, which can be suspected by the pallor of the skin, general weakness and frequent dizziness (sometimes with loss of consciousness).

Vomit and feces, stained with blood, become dark or black.

Erosive gastritis caused by medication for a long time may leak asymptomatic. Diagnosing the disease in this case can be difficult due to the signs of the underlying disease, which are “layered” on the symptoms of progressive hemorrhagic gastritis.

Diagnostics and necessary examinations

In addition to the external examination and history taking, the patient is prescribed the following diagnostic tests.

Lab tests:

biochemical analysis blood;
blood test to detect anemia;
stool occult blood test;
bacteriological and toxicological analysis of vomit, food debris, feces.

Instrumental studies:

fibrogastroduodenoscopy (FGDS) with targeted biopsy - performed to assess the condition of the mucous membrane and exclude the oncological nature of the disease;
X-ray of the stomach - study of the relief of the walls of the stomach;
intragastric pH-metry – assessment of the acid-forming function of the stomach;
breath test for helicobacteriosis.

Additionally, immunological studies, tests for syphilis and tuberculosis may be prescribed.

Treatment of erosive-hemorrhagic gastritis

Expert opinion

Irina Vasilievna

Practicing gastroenterologist

Depending on the duration of the disease, hemorrhagic gastritis is divided into spicy And chronic. The acute form is cured in 7-10 days, the chronic form may bother the patient long time and is much more difficult to treat.

Also, erosive gastritis can be primary (occurring for the first time) and secondary (arising against the background of existing stomach diseases).

The final treatment will depend on what form of hemorrhagic gastritis is diagnosed in the patient’s medical record.

Treatment of erosive gastritis is carried out on an outpatient basis or in a hospital. If there is gastric bleeding, hospitalization is required.

The patient is prescribed:

drug therapy (taking into account the form and severity of the disease);
hemostatic therapy (in case of bleeding);
herbal medicine (in remission);
surgical treatment (in exceptional cases, when all possibilities conservative treatment exhausted).

Treatment should only be prescribed by a doctor!

What do doctors usually prescribe?

Drug treatment of hemorrhagic gastritis is prescribed individually taking into account the etiology (causes of the disease) and the results of laboratory and instrumental studies. The list of drugs given below may vary depending on the characteristics of the disease.

Antibacterial therapy– the choice of antibiotics depends on the causative agent of the infection.
Inhibitors proton pump − omeprazole, pantoprazole.
H2-histamine receptor blockers− cimetidine, ranitidine.
Antacids− aluminum hydroxide + magnesium hydroxide.
Gastroprotectors− bismuth preparations.
Antispasmodics− atropine, platiphylline, papaverine hydrochloride.
Prokinetics− metoclopramide, domperidone.
Reparants– methyluracil, sea buckthorn oil, rosehip oil.
Herbal remedies– decoction of flax seed, plantain, yarrow, chamomile.

Folk remedies

Traditional medicine is good in the fight against erosive gastritis as an adjuvant therapy. How can you supplement the main treatment?

Propolis. A small piece of propolis should be consumed on an empty stomach once a day, chewing it thoroughly. The course of treatment is 1 month.
Juice . Freshly squeezed plant juice is boiled and then cooled. Drink 1 teaspoon half an hour before meals, 2 times a day. To enhance the effect, you can add a little to the juice.
Lettuce (salad). 1 tbsp. pour a spoonful of crushed leaves into 1 cup of boiling water and leave for 2 hours. Take the product ½ cup 2 times a day.
Sprouted wheat. Fill the wheat grains with water so that they are completely hidden and wait for them to germinate. Rinse the sprouts with chilled boiled water and chop. Then add to them olive oil. Take the resulting product 1 teaspoon between meals.
Mumiyo. This is incredible useful remedy from Altai, which treats many ailments, including gastritis. Mix 0.25 g. Shilajit with warm and a drop of honey. Have a drink healing agent in the morning on an empty stomach and before bed.

Before using any chosen product, you should always consult your doctor.

Diet for erosive-hemorrhagic gastritis

Diet therapy for hemorrhagic gastritis begins with a two-day fast, then for 4 days the patient is prescribed treatment table No. 0, then for 6-10 days – diet No. 1.

The patient is advised to eat fractional meals in small portions; overeating is excluded. Dishes must be served pureed. Recommended types of heat treatment are boiling, baking, stewing.

Allowed:

Prohibited:

Erosive gastritis is a type of inflammation of the stomach. It is characterized by damage to the mucous membrane with the formation of single or multiple erosions on it without damage to the muscle wall.

Types of erosive gastritis

There are exogenous and endogenous forms of erosive gastritis. Exogenous inflammation of the stomach develops as a result of exposure to external pathogenic factors. Endogenous gastritis occurs due to the influence internal reasons. Mixed inflammation also occurs.
According to the course, erosive gastritis can be acute and chronic. Acute erosions heal within 4-10 days, and with erosive chronic gastritis mucosal defects may remain for many months. The disease can also be primary or secondary. Primary gastritis with erosions develops against the background of an unaffected stomach in practically healthy people. Secondary inflammation affects individuals with certain pathologies digestive tract.
Erosion may appear predominantly in the fundus, body or antrum of the stomach. Erosive antrum gastritis is most often observed, since the antrum is the most lower section organ. It is here that gastric juice can stagnate and corrode the mucous membrane.

Etiology of erosive gastritis

As noted above, erosive-ulcerative gastritis can be caused by external, internal and mixed factors.

External reasons

Exogenous factors include the following:

various chemical substances(acids and alkalis), which can be taken accidentally or for suicidal purposes;
some medications (glucocorticoid hormones, anti-inflammatory drugs);
bacterial agents (diphtheria bacillus, salmonella, etc.);
errors in nutrition (too rough, spicy food, irregular snacking);
exposure to high temperatures (for example, drinking too hot).

Note: Smoking is a risk factor erosive and ulcerative lesions stomach, since nicotine constricts blood vessels and disrupts blood supply.

Internal reasons

Erosion of the stomach can develop as a result of the following background pathologies:

myocardial infarction;
reverse flow of bile (reflux gastritis);
with salt deposits uric acid on the walls of the stomach;
diseases with metabolic disorders.

Gastritis of mixed etiology can be caused by some forms of allergies, burns, radiation sickness, stress, etc.

Symptoms of erosive gastritis

The main manifestations of the disease are approximately the same for all species.
With the development of erosive gastritis, symptoms may be as follows:

abdomen or in the left hypochondrium, which worsen immediately after eating, but can also occur on an empty stomach;
nausea, vomiting of undigested food mixed with mucus and blood, sometimes the vomit has the appearance of “coffee grounds”, which occurs as a result of the action on the spilled blood gastric juice;
lack or sharp decrease in appetite;
sour belching;
heartburn;
flatulence;
stool disorders (diarrhea, sometimes constipation), which often has a dark, almost black color as a result of the admixture of coagulated blood.

Features of exogenous erosions

Helicobacter increases the risk of developing erosive gastritis

With acid or alkaline damage to the stomach, a burn of the esophagus is usually observed, which is manifested by salivation, severe pain behind the sternum, inability to eat due to pain. Erosive-hemorrhagic gastritis of drug etiology is characterized by almost complete absence pain.
If the disease is bacterial in nature, the temperature may increase, chills, weakness, and headaches may appear. IN severe cases Dehydration develops due to repeated vomiting and diarrhea. Visible mucous membranes become dry, the skin loses elasticity and tone, and decreases arterial pressure. With diphtheria damage to the stomach, erosions occur after the diphtheria films are rejected.
Erosive antral gastritis often occurs against the background of Helicobacter pylori infection. The localization of erosions in this case is determined using endoscopy.

Features of endogenous erosive inflammation

If the disease is caused by internal pathologies, then the picture of gastritis is superimposed on the symptoms of the underlying disease. For example, there may be signs of myocardial infarction: very severe burning pain behind the sternum, in the shoulder or arm, weakness, dizziness. With erosive reflux gastritis, patients are bothered by bitter belching, vomiting bile, and pain in the right hypochondrium.
Chronic with uremic intoxication are accompanied by anemia and edema. Uric acid salts can be deposited not only in the stomach, but also in the pleural, pericardial, abdominal cavities and even on the skin (“uremic powder”).

Signs of gastritis with erosions of mixed etiology

In case of burn disease, microcirculation of blood in the gastric wall is disrupted, which causes the appearance of erosions. Radiation affects the epithelium of the mucous membranes of the gastrointestinal tract, cells are rejected with the formation of erosions and ulcers. In this case, erosive gastritis is combined with infectious complications, radiation erosive enterocolitis. At allergic form inflammation, signs of the disease appear some time after the action of the allergen, most often food products play its role. At the same time, urticaria on the skin, swelling of the face, itching of the mucous membranes of the eyes and mouth may occur.

This type of gastritis (erosive-hemorrhagic), like any form, is an inflammatory process in the tissues of the gastric mucosa. This species is isolated due to the fact that the primary appearance of disorders in the submucosal layer becomes. The walls of blood vessels become thinner, focal hemorrhages occur, erosions and blood clots appear in small vessels. An alternative name is often used in relation to it - corrosive gastritis. This is the most dangerous and severe form.

The causes of hemorrhagic gastritis have in common with the causes of a complex of diseases under common name gastritis:

Eating foods of inadequate quality;
Abuse of strong alcoholic drinks and other bad habits;
Stress, overwork;
Poisoning with harmful substances;
Long-term use of non-steroidal drugs, mainly anti-inflammatory drugs. Even harmless aspirin can lead to such consequences;
Previous operations of the gastric region;
Liver dysfunction, diseases (cirrhosis, liver failure).

Erosive-hemorrhagic gastritis, depending on the specific cause of its development, is classified into one of two types:

Type A – autoimmune origin

Type B – bacterial infection

Symptoms

The appearance of a disease, inflammation of the mucous membrane, can be indicated by the symptoms that appear. The most severe phenomenon is bleeding, which is high level danger to the patient.

Other signs:

Discomfort in the stomach, increasing after eating junk food;
Decreased appetite followed by weight loss;
Heartburn, belching;
with blood spots;
Flatulence (bloating);
Feeling of heaviness;
Blood may be seen in the stool.

The presence of blood characterizes erosive-hemorrhagic gastritis, highlighting it in the list of pathological changes in the functioning of the gastrointestinal tract. In addition to the listed symptoms, anemia and tachycardia may be added. Lesions can be single or multiple.

It is possible to identify symptoms, establish their exact cause and make an appropriate diagnosis only after undergoing an examination. Analysis of the data obtained after diagnosis will confirm or exclude gastritis in a particular patient.

Diagnosis of pathology

The most informative method in the case of erosive-hemorrhagic gastritis is endoscopic examination. It happens different types, on which the final name depends, many people know it as fibrogastroscopy or videogastroscopy.

The introduction of a special tube through the mouth allows you to examine internal state mucosal walls, establish the area of the lesion, the number of erosions and their nature.

An addition is taking a blood test, which will help prescribe the correct treatment. Exact list necessary tests determined by a gastroenterologist.

If treatment is not timely, gastritis from the acute stage transforms into chronic, which will be more difficult to cope with, and in most cases it accompanies the patient for the rest of his life, worsening in the off-season.

Treatment of the disease

Hemorrhagic gastritis requires complex treatment. Drug treatment is enhanced in its effectiveness by following a proper diet with some restrictions. Diet is necessary and very important in the fight against the disease.

Self-medication, treatment folk remedies excluded due to high danger development internal bleeding. Treatment should be completed under the strict supervision of the attending physician.

Moreover, taking a certain medication that helps in other situations can worsen the situation.The preparations are different for different acidities.

The general principle by which drug treatment is carried out is the correct combination of drugs:

To influence the bacterium Helicobacter pylori, antibiotics are prescribed in the form of certain regimens for eradication (complete elimination) of bacterial damage.
If there is excess acid, antisecretory agents can be prescribed to help reduce the intensity and acidity of the secreted juice ().
To minimize and eliminate bleeding, coagulant drugs such as Vikasol, Etamzilat can be used.
Almagel, Maalox will help protect the delicate mucous membrane.
For improvement digestive process Pancreatin and Mezim are used.
A complex of vitamins and minerals to replenish the lack of substances supplied with food, which are minimized during inflammation.

Avoid strong alcohol.
Limit the consumption of fatty, spicy, smoked, and excessively salty foods.
Incorrect food temperature (too hot or cold food injure the mucous membrane).
It is not recommended to eat rough food.

Famous for their beneficial properties infusions pharmaceutical herbs and gastric collections can complement therapy, but it is advisable to use them after prior consultation with a specialist.

Types of erosive gastritis

There are exogenous and endogenous forms of erosive gastritis. Exogenous inflammation of the stomach develops as a result of exposure to external pathogenic factors. Endogenous gastritis occurs due to the influence of internal causes. Mixed inflammation also occurs.
According to the course, erosive gastritis can be acute and chronic. Acute erosions heal within 4-10 days, but with erosive chronic gastritis, mucosal defects can remain for many months. The disease can also be primary or secondary. Primary gastritis with erosions develops against the background of an unaffected stomach in practically healthy people. Secondary inflammation affects individuals with certain pathologies of the digestive tract.
Erosion may appear predominantly in the fundus, body or antrum of the stomach. Erosive antrum gastritis is most often observed, since the antrum is the lowest part of the organ. It is here that gastric juice can stagnate and corrode the mucous membrane.

Etiology of erosive gastritis

As noted above, erosive-ulcerative gastritis can be caused by external, internal and mixed factors.

External reasons

Exogenous factors include the following:

various chemicals (acids and alkalis) that can be taken accidentally or for suicidal purposes;
some medications (glucocorticoid hormones, anti-inflammatory drugs);
bacterial agents (diphtheria bacillus, Helicobacter, salmonella, etc.);
errors in nutrition (too rough, spicy food, irregular snacks);
exposure to high temperatures (for example, drinking too hot).

Note: smoking is a risk factor for erosive and ulcerative lesions of the stomach, since nicotine constricts blood vessels and impairs blood supply.

Internal reasons

Erosion of the stomach can develop as a result of the following background pathologies:

myocardial infarction;
reverse flow of bile (reflux gastritis);
chronic kidney failure with deposition of uric acid salts on the walls of the stomach;
diseases with metabolic disorders.

Gastritis of mixed etiology can be caused by some forms of allergies, burns, radiation sickness, stress, etc.

Symptoms of erosive gastritis

The main manifestations of the disease are approximately the same for all species.
With the development of erosive gastritis, symptoms may be as follows:

pain in the epigastric region of the abdomen or in the left hypochondrium, which intensifies immediately after eating, but can also occur on an empty stomach;
nausea, vomiting of undigested food mixed with mucus and blood, sometimes the vomit has the appearance of “coffee grounds”, which occurs as a result of the action of gastric juice on the spilled blood;
lack or sharp decrease in appetite;
sour belching;
heartburn;
flatulence;
stool disorders (diarrhea, sometimes constipation), which often has a dark, almost black color as a result of the admixture of coagulated blood.

In the article The Most dangerous symptoms, indicating erosive damage to the stomach, which we recommend that you read additionally, describes the main signs of the disease in more detail.

Features of exogenous erosions

With acid or alkaline damage to the stomach, a burn of the esophagus is usually observed, which is manifested by drooling, severe pain in the sternum, and the inability to eat due to pain. Erosive-hemorrhagic gastritis of drug etiology is characterized by an almost complete absence of pain.
If the disease is bacterial in nature, the temperature may rise, chills, weakness, and headaches may appear. In severe cases, dehydration develops due to repeated vomiting and diarrhea. Visible mucous membranes become dry, the skin loses elasticity and tone, and blood pressure decreases. With diphtheria damage to the stomach, erosions occur after the diphtheria films are rejected.
Erosive antral gastritis often occurs against the background of Helicobacter pylori infection. The localization of erosions in this case is determined using endoscopy.

Features of endogenous erosive inflammation

If the disease is caused by internal pathologies, then the picture of gastritis is superimposed on the symptoms of the underlying disease. For example, there may be signs of myocardial infarction: very severe burning pain behind the sternum, in the shoulder or arm, weakness, dizziness. With erosive reflux gastritis, patients are bothered by bitter belching, vomiting bile, and pain in the right hypochondrium.
Chronic kidney diseases with uremic intoxication are accompanied by anemia and edema. Uric acid salts can be deposited not only in the stomach, but also in the pleural, pericardial, abdominal cavities and even on the skin (“uremic powder”).

Signs of gastritis with erosions of mixed etiology

In case of burn disease, microcirculation of blood in the gastric wall is disrupted, which causes the appearance of erosions. Radiation affects the epithelium of the mucous membranes of the gastrointestinal tract, cells are rejected with the formation of erosions and ulcers. In this case, erosive gastritis is combined with infectious complications, radiation erosive enterocolitis. In the allergic form of inflammation, signs of the disease appear some time after the action of the allergen; more often, food plays its role. At the same time, urticaria on the skin, swelling of the face, itching of the mucous membranes of the eyes and mouth may occur.

Important: if signs of acute erosive gastritis appear, you should immediately seek help from a doctor.

But perhaps it would be more correct to treat not the effect, but the cause?

Hemorrhagic gastritis

Erosive (hemorrhagic) gastritis is an inflammatory process of the walls of the stomach with the formation of erosions, against which bleeding occurs. The disease is typical for adults and children. The main reason eating food that is harmful to the body becomes.

It is worth understanding: what are the types of erosive gastritis, the causes and symptoms of the disease, and most importantly, what is the treatment for hemorrhagic gastritis.

Types of hemorrhagic gastritis

The disease is divided into types, depending on the location of the erosions and the stage of development.

Acute hemorrhagic gastritis - the surface layer of the gastric mucosa is affected by shallow, rapidly developing erosions. Causes:

stress;
severe injuries or burns;
pain in the epigastric region;
signs of anemia.

Often manifestations acute gastritis invisible, manifested only in gastric bleeding and the formation of erosion. The sign is considered distinctive feature from other varieties. Erosive-hemorrhagic gastritis is treated for 5-10 days.

Chronic hemorrhagic gastritis is formed during a prolonged inflammatory process of the gastric mucosa, leading to bleeding. Healing of large erosions (3-7 mm) sometimes does not occur at all, it is probable death. The causes of the type are called:

Long-term use of antibiotics.
Viral diseases.
Alcoholism.

Erosive antral gastritis - the entry of Helicobacter pylori bacteria into the stomach causes an inflammatory process in the mucous membrane and leads to damage to the tissues of the organ, depriving the integument of the opportunity to recover.

Atrophic gastritis - characterized by depletion of the gastric mucosa. This type often leads to cancer. It usually occurs in atrophic manifestations in patients of pre-retirement age; young people are also at risk. Remember, the gastric mucosa can completely disappear; you should not neglect the doctor’s recommendations if you are diagnosed with “atrophic gastritis.”

Erosive reflux gastritis - with this type, the contents of the duodenum are thrown into the stomach, swelling occurs on the mucous membrane, leading to the formation of ulcers. Destruction of stomach tissue leads to exfoliation, and release from the body occurs along with vomit.

Etiology of hemorrhagic gastritis

The difference between simple gastritis and gastritis with a hemorrhagic component is that the occurrence of the second is caused by the influence of exogenous factors that are not associated with interaction with the secretory activity of the stomach.

Possible causes of the disease:

The appearance of the bacterium Helicobacter pylori in the stomach.
Poor poor quality food.
Excessive and uncontrolled use of drugs.
Alcohol abuse.
Stress.
Mechanical effect on the stomach.

Symptomatic manifestations of hemorrhagic gastritis

Hemorrhagic gastritis, the symptoms of the disease, are classified according to several criteria.

Based on patient complaints:

Lack of appetite.
Nausea and vomiting.
Heartburn.
Pain occurs after eating.
Sudden weight loss.
Belching.
Characteristic is the appearance of diarrhea, followed by constipation. At frequent changes the nature of defecation manifests itself as a hemorrhoidal process in the body. Foods that are poorly digestible by the body provoke blood stagnation in the pelvic organs. Vasodilation occurs, and then the hemorrhoidal node falls out.
Dizziness.

After inspection and clinical trials:

pale skin;
white coating on the tongue;
characterized by a decrease in pressure;
when pressing on the abdomen, pain appears;
black stool.

How is diagnosis carried out?

Erosive-hemorrhagic gastritis is diagnosed by a gastroenterologist during examination.

When interviewing the patient, associated symptoms are identified.
During an external examination, they are assessed skin and the condition of the nails.
The abdomen is examined and palpated.
Conducted laboratory research to compare the samples obtained with the norm (general and biochemical blood tests, general urinalysis, taking a coprogram).
Conducting instrumental studies allows you to clarify the preliminary diagnosis.

An informative study is esophagogastroduodenoscopy, which allows you to evaluate the gastric mucosa, determine changes in its structure, the source of erosion and the presence of blood discharge. An examination is carried out using an internal examination of the gastric contents using a probe with a sensor at the end. The patient, under the supervision of a doctor, swallows the tube, what happens is visible on the screen. A biopsy is taken - pinching off the required part. The process lasts no more than 5 minutes, but becomes a fundamental study for establishing a final diagnosis.

When conducting clinical studies, the acidity level must be determined to exclude other diseases gastrointestinal tract, the symptoms are sometimes similar.

Treatment of hemorrhoidal gastritis

Treatment is divided into types, carried out comprehensively on an outpatient or inpatient basis:

adherence to a certain diet or diet;
medications;
folk remedies.

Diet food

Diet for hemorrhagic gastritis is recognized as the optimal treatment, although it is not always simple for the patient. Normalizing your diet will be the first step on the path to recovery.

You will have to reconsider your own diet, exclude fatty, salty, spicy, pickled, fried foods. It is worth giving up coffee, chocolate, baked goods and confectionery, carbonated water, alcohol, grapes, cabbage, fatty meats (pork and lamb), canned foods.

The dietary menu is varied, so the treatment is healthy and tasty! Possible to cook for breakfast different kinds porridge: rolled oatmeal, buckwheat, pearl barley, oatmeal. For lunch, preference should be given to light dishes as a first course. vegetable soups with dietary meat - chicken, turkey. It’s easy to prepare for the second one mashed potatoes on water with steamed rabbit meat, steam cutlets. Dinner should be varied with a vegetable salad with boiled fish; bran bread is preferable.

In terms of drinks, the following are allowed: compote, jelly, weak green tea, herbal decoctions.

Remember the benefits of dairy products, which can be consumed in any quantity. Eggs are consumed raw or cooked, for example, in the form of an omelet. Be careful with milk - it leads to flatulence. You can't use sour cream.

Portions should be small, food should be steamed or cooked in water without the use of spices, and it is recommended to chew thoroughly. Food should not be hot when served.

A balanced diet, subject to a five-times-a-day diet and avoidance of overeating, will well restore the stomach environment, exclusively in combination with the main treatment.

Medications

IN modern world Choosing a medication is not easy. The difficulty is associated with a large variety depending on price, quality and manufacturer.

Medicines are prescribed to reduce inflammation, reduce acidity and prevent bleeding. For prevention, medications containing enzymes are prescribed - the drugs normalize digestive activity. If bleeding occurs, droppers and intramuscular injections are prescribed.

It is necessary to follow the doctor’s prescriptions, take medications in the indicated dosage, and not self-medicate, otherwise erosive-hemorrhagic gastritis will progress to the next stage of the disease. Then it will no longer be possible to do without surgical intervention. Surgery is possible if medication treatment does not lead to the expected result.

Folk remedies

Often even doctors prescribe home treatment. Based on the experience of patients, recipes are given to help them recover when a diagnosis of gastritis with a hemorrhagic component is made.

Potato juice. It is better to be treated with a course of ten days. During the specified time, juice in a volume of 200 ml is drunk in the morning before meals.
Cabbage juice or celery juice. Take 1/2 cup of juice from vegetable leaves a couple of times a day an hour before meals, warming it up a little.
Aloe vera juice. Take freshly squeezed juice 3 times a day, 1 teaspoon before meals.
Sprouted wheat grains. Pour into a container, add water until the grains are visible, wait for germination - add water if necessary. After germination, rinse with running water and grind. Add olive oil to the resulting mixture and cool. Take 1 teaspoon between meals.
Sea buckthorn oil. 30 minutes before meals, take 1 teaspoon for 1.5 months.
Birch juice. Having brought up 3 l birch sap to a boil, add 50 g of calendula - simmer over low heat, covered, for 10 minutes. Then add 200 ml of honey and stir. Use the resulting composition in the morning 40 minutes before meals and store in a cool place.
Propolis. It is taken in small pieces once a day for a month.
Lettuce. Chopped lettuce leaves in the amount of 25 g pour 250 g boiled water, infuse for 2 hours and take 100 ml.

Treatment with folk remedies should be started only after consultation with a doctor, in order to avoid complications.

Forecast

The main thing is timely diagnosis. Hemorrhagic gastritis is not fatal; treatment at the initial stage depends only on the patient. Already, based on the work done by the patient, the doctor makes a decision on more conservative methods, considering, for example, surgery.

Otherwise, complications are possible - the transition of an acute form of the disease to a chronic one: stomach ulcers, cancer and bleeding.

It is worth remembering that hemorrhagic gastritis is a disease compatible with life, but it is better to prevent the disease than to treat it.

A dangerous form of the disease is hemorrhagic gastritis.

The hemorrhagic type of gastritis is dangerous due to bleeding, which poses a direct threat to the patient’s life. The stomach becomes inflamed, resulting in erosions and ulcers appearing on its mucous membrane.

Therefore, the disease is also called “erosive-hemorrhagic gastritis.” The antrum of the stomach is especially affected by erosions.

The antrum is the most Bottom part organ in which gastric juice accumulates under the influence of gravity. Therefore, it is the antrum that suffers first from stagnation of juice.

Fortunately, inflammation in hemorrhagic gastritis never reaches the internal tissues of the stomach, and erosion affects only the top layer - the mucous membrane.

The patient is concerned about:

nausea with salivation;
heartburn, belching, gas;
rumbling and pain in the abdomen.

A characteristic symptom characteristic only of hemorrhagic gastritis is vomiting “coffee grounds”. This color is given to vomit by an admixture of blood released from the stomach.

Stomach bleeding can occur without vomiting blood. General analysis blood in this case will show signs of iron deficiency anemia.

Why does hemorrhagic gastritis develop, what are the reasons for its appearance?

The disease is caused by:

systematic poisoning (may occur among workers in hazardous industries if safety regulations are not observed);
long-term treatment with certain medications and folk remedies;
infection with the bacterium Helicobacter pylori;
treatment with anti-inflammatory non-steroidal medications - sometimes a single dose is enough for erosion to form.

If the disease occurs for the first time or there is an exacerbation of chronic hemorrhagic gastritis, then it is called acute. Acute gastritis has more severe symptoms inflammation.

Unlike chronic gastritis, acute gastritis does not occur due to disturbances in the secretory functions of the stomach. Its causes are always outside the body - this is unfavorable factors environment.

Reasons why acute gastritis may occur:

blunt trauma to the stomach;
poor quality alcohol;
poisoning with chemicals, industrial poisons.

Treatment of hemorrhagic type of disease

Treatment of hemorrhagic gastritis traditional methods or over-the-counter medications is fraught with complications, threatening for life.

This may be a rupture of erosion or severe gastric bleeding. In this case, only a doctor can provide the necessary assistance and save the patient from a painful death.

Therefore, treatment of this disease should be carried out on an outpatient basis, under the supervision of a gastroenterologist.

The doctor can make a diagnosis after initial examination patient.

Signs of hemorrhagic gastritis will be:

pale skin;
whitish coating on the tongue;
dull pain when pressing on the abdomen in the stomach area;
rapid pulse with low blood pressure.

The primary diagnosis of “hemorrhagic gastritis” requires mandatory confirmation using FGDS.

Fibrogastroduodenoscopy is the only reliable way diagnostics, allowing medical worker see with your own eyes what is happening inside the stomach, and also take a tissue sample for microbiological and histological examination.

The doctor can supplement the results of fibrogastroduodenoscopy with tests for Helicobacter pylori infection and gastric acidity.

After diagnosis, the doctor will prescribe medication. It will be symptomatic.

So, if as a result of FGDS it is discovered that blood is being released from the stomach, the doctor will inject into the antrum of the stomach necessary medications(Vikasol or Etamzilat) right during the study.

The treatment regimen will depend on the degree of organ damage and accompanying symptoms.

The doctor may prescribe:

drugs that reduce the production of gastric juice: Omeprazole, Dalargin. Reducing the amount of gastric juice and reducing it of hydrochloric acid will stop development inflammatory process and prevent the appearance of new erosions;
gastroprotective drugs, that is, agents that envelop and protect the surface of the stomach from further corrosion: Phosphalugel, Maalox;
antibiotics to cleanse the stomach of the Helicobacter bacteria;
enzyme preparations to facilitate digestion: Mezim, Pancreatin;
painkillers and antispasmodics - Analgin, No-shpa;
restoratives: aloe preparations, vitamins, Actovegin.

Nutrition for illness

In the treatment of gastritis vital role diet plays. For acute and chronic form For hemorrhagic gastritis, the diet will be different.

The diet for acute gastritis should help unload the stomach. You will have to give up food and drink for a day. If the “dry” diet is difficult, then you can drink up to a liter of warm distilled water during these days.

“On hunger,” acute gastritis weakens its grip within a day. On the second day, you can eat slimy soup (made from oatmeal or rice) and drink warm tea with chamomile, lemon or honey.

After another day, you can eat viscous soups made from barley and any other cereal, semolina porridge with milk, skim milk, soft-boiled eggs, omelet, souffle, jelly.

When the pain subsides, you can enter into the menu meat broths. The bread should be stale or in the form of crackers.

The diet will no longer be needed when the symptoms of acute gastritis disappear. At this time, you can return to your previous diet. However, you will have to give up fried and spicy foods for a long time.

Will remain on the banned list dairy products, raw vegetables, soda, alcohol.

The diet for chronic hemorrhagic gastritis is aimed at reducing the production of gastric juice.

This diet includes:

If you have hemorrhagic gastritis, you should not eat foods that cause strong discharge gastric juice: salty, spicy, fried, fatty, sour, pickled, strong broths, canned meat, hard-boiled eggs, chocolate, ice cream, unripe fruit, carbonated drinks.

Treatment of hemorrhagic gastritis with folk remedies can only be carried out as a supplement.

In folk medicine, herbs are used against stomach bleeding: yarrow, nettle, oak bark.

A tablespoon of plant material is brewed with a glass of boiling water and drunk half a glass half an hour before meals.

However best treatment gastritis using folk remedies (and at the same time prevention) is a regular good nutrition, daily use soups and a quiet lifestyle.

If adequate drug treatment has been carried out and the diet has been followed, the prognosis for hemorrhagic gastritis is usually favorable.

But the success of treatment will depend on whether the causes that led to the disease can be eliminated.

So, if it turns out that erosions appeared as a result of treatment with certain drugs, then their use will have to be stopped forever.