Acute and chronic erosive-hemorrhagic gastritis: antral, fundal, focal. Erosive-hemorrhagic gastritis: the essence of the disease, causes, symptoms, treatment

Hemorrhagic gastritis is also called erosive and the disease occurs with superficial damage to the gastric mucosa, which often leads to bleeding from the stomach; healing occurs without scarring.

Hemorrhagic gastritis, like all gastritis, can be either acute or chronic.

Acute hemorrhagic gastritis is provoked by injuries, blood loss, burns or shock states, renal failure or liver failure. Symptoms that help make the diagnosis of hemorrhagic gastritis, such as: tarry stool or vomiting with blood.

Treatment of erosive-hemorrhagic gastritis

For the treatment of gastritis, ranitidine 50 mg and quamatel 20 mg are prescribed intravenously 4 times a day.

Treatment of hemorrhagic gastritis with medications is very effective.

For erosive gastritis, it is necessary to follow the diet prescribed by gastroenterologists.

Traditional treatment of erosive gastritis

Erosive gastritis is one of the most common diseases digestive system. Erosive gastritis is an inflammation of the gastric mucosa, accompanied by the formation of multiple surface defects. Very often the acute form of the disease develops into chronic illness, which may cause the development of ulcers or stomach cancer in the future.

If erosive gastritis is diagnosed in a timely manner, treatment folk remedies in combination with proper nutrition helps you recover completely.

Often treatment erosive gastritis folk remedies are much more effective than treatment medicines. There are many recipes that will help you not only recover faster, but also strengthen your immune system and improve the condition of your entire body.

To treat erosive-hemorrhagic gastritis, take 10 tablespoons of the following herbs: St. John's wort, calamus root, valerian root, oregano, calendula flowers, toadflax, mint, plantain, knotweed herb, tripoli, yarrow, fennel fruit; 5 tablespoons of wormwood and horsetail. The mixture is brewed at the rate of 40 grams per half liter of boiling water. Leave to infuse for 60 minutes. The infusion is taken 20-30 minutes before each meal, 150-200 grams. This amount of herbs will be enough for you to complete the course of treatment for erosive gastritis.

When treating erosive gastritis with folk remedies, rosehip decoction is also used. A concentrated decoction is prepared at the rate of 80 rose hips per 250 grams of boiling water. The berries must be poured into a thermos, pour boiling water over them, and leave to infuse overnight. It is recommended to drink this infusion 4-5 glasses per day.

Mix a teaspoon of propolis with 200 ml of milk and heat over low heat until the propolis is completely dissolved in the milk. Strain the broth if necessary. The medicine is used in the morning on an empty stomach, 200 ml. In case of severe exacerbation, you can take an infusion of 100 ml four times a day.

To treat erosive gastritis, mix aloe juice with honey in equal proportions and take 1 tablespoon before each meal.

To enhance the selection gastric juice If you have low acidity, it is useful to take honey. A teaspoon of honey is dissolved in a glass warm water and take 15-20 minutes before meals.

When treating gastritis with folk remedies, do not forget about diet. It is necessary to exclude spicy, fatty, salty, pickled, fried foods, coffee, and alcohol from your daily diet.

Diet for erosive gastritis

Gastritis refers to inflammation of the gastric mucosa, or the lining that protects the stomach from erosion from acidic juices digestive tract. Erosive gastritis is a sudden but mild onset of inflammation that causes mucosal damage and erosion. Symptoms may include nausea or vomiting, upper abdominal discomfort, and in some cases it can lead to ulcers and bleeding. Diet for erosive gastritis - an important part treatment.

Nutrition for erosive gastritis

Fresh fruits and vegetables are not only good sources protein, but also nourish your immune system while it works to fight damage. Choose low acid fruits such as apples, peaches, bananas and grapes. Vegetables can be lightly cooked to aid digestion. Carrots, mushrooms, beans, zucchini and leafy greens are best to use during flare-ups of erosive gastritis symptoms as they contain low acid variants. Broccoli, cabbage and onions are nutritious, but can cause bloating and gas if you eat them daily. Limit these vegetables to once a week until symptoms go away.

High-fat foods in an erosive gastritis diet may increase stomach inflammation when you have erosive gastritis. Swap fatty red meat for lean skinless poultry, baked fish, and low-fat dairy products. Use olive oil in your gastritis diet for cooking, baking and salads instead butter high in fat. Coffee, alcohol and carbonated drinks can irritate the stomach during an infection outbreak. Drink more plain water throughout the day to reduce stomach acid and maintain hydration.

How to treat erosive gastritis?

The most common cause of erosive gastritis is long-term use of non-steroidal anti-inflammatory drugs, and excess alcohol, stress and direct injury can also cause this condition. When drugs or alcohol are the cause, treatment focuses on eliminating the irritants and then reducing stomach acid with medications. Your doctor may temporarily prescribe an antacid, a histamine-2 blocker, and an inhibitor proton pump to neutralize stomach acid. In addition, the diet for erosive gastritis should not contain foods that can increase the acidity level of the body, such as soda, fatty varieties meat, fried food and alcohol.

Causes of erosive-hemorrhagic gastritis

The development of the chronic form of hemorrhagic gastritis is influenced by:

• Addiction to alcoholic beverages;
• Use of non-steroidal anti-inflammatory drugs;
• Viral infections;
• Crohn's disease.

Symptoms of erosive-hemorrhagic gastritis

Hemorrhagic gastritis can develop without symptoms, only accompanied by slight nausea. People with this hemorrhagic gastritis They go to the clinic only when stomach bleeding begins.

The symptoms of erosive-hemorrhagic gastritis are similar to the symptoms of gastritis with increased acidity or normal acidity of the stomach.

• Accompanied only by stomach bleeding.
• Anemia, constant gag reflexes.
• Tarry stool due to gastritis.
• Fatigue and weakness with hemorrhagic gastritis.
• Dizziness or fast heartbeat.

Gastric acidity in hemorrhagic gastritis can be normal, increased or decreased.

Hemorrhagic gastritis - diagnosis

Endoscopic examination is a frequently used stage in the diagnosis of erosive hemorrhagic gastritis. With the help of such a study, redness, bleeding, swelling upon contact with the gastric mucosa is determined, erosions or petechiae are also visible.

X-ray examination stomach.

Histological examination.

The accuracy of the diagnosis of hemorrhagic gastritis completely eliminates diseases such as ulcers, stomach tumors, disorders of motor or secretory functions.

It is also necessary to determine the exact form of hemorrhagic gastritis, and whether there is any stomach disease associated with it.

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:

1. Type A – autoimmune origin
2. 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 pathological changes work 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

Most informative method in the case of erosive-hemorrhagic gastritis, endoscopic examination becomes necessary. 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 and treatment with folk remedies are excluded due to the high risk of 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 bacteria 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.
• To improve the 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.
• Violation of food temperature (too hot or cold food injures the mucous membranes).
• 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.

is a type of inflammatory process of the gastric mucosa of acute and chronic origin, distinctive feature which is the formation of small defects (erosions) on its surface.

This means that erosive gastritis:

It differs from simple gastritis in the presence of multiple eroded areas of the mucous membrane against the background of its hyperemia (redness) and inflammation. Sometimes they can spread over the entire surface of the stomach;

It can occur, both acutely, when poor-quality food and toxic compounds enter the stomach cavity, and also when chronic course in case of disruption of the normal secretory-motor mechanisms of the digestive system;

May be caused by Helicobacter pylori infection;

Prone to protracted flow;

Treatment takes longer and is more difficult compared to other types of gastritis;

Can cause stomach bleeding of any severity. This feature can be a real problem if bleeding occurs simultaneously from the entire eroded surface of the stomach.

Pathogenetic mechanisms for the development of erosive gastritis can be:

In acute erosive gastritis, damage to the mucous membrane occurs as a result of its direct contact with aggressive environments (poor quality food, acids, alkalis, chemicals, drugs, etc.). In this case, a kind of burn occurs, which is accompanied by inflammation during its healing;

Chronic erosive gastritis is based on impaired secretory processes. They can be associated both with eating disorders and with internal malfunctions of the body. In this case, there is a disruption of microcirculatory processes, blood circulation in the stomach and increased secretion of aggressive components of gastric juice. Naturally, the ischemic mucous membrane is not able to resist them, which leads to its inflammation with further ulceration and the formation of erosions.

Symptoms of erosive gastritis

To suspect the erosive form of gastritis only by clinical signs and the patient’s complaints are extremely difficult. The exception is those cases when gastric bleeding occurs against the background of confirmed gastritis. In such situations, the fact of erosion formation becomes obvious. All other symptoms are typical for any type of gastritis and can only indirectly indicate its erosive type by their strong severity and persistence.

Symptoms of erosive gastritis include:

Pain in the projection of the stomach (epigastric area of ​​the upper abdomen). With erosive gastritis, it may not be intense, but with a widespread process, it may even require the administration of strong analgesics to stop it;

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Antrum gastritis is one of the most common forms of gastritis based on the localization of inflammatory processes in the mucous membrane, in which the progression of pathology can occur at a fairly rapid pace. Erosive antral gastritis is more late stage diseases when superficial inflammation of the epithelium develops into focal erosions - areas of damage to the upper layer of the mucosa. In the antrum of the stomach, located in the lower part of the organ, there are glands responsible for the secretion of mucus and enzymes that ensure alkalization of an overly acidic environment (since the antrum is adjacent to the duodenum, which is characterized by alkaline environment). If superficial gastritis is fairly easy to treat, then therapy for its erosive form is a rather complex and lengthy process, since erosion affects large areas of the mucosa and penetrates into deeper layers. Without treatment this pathology progresses rapidly, causing severe complications, from stomach ulcer before the development of malignant neoplasms.

Without treatment, the patient's condition worsens

The severity of inflammatory processes may be indicated by the symptoms of the disease, but you should not rely too much on these signs - they are characteristic of many gastrointestinal pathologies. The diagnosis can only be clarified through a thorough examination using laboratory and modern instrumental methods.

In the outdated medical classification, antrum gastritis is classified as “B” type (bacterial) gastritis; the Sydney classification, adopted in 1990, is more accurate and allows gastritis to be divided according to four criteria. At acute course disease, its symptoms manifest themselves in a pronounced form, and in many cases such exacerbations become the cause of the development of a chronic form of the disease, in which erosions spread throughout the antrum. Note that on early stages diseases, healing of erosions is possible without replacing dead cells with fibrous connective tissue.

Reasons for the development of the disease

In approximately 90% of cases when diagnosing erosive gastritis antrum stomach is observed increased content in the lower part of the stomach, the pathogenic bacterium Helicobacter pylori, for which the alkaline environment of the mucous membrane is an ideal habitat. However, this bacterium is the only one in the microflora of the digestive tract for which acidic environment with acidity in the region of 2 - 4 and even higher is not lethal. But the bacterium actively multiplies when more favorable conditions, therefore it is not surprising that its primary distribution area is the antrum.

Erosive gastritis of the antrum of the stomach is characterized by either the presence of one extensive lesion or many small erosions, which subsequently still merge into a large area of ​​necrosis, causing intragastric bleeding.

Alcohol is one of the factors that provoke gastritis

The following factors can cause the occurrence and spread of erosion foci:

• other chronic pathologies digestive tract, including chronic superficial gastritis, localized in other parts of the stomach;
• long-term use of certain medications (hormonal, anti-inflammatory, cytostatics);
• bad habits (uncontrolled drinking of alcohol, smoking);
• abuse of fatty, spicy, salty, hot foods, fast food, irregular meals);
• stress and other psycho-emotional disorders that cause the development of neuroses;
• vascular pathologies.

The cause of acute erosive gastritis can be conditions such as renal/liver failure, extensive blood loss, sepsis, and large-area burns.

Symptoms of the erosive form of antral gastritis

The problem with most types of gastritis is that their classic manifestations are not perceived by patients as pathology. Belching with pronounced sour taste, bowel irregularities, bloating and short-term pain in the stomach are often simply ignored, in best case scenario painkillers or drugs that facilitate the digestion process are taken. And only with an exacerbation of the disease, when the erosive areas deepen at a rapid pace, this leads to sharp deterioration the patient's condition, which forces him to seek qualified medical care. In any case, the symptoms and treatment of this form of gastritis should be monitored by the attending physician.

Symptoms of acute erosive antral gastritis:

• sharp abdominal pain of a constant or paroxysmal nature, which increases immediately or some time after eating;
• heartburn with nausea, which also appears after eating;
• attacks of vomiting with the presence of mucus in the vomit, blood clots and gastric juice;
• diarrhea, the presence of blood clots in the stool indicate the development of intragastric bleeding.

Symptoms of chronic erosive antral gastritis manifest themselves in a milder form: attacks of nausea, bloating, a feeling of heaviness in the epigastric region, short-term stomach pain, and possibly unstable stool. There are frequent cases when the chronic form of erosive gastritis long time is generally asymptomatic.

Features of treatment

Choosing a treatment regimen for antral gastritis erosive form depends on many factors: the patient’s medical history, the causes of the pathology, diagnostic results, and the presence of concomitant diseases.

Because in most cases this type gastritis is accompanied by extensive Helicobacter pylori infection, antibacterial therapy is a mandatory component of treatment. In this case, a regimen is usually used using two or three different antibiotics (Metronidazole, Amoxicillin, Levofloxacin). It should be noted that while the full course of treatment for a chronic form of the disease can last up to a year, antibiotic therapy is used for no longer than two weeks.

This is interesting: The majority of the population is carriers of Helicobacter (according to some data, up to 80 - 90%), but not everyone has gastritis. The point is that in in good condition The bacteria Helicobacter pylori in the stomach are not active, and only under favorable conditions, which include inflammatory processes in the mucous membrane, do they actively multiply.

Treatment of antral erosive gastritis involves the mandatory use of proton pump blockers and antacids - drugs whose therapeutic effect is to reduce the level of acidity of gastric juice, since this form of pathology is characterized by increased secretion of hydrochloric acid, which negatively affects the epithelial layer of the mucosa. These are the drugs Almagel, Maalox, Phosphalugel, Nizatidine. During exacerbations good effect observed when using Ranitidine, Famotidine.

A decrease in the acidity of gastric juice sometimes needs to be compensated with enzyme preparations that facilitate the digestion of food (Festal, Maalox). The pain syndrome is relieved by taking antispasmodics, the most popular of which are No-shpa, Papaverine.

Drug treatment of antral gastritis in the erosive form should be combined with a diet. Without following a proper diet drug therapy doesn't make any sense because it positive effect completely neutralized by the use of products that irritate the mucous membrane.

Diet for antral gastritis

If found reliable symptoms erosive antral gastritis, treatment of the pathology should be accompanied by careful adherence to a proper diet.

This means not only the composition of the menu, but also the volume of food consumed, and compliance with general recommendations:

• meals should be fractional (frequent, but in small portions): the number of meals should be increased to 5 - 6;
• You need to learn to chew food as carefully as possible: the preliminary action of enzymes contained in saliva will make it easier for the stomach to digest foods, reduce the load on its glands, and reduce irritation of the mucous membrane;
• the diet recommends eating food heated to a person’s body temperature (food that is too hot further injures the epithelium, which does not contribute to the healing of inflamed areas, and cold foods take much longer to digest, since appropriate temperature conditions are required for enzymes to work);
• Most products with a solid consistency should be crushed and consumed in a well-cooked state.

You should avoid fried, spicy, smoked foods and canned food (including homemade food). Spices, spices are also taboo, as are vegetables/fruits with high content fiber. It is not recommended to eat fresh bread made from rye flour, eat sweets, baked goods, strong tea/coffee and carbonated drinks.

First courses should be prepared with water/milk; the use of rich broths (meat/vegetables) is prohibited. Whole milk is also not included in the diet for the treatment of erosive antral gastritis, since it leads to increased gas formation. You should not eat sour berries/fruits, especially citrus fruits, or drinks made from them.

• light cereal soups (possibly including small pieces of lean meat);
• buckwheat porridge, oatmeal, rice, mashed potatoes, pasta made from premium flour;
• low-fat sour cream, kefir, yogurts;
• lean fish/meat, the preferred cooking method is steamed;
• Allowed drinks are weak tea, non-carbonated mineral water, dried fruit compotes.

Conclusion

Erosive antral gastritis is a disease that is accompanied by extensive dysfunction of the digestive tract. Without proper treatment, the prognosis is unfavorable - there is a high risk of developing peptic ulcer, stomach cancer. In the chronic form, the disease will have to be treated for about a year, but even during the period of remission you should adhere to the principles of light nutrition (diet No. 5).

Hemorrhagic gastritis is an inflammation in the mucous parts of the stomach, although first disturbances occur in the vessels located there. Erosive-hemorrhagic gastritis causes bleeding from the stomach in the presence of a strong inflammatory process and damage to the gastric mucosa by erosion. Erosive-hemorrhagic gastritis can be a consequence of the usual hemorrhagic “brother” or arise on an independent basis.

Both types of illnesses have acute and chronic forms. The symptoms of these diseases are almost the same, which often leads to confusion with terminology.

As a result of exposure to hemorrhagic gastritis, the gastric mucosa becomes saturated with blood, and bleeding may begin. Blood clots often form in the capillaries passing through this organ. This intensifies the inflammatory process and leads to erosion. In order to find out about gastritis, what it is, it is better to seek advice from the appropriate doctor.

• 1Causes of the disease
• 2Main symptoms
• 3Factors leading to the development of acute gastritis
• 4Diet food
• 5Conservative treatment

1Causes of the disease

The reasons why the hemorrhagic or erosive type of disease occurs are as follows:

1. Most often, the disease is caused by uncontrolled and improper use by people. various drugs, for example, anti-inflammatory medications, glucocorticoids, analgesics, etc.
2. The disease can develop when eating poor quality foods.
3. Infection of the stomach with salmonella, Helicobacter, and diphtheria bacilli often causes erosive gastritis.
4. Irregularity of nutrition, consumption of a variety of smoked meats, fatty and spicy food leads to damage to the mucous structure gastrointestinal tract with the formation of various defects on it, which then causes erosive gastritis.
5. Too hot food can lead to internal burns, which can then trigger erosive gastritis.
6. The appearance of defects in the gastric mucosa can occur due to severe stress. This is especially common when the patient has chronic psychological trauma.

The development of bleeding is caused by microcirculatory disturbances in the capillaries of the stomach, the penetration of blood particles and fragments cellular structures into the lumen of the gastrointestinal tract.

2Main symptoms

The symptoms of the described type of gastritis are not specific in clinical manifestations. The main symptoms of this disease correspond to almost all types of gastritis or peptic ulcers in the gastrointestinal tract. But there are some differences from other similar diseases. Symptoms of hemorrhagic gastritis may look like this. The patient begins to experience unpleasant pain in the projection of the stomach and epigastric zone, and the person complains of increased pain after finishing eating.

Gastric dyspepsia and nausea may develop. Many patients experience belching and heaviness in the gastrointestinal tract. Patients with this type of gastritis may begin to vomit the stagnant contents of bloody or Brown. Often people with gastritis begin to feel dizzy. Outgoing feces painted black.

When examining a patient, doctors note the pallor of his skin. A specific coating forms on the human tongue during gastritis. When palpating the gastric area, the patient complains of severe pain. If a patient develops bleeding, it can cause a severe drop in blood pressure in the arteries. At the same time, an increase in heart rate is noted.

When diagnosing using fibrogastroduodenoscopy, reliable data are obtained about the places of multiple erosion of the mucous structures of the stomach against the background of their impregnation with blood plasma. The erosions themselves can also bleed. Patients are diagnosed with an increase or decrease in stomach acidity. Blood tests often show anemia, and the Helicobacter test is negative.

3Factors leading to the development of acute gastritis

Acute hemorrhagic gastritis can occur suddenly. If a person has already had it, then reappearance the disease takes on a lightning-fast character. This type of disease has brighter clinical manifestations due to a transient inflammatory process, but with it bleeding occurs much less frequently.

Usually, the appearance of this type of lesion is caused by poor quality food or food that has been spoiled due to long-term storage. But such an illness can also occur when food is poisoned with toxins.

Chemicals, heavy metal salts, and poison can provoke acute gastritis. This may result in strong chemical burn on the mucous membranes of the stomach, and this leads to the development of hemorrhagic or erosive gastritis. Constant consumption of low-quality alcoholic beverages can have the same effect.

Systemic diseases often play a provoking role. connective tissues, which occur against the background of ailments that impair normal circulation blood in the gastrointestinal tract.

Gastritis can appear due to injuries to the abdomen, or when the stomach is bruised during a closed blunt trauma.

Under the influence of these factors, the development of acute gastritis is not associated with the secretory activity of mechanisms in the gastrointestinal tract, and therefore it occurs in a relatively short time. This mainly affects external factors, which gives clear symptoms of this type of disease.

4Diet food

Diet is one of the main methods of combating the disease, so it is prescribed to all patients with gastritis. Simply following doctors' recommendations when selecting foods and dishes to feed a patient during gastritis in many cases allows him to be protected from repeated manifestations of the disease.

At acute form disease, patients are prescribed dietary table No. 1, and after the crisis period has passed, the person is transferred to food in the form of table No. 5. The measures taken include the following recommendations for food selection: complete exclusion from the diet of spices, coarse, fatty, spicy, canned, fried, smoked foods. Citrus fruits, sweet products and fresh bread are prohibited. You cannot eat tomatoes, peas, or other legumes.

Products allowed for consumption include: bran bread (you can also use a stale white loaf or crackers), various porridges (rice, oatmeal, buckwheat). The meat is selected without fat and only dietary grade. It is best to use rabbit and chicken meat in your diet. It is recommended to eat omelet or soft-boiled eggs, various fermented milk products (low-fat cottage cheese, yogurt, kefir). Boiled vegetable dishes, fruit and berry juices and compotes are required; you can also drink fruit drinks.

Liquid and semi-liquid dishes (broths, various soups, jelly, purees, etc.) should be eaten warm by the patient.

You should not give him hot or very cold food, as this may cause repeated attacks of the disease.

All dishes must be steamed or boiled. The patient should be given food in moderate portions 5-6 times a day. Meal times should be the same. The patient should not overeat, as this will only worsen his situation.

5Conservative treatment

To eliminate this disease, it is mainly used conservative methods. After gastritis has been diagnosed, treatment of the disease begins with the use of various medications.

To eliminate the disease, drugs are used that reduce the secretion of gastric acid and juice. This creates opportunities to reduce inflammation. Doctors usually recommend drugs to patients such as Dalargin, Omeprazole, Nolpaza, Ranitidine, Kvamatel.

To protect the mucous structures of the gastrointestinal tract from acid in the stomach, the following can be used: medications, like Venter, Phosphalugel, Maalox, etc.

If bleeding is detected in the patient, it is recommended to drink Vikasol, aminocaproic acids, and Etamsylate.

To facilitate digestive processes the patient should take medications such as Creon, Pancreatin, Mezim. These are enzyme preparations that eliminate stomach discomfort.

Various can be used vitamin complexes, aloe-based tinctures. Medicines such as Plazmol and Actovegin have proven themselves well.

All these medications should be used in parallel with the prescribed diet.

What is duodenal erosion: pathology clinic and effective treatment

Erosion duodenum- This is a local destruction of the surface epithelial layer of an organ without damage to deep tissues. Timely treatment of the pathology gives a favorable prognosis - erosive defects of the mucous membrane heal quickly and do not leave scars.

Provoking factors

In most cases, the pathology is characterized by a pronounced picture due to the presence hemorrhagic syndrome. Erosion often occurs in the gastroduodenal region, that is, together with small intestine the gastric mucosa is damaged. In this case, the pathology is called erosive gastroduodenitis.

The causes of erosion have now been well studied. The main risk factor is damage to the duodenum by the bacterium Helicobacter pylori, which also colonizes the stomach wall. Typically, defects arise against the background of an existing chronic inflammation intestines in the area of ​​the bulb or as a result of drug aggression.

Other causes of the disease:

• Acute infectious gastroenteritis, in which symptoms of intoxication of the body and disruption of the digestive system appear. Such a patient needs timely drug treatment, replenishing fluid deficiency, diet.
• Poor nutrition, addiction to spicy foods, hot foods, spices, and alcoholic beverages. Abuse of these products leads to disturbances in stomach acidity and dyspepsia.
• Chronic inflammatory lesion of the wall of the duodenum, not associated with Helicobacter pylori infection. A long-term inflammatory process leads to the appearance of shallow defects in the mucosa - erosions.
• Long-term treatment with anti-inflammatory drugs, including reserpine, antibiotics, NSAIDs (non-steroidal anti-inflammatory drugs), steroid hormones.

The psycho-emotional factor also contributes to the appearance of erosive areas on the inner wall of the intestine. The development of pathology may be preceded by severe stress, depressive disorder. Treatment is effective only with the use of psychotherapeutic techniques in combination with drug therapy.

Signs

The nature and intensity of symptoms of erosions in the duodenum depends on the severity of the hemorrhagic syndrome (defects in the mucosa are prone to bleeding), the number and size of the defects, and the degree of the inflammatory process.

Manifestations of the disease include:

• painful sensations in the projection area of ​​the duodenum (in the epigastric region);
• nausea, vomiting, sometimes streaked with blood;
• against the background of hidden chronic bleeding from the upper gastrointestinal tract, general malaise and pale skin appear;
• Acute massive bleeding (sharp pallor, drop in systemic pressure, fainting) occurs less frequently;
• decrease in hemoglobin level in the blood;

How to treat

Treatment begins with eliminating the causative factor. For this purpose, laboratory, instrumental diagnostics; the patient is examined by a surgeon, gastroenterologist and nutritionist (if necessary, by an infectious disease specialist or immunologist).

With intestinal erosion, there is a deterioration in appetite, since eating is accompanied by pain. Chronic hemorrhagic symptoms and persistent inflammation lead to the appearance of deficiency anemias, which are characterized by damage to the gastrointestinal tract, skin, and nervous system.

These patients can be treated by general practitioners, gastroenterologists, and, less commonly, by surgeons. Modern therapy is aimed at eliminating the root cause of the disease and inflammation of the mucous membrane of 12-PC, relieving dyspepsia. When diagnosing bleeding erosions, hemostatic treatment is carried out.

The most commonly used drugs are:

• antibiotics of the penicillin or macrolide series - for confirmed Helicobacter pylori infection;
• antacids and antisecretory agents (Omez, Phosphalugel, Ranitidine or Maalox) - they neutralize high acidity, protect the wall of the duodenum and stomach from further damage;
• prokinetics (Cerucal, Domperidone) - medications restore normal motor function of the gastrointestinal tract, eliminate nausea and vomiting;
• injectable vitamins (C, B6, 9 and 12, PP) – strengthen the walls of blood vessels, fight the symptoms of anemia;
• angioprotectors (Etamzilat) – stops internal bleeding. May be injected or taken in tablet form.

The effectiveness of treatment is assessed according to the following criteria:

1. The symptoms of the disease subside (the pain goes away, the patient’s well-being improves significantly). During this period, supportive treatment is continued, a diet and restrictions on physical activity are prescribed.
2. Beginning of healing of superficial erosions; There are no hemorrhagic changes, swelling and redness disappear.
3. Epithelization of chronic affected areas, endoscopic control is carried out.

Complicated erosion

Patients with bleeding are admitted to surgery department. Gastric and duodenal lavage is performed cold water, after which hemostatic drugs and glucose-saline solutions are administered.

In case of massive blood loss (a rare occurrence for erosions), the patient is prescribed infusions with whole blood and plasma.

Nutrition

Nutritional therapy is extremely necessary for patients with diseases of the duodenum. The diet involves eliminating irritating foods, hot dishes, and alcohol.

The diet is based on the following principles:

• compliance temperature regime when cooking;
• fractional meals;
• preference for liquid and soft foods, soups, cereals and purees;
• all dishes are allowed boiled and steamed;
• fried foods, canned foods, salted and smoked foods are excluded;
• a therapeutic diet allows you to drink a little milk or kefir, but only with normal bowel movements.

Foods that can provoke increased secretion of gastric juice are prohibited:

• meat and mushrooms, everything salted, fish broths, seasonings, pickled foods, spices;
• rye and fresh bread, baked goods with yeast;
• sorrel, onions, radishes, cabbage, corn;
• products that increase gas formation and provoke painful sensations: carbonated drinks, strong coffee and tea.

Forecast

If a lesion of the duodenum is diagnosed, the patient always needs treatment and medical supervision. Since erosions are superficial defects, they are able to “heal” without leaving scars (the average duration of epithelium renewal in the gastrointestinal tract is 1 month).

If treatment is started in a timely manner and all recommendations are followed, the disease has a favorable outcome, and properly selected prevention will help avoid relapses.

Erosive hemorrhagic gastritis, the treatment of which involves complex therapy, aimed at improving the patient’s condition, is a disease that leads to the destruction of the mucous walls of the stomach. Initially, erosion forms on a small part of the stomach wall, but over time it can gradually spread to the entire stomach. In parallel, the symptoms of this disease progress.

Symptoms of erosive hemorrhagic gastritis

Internal factors include some diseases and pathologies in the human body. For example, diseases associated with metabolic disorders and kidney failure can give impetus to the formation of erosions in the stomach.

It is extremely difficult to independently determine this particular type of gastritis. Only in the case of an advanced form of erosive gastritis, which is accompanied by stomach bleeding, you can independently assume this diagnosis. However, it is not recommended to go to this extreme, and as soon as the first minor symptoms appear, you should consult a gastroenterologist.

Symptoms of erosive gastritis include:

• pain that occurs in the upper abdomen. Initially, the pain syndrome may not be so pronounced, but as the erosion spreads, the patient may need painkillers, as the pain intensifies and becomes difficult to bear;
• constant heartburn, which occurs in most cases with this disease;
• indigestion and a feeling of heaviness in it, which often accompany the disease;
• periodic occurrence of belching with a putrid odor, as well as a bitter taste in the mouth;
• the occurrence of spontaneous pain in the morning on an empty stomach or after a short period of time after eating.

As soon as you notice at least some of the symptoms characterizing erosive gastritis, you should immediately contact a gastroenterologist. But remember that even he is not able to determine the nature of the disease without conducting a set of certain studies. Thanks to examinations and tests, the doctor will determine the nature of the disease and its stage, after which he will prescribe comprehensive treatment and a biopsy if necessary.

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Transition from erosive gastritis to erosive-hemorrhagic

If treatment for erosive gastritis is not started in time, it can develop into a more complex form - erosive-hemorrhagic gastritis, which in most cases is accompanied by gastric bleeding. Their character is directly related to the depth and area of ​​erosion located on the mucous wall of the patient’s stomach. The most dangerous in the case of erosive hemorrhagic gastritis are not large erosions in diameter, but small and deep ones, distributed throughout the mucosa. Symptoms during the transition of erosive gastritis to a complex form:

• reduction in the severity of pain, after which bleeding occurs;
• vomiting, the nature of which directly depends on the size of bleeding erosions. The vomit will contain clots of baked blood;
• severe anemia (weakness in the body, low blood pressure and pale skin) due to bleeding in the stomach;
• dark color of stool, since even with minor bleeding in the stomach, blood enters the intestines.

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Causes of erosive gastritis

The disease can be caused by both external and internal factors. External ones include the ingestion of chemical and alkaline substances into the body that can corrode the gastric mucosa. Some medications because of long-term use can also cause erosion. This group of factors also includes poisoning and the entry of salmonella or Helicobacter into the body, junk food, frequent use spicy and sour foods, as well as very hot drinks, which have a detrimental effect on the mucous walls of the stomach.

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Diet for erosive hemorrhagic gastritis

Erosive hemorrhagic gastritis, treatment of which with medications will not bring relief desired result, if you do not follow a diet, requires an integrated approach.

Dietary nutrition is one of the main components that contribute to rapid recovery. A patient with gastric erosion should completely avoid fried, very salty, and pickled foods. You should also exclude spices and smoked foods from your diet, refrain from eating sweets, white and rye bread, sweet buns, coffee drinks and sour fruits. Products that contain a large number of fat, can worsen the patient’s condition, so they should also be excluded. Alcohol and carbonated drinks, which can provoke the formation of new foci of erosion, are strictly prohibited.

Dishes that a patient with erosive hemorrhagic gastritis should eat daily:

• light vegetable soups;
• buckwheat, oatmeal, rice porridge;
• vegetable puree with the addition of refined vegetable or olive oil;
• vegetable stews cooked on vegetable oil, possible with the addition of greens;
• fresh cottage cheese or non-acidic kefir;
• steamed fish or chicken, boiled eggs, omelette.

If there is a large loss of blood caused by gastric bleeding, it is recommended to eat boiled liver and baked apples. These products contain iron, the lack of which is felt by patients with hemorrhagic gastritis. It is recommended to eat at least six times a day, or even more often, but little by little. Food must be chewed thoroughly or taken in puree form so that pieces of food do not damage the already irritated gastric mucosa. Tea and coffee should be replaced chamomile tea or herbal infusion.