Chronic erosive hemorrhagic gastritis. Acute hemorrhagic gastritis (K29.0). Signs and symptoms

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 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In the outdated medical classification, antrum gastritis is classified as “B” type (bacterial) gastritis; the Sydney classification, adopted in 1990, is more accurate and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 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 of the antrum of the stomach, increased content pathogenic bacteria 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 frequent cases when the chronic form of erosive gastritis long time is generally asymptomatic.

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 if full course Treatment of a chronic form of the disease can last up to a year, but antibiotic therapy is used 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 that therapeutic effect which 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, a good effect is 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 and spices are also taboo, as are vegetables/fruits with a high fiber content. 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 ulcers and 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 form. 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:

Most often, the disease is caused by uncontrolled and improper use by people. various drugs, for example, anti-inflammatory medications, glucocorticoids, analgesics, etc.
The disease can develop when eating poor quality foods.
Infection of the stomach with salmonella, Helicobacter, and diphtheria bacilli often causes erosive gastritis.
Irregularity of nutrition, consumption of a variety of smoked meats, fatty and spicy foods leads to damage to the mucous structure gastrointestinal tract with the formation of various defects on it, which then causes erosive gastritis.
Too hot food can lead to internal burns, which can then trigger erosive gastritis.
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. The stool that comes out is 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 area, 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 the reappearance of 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 or spoiled due to long-term storage food. 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 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 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.

In the acute form of the disease, patients are prescribed dietary 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 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, 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. This enzyme preparations, which 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 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, together with small intestine the gastric mucosa 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:

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 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 projection area of the duodenum (in the epigastric region);
nausea, vomiting, sometimes streaked with blood;
against the backdrop of a hidden chronic bleeding from upper sections In the gastrointestinal tract, general malaise and pale skin appear;
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 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 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:

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.
Beginning of healing of superficial erosions; There are no hemorrhagic changes, swelling and redness disappear.
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 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 surface defects, they are able to “heal” without leaving scars ( average duration renewal of epithelium in the gastrointestinal tract - 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.

The pathology and its causes are rather poorly understood, since it is not completely clear what may result in microcirculatory disorders in the small vessels of the superficial layer of the stomach. Erosion that occurs can go away in 4-10 days with an acute course. Chronic hemorrhagic gastritis in most cases cannot be cured.

General information about the disease

It should be noted that not every hemorrhagic gastritis has an erosive form. Just like erosion, they can form not only as a result of dystrophic changes in vessels. Gastroenterologists usually consider both forms as independent diseases, although they sometimes have interrelated causes.

The name of the pathology is associated with the main cause of the inflammatory process. It becomes hemorrhages and ruptures small vessels, after which a characteristic leukocyte infiltration in the affected area and the formation of inflammatory areas, and subsequently erosion.

Treatment is symptomatic in nature, associated with the restoration of microcirculatory processes, small vessels, and the mucous layer damaged by erosion. IN in some cases Endoscopic removal of damaged areas is recommended. The prognosis of the disease is associated with individual clinical picture, most often the disease is recurrent if the vascular pathology cannot be cured. Often hemorrhagic gastritis is secondary disease associated with impaired microcirculation in peripheral vessels, thrombophlebitis.

In this case, attention is paid to treating the underlying pathology.

This stomach pathology is divided into two forms:

type A, associated with vascular pathology;
type B, associated with Helicobacter pylori infection (antral gastritis).

Diagnostic methods

The main diagnostic method with a reliable result is fibrogastroduodenoscopy. This is the only reliable way to study the nature of such pathological process, which can form the basis final diagnosis. Using this procedure, erosions on the walls of the stomach with areas soaked in blood are determined. Erosive-hemorrhagic gastritis in the vast majority of cases is benign in nature, and the size does not exceed 3 mm.

To make a diagnosis, a test for Helicobacter pylori infection is also prescribed, and a connection is established between mucosal lesions and bacterial invasion. If detected, treat infectious process, and then a course to restore or compensate for vascular disorders.

The clinical picture includes signs of anemia in a general blood test, normal or increased stomach acidity. In the second option, increased acidity can provoke a secondary inflammatory process.

Signs of the disease

The main problem in making an accurate diagnosis is due to the fact that erosive-hemorrhagic gastritis manifests itself in the same way as a number of other gastric disorders. Nevertheless, a thorough analysis of complaints allows us to compare them with this particular pathology and prescribe an examination to the patient, which will help make a final diagnosis.

The main symptoms include the following:

pain “in the pit of the stomach” (in the epigastric region);
increased pain after eating;
nausea, heaviness in the stomach and belching (dyspepsia);
possible signs of bleeding areas: vomiting, congestion dark discharge, dark stool (almost black), severe dizziness;
pale skin due to anemia;
weight loss due to anemia and poor diet.

Experts take a differentiated approach to making a diagnosis, first of all excluding more serious pathologies And infectious lesion mucous membrane. After the examination, the patient is prescribed a course of treatment, which is repeated several times in case of chronic manifestations of the disease. The acute form is subjected to massive treatment, quite often it is possible to achieve full recovery and restoration of the gastric mucosa without relapse.

Determining the cause of the disease

To choose the right treatment tactics, it is necessary to establish the causes of vascular microcirculation disorders. Many experts consider hemorrhagic gastritis to be one of the most complex pathologies of the stomach.

The causes of pathology may be associated with the following factors:

poor nutrition and a single intake of poor quality food, which led to damage to the mucous membranes by toxic substances;
chemicals, toxins of various origins, ingested with food, resulting in a chemical burn of the mucous membrane;
excessive alcohol consumption, poor quality drinks;
connective tissue pathologies, as well as severe intoxication due to a number of diseases;
mechanical trauma and bruise of the stomach.

With external unfavorable factors and poisoning, the occurrence of acute form gastritis and adequate treatment, which also takes into account the cause of the pathology, a complete cure is possible. As a result external reasons Not only the stomach may be affected.

In particular, bulbitis is often observed - erosive damage to the bulb, and duodenitis - inflammation of the duodenum. Also known in medical practice erosive reflux gastritis, which is characterized by deeper structural lesions of the stomach tissue.

Professional restrictions

Erosive gastritis of any etiology is a serious reason, as a result of which the patient may be declared unfit for military service. In this case, the decision is made by the commission after effective treatment.

After initial examination and undergoing a medical examination, the patient is sent to undergo ambulatory treatment. If it is ineffective, it is recommended to take a course in a hospital. Upon completion, a decision is made on suitability for military service. On average, examination and treatment takes about 6 months. After unsuccessful treatment, the medical board may recommend that the patient be released from military service.

How is erosive-hemorrhagic gastritis treated?

Treatment of hemorrhagic gastritis is complex and is aimed primarily at restoring the function and structure of small vessels, as well as the epithelium.

The following drugs are used:

Sorbents for removing toxic components: Enterosgel, Smecta, Sodium Thiosulfate.
Antisecretory drugs to reduce acidity: Ranitidine, Kvamatel, Nolpaza.
Gastroprotectors that ensure restoration of the gastric mucosa: Phosphalugel, Almagel, Venter, Maalox, Vinilin;
Drugs acting on the blood system, including hemostatic: Vikasol, aminocaproic acid, vitamin PP.
Enzymes: Mezim, Pancreatin.
Biostimulants that restore the epithelium and vascular walls: aloe extract, Actovegin.
Painkillers: Plazmol.

An important component is rehabilitation therapy based on Vikasol (vitamin K), which is used for vascular rupture after chemical damage, as well as Actovegin and aloe extract. To treat erosion, Vinilin (Shostakovsky balm) is used, oil helps well tea tree orally mixed with burdock oil (3-15 drops per 10 g base oil, 3-5 times a day).

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 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:

Stomach injuries.
Consumption of low-quality products.
Excessive consumption of smoked, salty, hot and spicy foods.
Thermal effects of hot food;
Alcoholism.
Gastrointestinal infections.
Frequent.
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:

Decreased performance.
Nausea.
Heartburn.
Increased sweating.
Intestinal disorders.
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. A distinctive component of the hemorrhagic type of disease is the presence of blood in the stool and vomit. And if the hemorrhage is internal, then the disease develops asymptomatically and can manifest itself simultaneously stomach 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:

Atrophic.
Autoimmune.
Hypertrophic.
Allergic.
Reflux.
Infectious.

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

Spicy.
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 case of absence 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:

Focal.
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:

Catarrhal.
Erosive.
Phlegmonous.
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 in therapy erosive form timeliness is important. 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 to the tissue it is very a long period are being restored.

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, the erosions are not yet deep and do not affect the 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:

Single.
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 impact 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 posterior wall, 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 complex treatment. 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:

Fecal occult blood test.
Biopsy of the affected organ with mandatory subsequent histology.
Electrogasteroenterography;
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 of hemorrhagic gastritis with medications, a professional integrated 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, for 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:

Preparations with enzymes, for example “Mezim”, “Creon”.
Anti-Helicobacter antibiotics.
Preparations to protect the mucous membranes, for example Almagel.
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 in therapy is strict adherence to the diet. Table No. 1 is assigned, and when it subsides acute stage – № 5.

The following must be excluded from the diet:

Spicy and fatty foods.
Smoked meats, pickles.
Baking.
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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Hemorrhagic gastritis is an inflammation in the mucous parts of the stomach, although first disturbances occur in the vessels located there. Erosive-hemorrhagic gastritis occurs 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.

1 Causes of the disease

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

Most often, the disease is caused by uncontrolled and improper use of various drugs by people, for example, anti-inflammatory medications, glucocorticoids, analgesics, etc.
The disease can develop when eating poor quality foods.
Infection of the stomach with salmonella, Helicobacter, and diphtheria bacilli often causes erosive gastritis.
Irregularity of nutrition, consumption of a variety of smoked meats, fatty and spicy foods leads to damage to the mucous structure of the gastrointestinal tract with the formation of various defects on it, which then causes erosive gastritis.
Too hot food can lead to internal burns, which can then trigger erosive gastritis.
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.

2 Main symptoms

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 stagnant contents that are bloody or brown in color. Often people with gastritis begin to feel dizzy. The stool that comes out is 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 region, 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.

3 Factors leading to the development of acute gastritis

Acute hemorrhagic gastritis can occur suddenly. If a person has already had it, then the reappearance of the disease takes on a lightning-fast character. This type of disease has more pronounced clinical manifestations due to the 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. In this case, a severe chemical burn may occur 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 the provoking role is played by systemic diseases of 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. Basically, this is influenced by external factors, which gives clear symptoms of this type of disease.

4 Diet food

In the acute form of the 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 of 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.

5 Conservative treatment

To eliminate this disease, conservative methods are mainly used. Once the diagnosis has been established, the disease begins with the use of various medications.

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

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, causes and symptoms of the disease, and most importantly, what is the treatment for 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.

Chronic hemorrhagic gastritis - formed during prolonged inflammatory process 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.

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, the skin and the condition of the nails are assessed.
The abdomen is examined and palpated.
Laboratory tests are carried out to compare the samples obtained with the norm (general and biochemical blood tests, general urinalysis, taking a coprogram).
Carrying out 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. The examination is carried out using internal inspection 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 level of acidity must be determined to exclude other diseases of the 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

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 medicine It's not easy to choose. 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 won't 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 to the resulting mixture olive oil 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 3 liters of 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 folk remedies You should start only after consulting a doctor 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.