Hemorrhoidal gastritis. Erosive-hemorrhagic gastritis. Focal and diffuse types of chronic hemorrhagic gastritis

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 refers to a later stage of the disease, 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. If left untreated, this pathology rapidly progresses, causing severe complications, from gastric ulcers to 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In the outdated medical classification, antrum gastritis is classified as “B” type (bacterial) gastritis; the Sydney classification, adopted in 1990, is more accurate and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. In the acute course of the 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 entire antrum. Note that in the early stages of the disease, 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 of the antrum of the stomach, an increased content of pathogenic bacteria is observed in the lower part of the stomach 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 an acidic environment with acidity in the region of 2–4 and even higher is not fatal. But the bacterium actively reproduces under more favorable conditions, so 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 others psychoemotional disorders, which are the cause of 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 often cases when the chronic form of erosive gastritis is completely asymptomatic for a long time.

Features of treatment

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

Since in most cases this type of gastritis is accompanied by extensive Helicobacter pylori infection, antibacterial therapy is a mandatory component of treatment. In this case, a scheme 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 fact is that in the normal state of the stomach, Helicobacter pylori bacteria 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). Pain syndrome can be relieved by taking antispasmodic drugs, the most popular of which are No-shpa and Papaverine.

Drug treatment of antral gastritis in the erosive form should be combined with a diet. No compliance correct mode nutrition 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 human body temperature (too hot food 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 the 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. At chronic form It will take about a year to treat the disease, 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 of various drugs by people, 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 disorders in the capillaries of the stomach, the penetration of blood particles and fragments of 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.

May develop gastric dyspepsia, nausea occurs. 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. In the human tongue with gastritis it is formed specific plaque. When palpating the gastric region, the patient complains of severe pain. If the patient develops bleeding, it may cause strong fall 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 and salt can provoke acute gastritis heavy metal, I. 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.

Often play a provoking role systemic diseases on connective tissues, which occur against the background of ailments that disrupt normal blood circulation 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 diseases are prescribed to patients diet table No. 1, and after passing crisis period transfer a person 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 products fermented milk content (low-fat cottage cheese, yogurt, kefir). Boiled ones are required vegetable dishes, fruit and berry juices and compotes, 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 techniques. 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, medications such as Venter, Phosphalugel, Maalox, etc. can be used.

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 pathology gives 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 of hemorrhagic syndrome. Erosion often occurs in the gastroduodenal region, that is, along with the small intestine, the mucous layer of the stomach is damaged. IN 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:

• Spicy infectious gastroenteritis, in which symptoms of intoxication of the body appear, disruption of work digestive system. Such a patient needs timely drug treatment, replenishment of fluid deficiency, and diet.
• Poor nutrition, addiction to spicy foods, hot foods, spices, alcoholic drinks. Abuse of these products leads to disturbances in stomach acidity and dyspepsia.
• Chronic inflammatory lesion walls 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 area of ​​projection of the duodenum (in epigastric region);
• nausea, vomiting, sometimes streaked with blood;
• against the backdrop of a hidden chronic bleeding general malaise and pale skin appear from the upper gastrointestinal tract;
• Acute massive bleeding occurs less frequently (sharp pallor, falling system pressure, fainting);
• decrease in hemoglobin level in the blood;

How to treat

Treatment begins with eliminating 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 symptom and persistent inflammation lead to the appearance of deficiency anemia, which is 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 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 increased 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.

At massive blood loss (a rare event 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;
• excluded fried food, canned products, salted, smoked;
• 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 pain: 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.

Hemorrhagic gastritis is an acute inflammatory process that affects the gastric mucosa. This disease, diagnosed in both adults and children, is accompanied by the formation of superficial erosions and hemorrhages. Of all possible inflammatory injuries, this type is considered the most severe. Experts note a significant increase in the number of cases of this pathology over the past few years. last decade.

Although the disease is not rare, its etiology is not fully understood.

Clinical picture of hemorrhagic gastritis

Among the main causes of hemorrhagic gastritis are the following:

1. Stomach injuries.
2. Consumption of low-quality products.
3. Excessive consumption of smoked, salty, hot and spicy foods.
4. Thermal effects of hot food;
5. Alcoholism.
6. Gastrointestinal infections.
7. Frequent.
8. Uncontrolled use of drugs.

In particular, “heavy” drugs include antibiotics, corticosteroids, and analgesics. However, the most common cause The development of this disease is considered to be the entry of the bacterium Helicobacter pylori into the body. There are two ways of infection: poor quality food or water.

All symptoms characterizing hemorrhagic gastritis are conditionally divided into two groups. Local signs- these are processes occurring in the stomach, and general ones are those that manifest themselves throughout the body.

Characteristic symptoms:

1. Decreased performance.
2. Nausea.
3. Heartburn.
4. Increased sweating.
5. Intestinal disorders.
6. Vomit that looks like coffee grounds.

Decreased appetite and pain in the epigastric region after eating also accompany the pathology.

The clinical picture is similar to ordinary gastritis. Distinctive component hemorrhagic type disease is the presence of blood in stool and vomit. And if the hemorrhage is internal, then the disease develops asymptomatically and can immediately manifest itself as gastric bleeding. Thus, anemia is added to the main symptoms.

Types of acute and chronic hemorrhagic gastritis

Exist different kinds hemorrhagic gastritis. It is classified according to the following criteria: the cause of the disease, the nature of the course and the location of the lesion.

According to the mechanism of development of the disease, the following types are distinguished:

1. Atrophic.
2. Autoimmune.
3. Hypertrophic.
4. Allergic.
5. Reflux.
6. Infectious.

Depending on the degree of development of the disease, there are the following forms:

1. Spicy.
2. Chronic.

The acute course of the disease is observed at the first stage of its development. But there may be cases when acute attacks begin with the stages of exacerbation in a chronic type of pathology.

The acute version of hemorrhagic gastritis is best treated. Erosion heals without leaving scars. It should be noted that the acute form of the disease is provoked by irritating foods, allergens, medications. In the absence of necessary therapy, the acute form becomes chronic.

Focal and diffuse types of chronic hemorrhagic gastritis

The chronic form of hemorrhagic gastritis leads to the appearance of ulcers from erosions and the development of bleeding varying degrees gravity. It has several types of disease, determined by the number and prevalence of erosions, including:

1. Focal.
2. Diffuse.

The focal type of hemorrhagic gastritis is a consequence of poor diet and a chronic form of the disease that was not treated in a timely manner. The affected stomach tissues are no longer restored, and this reduces the quality of its work. Tissue damage is increasing, so the situation needs constant monitoring through regular examinations. The main danger of this pathology is that it can develop into oncology.

The diffuse type of hemorrhagic gastritis has become widespread due to the abundance of synthetic food additives. The disease is characterized by a significant area of ​​damage: the gastric mucosa suffers from pathology evenly over its entire surface.

Depending on the severity of damage to the mucous membrane, the following forms of gastritis are distinguished:

1. Catarrhal.
2. Erosive.
3. Phlegmonous.
4. Necrotic.

Erosive-hemorrhagic form of gastritis in the antrum

The erosive form of hemorrhagic gastritis is characterized by the formation of multiple eroded areas on the inflamed and irritated mucosa. The danger is that they can spread throughout the stomach. This form of pathology can be caused either by Helicobacter pylori infection or by toxic compounds entering the stomach.

It is important to understand that timeliness is important in the treatment of the erosive form of the disease. Progressive pathology is fraught with dangerous consequences.

The erosive-hemorrhagic form of gastritis in the antrum is most often provoked by pathogenic bacteria Helicobacter pylori, which develop precisely in lower parts stomach. This form is quite complex, since after bacterial damage the tissues take a very long time to recover.

Hemorrhagic antral type of gastritis is characterized by the fact that vascular changes are localized on the mucous membrane in the antrum. The disease can occur in acute or chronic form.

The erosive antral type of the disease is the most common; it affects the fundus-type sections of the stomach.

Acute and superficial forms of erosive-hemorrhagic gastritis

The acute form of erosive-hemorrhagic gastritis is characterized by severe pain in the abdominal cavity. Signs such as nausea and vomiting may occur. Pathology requires constant medical supervision.

Erosive reflux gastritis is characterized by the appearance of large ulcers on the surface of the stomach.

Based on the stage of the disease, superficial and erosive types of pathology can be distinguished.

The superficial appearance of hemorrhagic gastritis is diagnosed when vascular changes in the form of bleeding are noticeable on the mucous membrane. At this stage, erosion is not yet deep and does not affect blood vessels. The disease does not appear immediately, but if detected it can be cured.

In this form of the disease, mucosal lesions may include:

1. Single.
2. Multiple.

The more advanced the form of the disease becomes, the more likely development of small damage into erosion.

Superficial erosive gastritis with a pronounced hemorrhagic component

Superficial gastritis with a pronounced hemorrhagic component manifests itself in the form of defects in the gastric mucosa, which cause bleeding in the digestive tract. This type of inflammation is possible in the early stages of a chronic disease.

It is important to understand that any negative effect on the affected tissue can cause the development of erosive gastritis with a pronounced hemorrhagic component. It is characterized by ulcerative lesions gastric mucosa with numerous inflammations and hemorrhages into the cavity of the affected organ.

Hemorrhages in gastritis with hemorrhagic erosions

The likelihood of developing hemorrhages during gastritis with hemorrhagic erosions of different sizes depends on the location of the deepest foci. When the largest damage is concentrated on the fundus of the stomach, its anterior or back wall, then the risk of bleeding is not too great.

According to doctors' observations, gastritis in last years have become quite common not only among adults, but also among children. The causes of the development of the disease are associated with Helicobacter pylori infection and dietary errors. The factor of heredity in this pathology cannot be ruled out. As a result of the influence of all unfavorable factors Inflammation of the stomach walls occurs and gastritis forms.

As the disease progresses, focal changes mucous membrane, the epithelial layer is affected. If erosions and small hemorrhages occur in the wall of the stomach, this indicates the development of erosive or hemorrhagic gastritis in the child.

In such a situation, timely diagnosis and comprehensive treatment are very important. Otherwise, the disease develops, the digestion process is disrupted, and the pathology enters an irreversible stage.

Diagnosis of hemorrhagic gastritis

No disease can be treated without a comprehensive examination. Therefore, the following diagnostic measures are mandatory:

1. Fecal occult blood test.
2. Biopsy of the affected organ with mandatory subsequent histology.
3. Electrogasteroenterography;
4. Ultrasound of all organs and systems.

You need to understand that when timely diagnosis therapy has a positive prognosis and produces the desired results.

Refusal of treatment can lead to the following consequences: ulcers, oncology and transition of the disease to the chronic stage.

How to treat hemorrhagic gastritis: drugs and diet

For effective treatment with the help of medications for hemorrhagic gastritis professional A complex approach is an important component of success. The first step in therapy is to eliminate excessive secretion gastric juice. For this purpose, drugs such as Kvamatel or Omez are prescribed.

An important step in the treatment of erosive-hemorrhagic gastritis is neutralizing the aggressive effects of hydrochloric acid. Preparations such as Phosphalugel and Maalox not only eliminate excess acidity, but also form a protective film over erosions, which promotes healing and soothes inflamed mucous membranes.

Also when erosive disease hemostatic drugs are used: “Etamzilat”, “Ditsinon”. It is preferable to use the injection method of administering the drug (intramuscular or intravenous).

Standard therapy includes the use of:

1. Preparations with enzymes, for example “Mezim”, “Creon”.
2. Anti-Helicobacter antibiotics.
3. Preparations to protect the mucous membranes, for example Almagel.
4. Vitamins and restoratives, such as Plazmol.

According to indications, anemia and blood transfusions are corrected. An effective remedy sanatorium-resort treatment remains.

You need to understand how to effectively treat hemorrhagic gastritis not only with medications. An important point therapy is strict adherence to diet. Table No. 1 is assigned, and when the acute stage subsides - No. 5.

The following must be excluded from the diet:

1. Spicy and fatty foods.
2. Smoked meats, pickles.
3. Baking.
4. Alcohol.

The emphasis should be on pureed food, soups, cereals, fermented milk products. It is advisable to cook it by steaming or in the oven.

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Of all the variety of types of inflammation of the gastric mucosa, hemorrhagic gastritis is the most insidious and dangerous form of the disease. It stands out from the general picture due to the peculiarity of the mechanism of damage, the rate of progression and severe consequences in case of delay in medical treatment.

The insidiousness of this type of gastritis lies in the absence of characteristic signs. Tissue damage begins from the submucosal layer, in which, for one reason or another, blood microcirculation in the vessels and capillaries is disrupted. This entails the sweating of blood onto the surface of the mucosa, and the formation of hemorrhages, and with the formation of blood clots, bleeding erosions appear. As a result, inflammation develops leukocyte infiltration threatening internal bleeding.

Damage to the submucosal layer produces scanty, vague symptoms, regardless of the cause of the disease. On early stage illness, a person periodically feels heartburn, weak and vague pain in the epigastric region, more like discomfort, and nausea from time to time.

Such a picture of symptoms can mislead not only the patient himself, but also the diagnosing doctor. Quite often, these manifestations are associated with poor-quality food, exacerbation of the chronic process of an existing disease of the digestive system, or suggest other causes of illness. Moreover, the main lesion most often affects the antrum, the farthest section, since there is a cluster of main vessels there.

As a result, it is possible to determine the form of gastritis only with the onset of gastric bleeding, when the condition can threaten a person’s life.

The similarity of symptoms and the presence in some cases of erosions on the mucous membrane gives reason to consider hemorrhagic form identical to the erosive type. In many sources, the classification is called erosive-hemorrhagic gastritis. This is not an entirely correct formulation, since hemorrhagic gastritis can occur either with the formation of erosions or manifest itself only as hemorrhages. In turn, erosive gastritis is not always complicated by bleeding.

It would be more correct to call hemorrhagic gastritis morphological type changes when endoscopic examination, with minimal histological manifestations. The paradox is that the affected vessels become provocateurs of destruction epithelial tissue mucous membrane, causing inflammation and erosive manifestations, but cellular infiltration is minimal or completely absent. In the vast majority of cases, the antrum of the stomach suffers, due to its anatomical location, which additionally contributes to inflammatory processes, due to stagnation of gastric juice.

This form of the disease, being one of the most severe damage to the gastric mucosa, still remains poorly understood. According to world organization Over the past decade alone, the number of cases of diagnosing hemorrhagic gastritis has increased tenfold. Of all patients admitted with bleeding of the upper digestive system, more than 5% are provoked by this particular form of the disease. And, approximately 2% of hemorrhagic gastritis, complicated by bleeding, are fatal. This picture forces scientists to redouble their efforts to study the causes of pathology that provoke the mechanisms of damage.

The pathology is polyetiological; the disorder can be provoked by completely different negative factors and causes.

In the first place is the addiction to alcoholic beverages. Almost half of alcoholics are diagnosed with hemorrhagic gastritis of varying severity during examination.

But, very rarely, symptoms of hemorrhagic gastritis appear only due to one provoking factor.

Usually the reasons combine several indicators at once, these include:

1. Pathological eating habits. This may be an excessive love of seasonings, consumption of smoked meats in large quantities, irregular eating, fasting, strict vegetarianism.
2. The very prescription and uncontrolled use of medications, for example:
   • 3rd generation analgesics;
   • glucocorticoids,
   • antibiotics;
   • NSAIDs.
3. Massive blood loss during surgery or injury.
4. Extensive burns covering more than 40% of the entire skin surface.
5. Insufficient functioning of such internal organs and systems as:
   • liver;
   • kidneys;
   • lungs;
   • heart,
   • vessels.
6. Severe stress can provoke hemorrhagic gastritis, against the background long stay in reanimation.
7. Placement of a nasogastric tube for a period exceeding 5 days.

Hemorrhagic gastritis, unlike other types, never occurs due to the development of Helicobacter pylori. That's why bacterial analysis will always be negative.

Symptoms and signs

The development of hemorrhagic gastritis can occur in acute or chronic form, which differ in the degree of manifestation of symptoms and the size of tissue damage.

In acute form general symptoms gastritis manifest themselves quickly and clearly. Acute attack increases over several hours, but signs of bleeding may be delayed, especially if the lesion affects the antrum of the stomach.

Chronic course The disease is characterized by blurred symptoms. For a long time, the patient cannot understand the symptoms and has no idea about the pathology. During this time, more and more people become involved in the pathological process. deep tissue, form extensive erosions, some of which can completely corrode the wall of the stomach, up to perforation. This threatens not only gastric bleeding, but also blood penetration into the abdominal cavity.

Both forms of the disease require taking emergency measures Therefore, treatment of hemorrhagic gastritis is carried out only in a hospital setting.

It is impossible not only to cure this form of gastritis with folk remedies or at home, but even to temporarily alleviate the condition. But it is quite possible to worsen the situation.

Symptoms such as:

• severe pain in the epigastric region, worsening after eating;
• symptoms of indigestion, for example: heaviness in the stomach, increased gas formation, general malaise;
• symptoms of dyspepsia: nausea, flatulence;
• symptoms of internal bleeding: weakness, rapid heartbeat, dizziness, attacks of vomiting with streaks of scarlet blood if the affected area is in the upper parts of the stomach, and with an admixture of digested blood (black spots) if the antrum of the stomach is affected.

Upon examination, the doctor sees such signs of hemorrhagic gastritis as:

• severe pallor of the skin;
• coating on the tongue of a whitish or grayish tint;
• severe pain in the peritoneum in the stomach area upon palpation;
• low arterial pressure and severe tachycardia.

Hemorrhagic gastritis is confirmed using fibrogastroduadenoscopy, a study that allows the doctor to clearly determine the presence of hemorrhages, bleeding erosions and the absence or intensity of bleeding. Adequate treatment can be prescribed only after the localization of bleeding has been established, since the antrum has a different environment from the other part of the stomach and requires a special approach. During the course of the study, a sample is taken to determine the level of acidity of gastric juice and the presence of bacterial flora.

Appointed:

• clinical blood test to determine hemoglobin level;
• stool occult blood test;
• a general urine test to determine the level of kidney function.

Treatment methods

Treatment of a disease as complex as hemorrhagic gastritis requires rapid medicinal action that can comprehensively affect all links of the pathological chain.

Of primary importance is the elimination of bleeding, while simultaneously addressing the underlying causes vascular disorders. Gastric lavage or administration of medications through a gastric tube may be necessary.

A strict diet combined with drug treatment and psychological peace give a chance for full recovery in acute form and long-term remission in chronic gastritis.

The first day a fasting diet is prescribed. It is not recommended to even drink water while bleeding is being stopped. An ice pack is applied to the epigastric region of the abdomen. Coagulating drugs are prescribed intravenously in a stream or in droppers. Further treatment involves the introduction of inhibitors, regulators of gastric juice synthesis and correction of the enzyme composition. The antrum of the stomach reacts especially sharply to the composition of gastric juice and its acidity. In case of antral hemorrhagic gastritis

Taking any medications through the esophagus is strictly contraindicated, since it is necessary to allow the stomach to rest and stop hemorrhages and erosions.

Bleeding in the antrum of the stomach is most dangerous, since blood can accumulate in large quantities, and stay there for several days. Which ultimately leads to the development of purulent processes. Treatment in this case involves removing accumulated blood through a tube, gastric lavage and fasting for several days.

Many medicinal plants have hemostatic properties, and can also gently regulate the production of stomach acids. But treatment folk remedies independently, when it is not known exactly what form of hemorrhagic gastritis, and how deep the tissue damage is, it is simply dangerous.

If you do not consult a doctor in a timely manner and start treatment with folk remedies, you may waste precious time. Then it will be difficult even for surgeons to cope with the pathology.

There are many cases of development severe complications after exposure to the stomach using folk remedies without prior consultation with a doctor.
The correct action is not treatment with folk remedies, but diet. More precisely, complete refusal of food during an attack, calling a doctor, and strictly following his instructions.

Prevention

Hemorrhagic gastritis is one of those types of pathology, the prevention of which depends entirely on the person himself. First of all, a diet that involves eating regularly and selecting healthy foods.

The various types included in the weight loss diet have a very harmful effect on the condition of the gastric mucosa. Mono diet, starvation diet, dry diet, all of them can be the last straw in the development of hemorrhagic gastritis.