Acute gastritis

Acute gastritis is an acute inflammatory reaction in the mucous tissue of the stomach, provoked by some damaging factors.

ICD-10 code

According to the international classification of diseases, acute gastritis of microbes 10 is classified:

• class XI - diseases of the digestive organs (K00-K93)
• diseases with dislocation in the esophagus, stomach and duodenum (K20-K31)
• K29 - gastritis and duodenitis;
• K29.1 - other acute gastritis.

Among other manifestations of the disease, acute gastritis with hemorrhage (K29.0), alcoholic gastritis (K29.2), hypertrophic gastritis, granulomatous (K29.6) and unspecified gastritis (K29.7) are isolated.

Causes of acute gastritis

The causes of inflammation of the gastric walls can be various factors:

• inaccuracies in the diet (intake of rough, spicy, sour, too hot food);
• allergic manifestations on any products (in this case, gastritis is accompanied by other signs of allergy);
• consuming a lot of strong coffee (especially soluble) or alcohol. Strong alcohol and coffee irritate the gastric mucosa and gradually damage it;
• getting into the stomach with food of various chemical substances (ethyl, methyl alcohol, acetic or other acid, alkaline solutions, salts of heavy metals, etc.);
• overdose of drugs, especially for a long time (taking salicylic acid derivatives, antibacterial agents). Such medications can destroy the mucous and barrier function of the stomach, disrupt blood circulation and prevent the formation of gastric juice enzymes;
• functional disorders of the digestive system, triggered by burns, injuries, surgical interventions, the formation of neoplasms of the stomach;
• infectious lesions of the digestive organs (infection of staphylococcus, salmonellosis, dysentery, influenza, measles, typhus, etc.);
• disorders of metabolic processes;
• exposure to radiation ("radiation" gastritis).

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Pathogenesis of acute gastritis

Inflammation of the gastric mucosa can be attributed to a number of pathologies, provoked by a variety of etiological causes. Such reasons include:

• exogenous (external) factors - poor nutrition, eating too much food, eating dry, drinking alcohol, etc. Gastritis can be triggered by banal bad chewing of food slices, eating "on the run";
• endogenous factors (affecting directly inside the body) are metabolic diseases (thyroid pathologies, diabetes mellitus), psychogenic causes (stresses, emotional stresses that provoke disorders of secretory functions and gastric motility), poisoning (acids, alkalis, high concentrations of alcoholic beverages ) and etc.

Among the acute forms of gastritis, one can distinguish such variants of the course:

• acute erosive gastritis. This is one form of exogenous gastritis. His symptoms are somewhat different from other types of disease. The appearance of this type of gastritis is associated with the use of poor-quality food or inadequate doses of medications (salicylates, bromine, iodine, etc.). The first signs of the disease are dyspepsia (nausea, upset stomach), pain in the epigastric zone and gastric bleeding. It happens that the symptomatology is reduced to only one bleeding. Hemorrhagia occurs due to the formation of erosive sores on the surface of the gastric mucosa. Bleeding can be diagnosed primarily by examining the vomit: as a rule, they may have a brownish or reddish tinge.
• acute hemorrhagic gastritis - this is the second name of erosive gastritis with obvious signs of gastric bleeding, such terms are often of a combined nature.
• acute catarrhal gastritis - sometimes it is called the term "simple" gastritis, or alimentary. The disease is an acute form of the inflammatory process in the gastric mucosa provoked by eating disorders or stressful situations. The reasons for this form of pathology can be overeating, improper diets, eating dry, long-term hunger. The detection of catarrhal gastritis is not difficult, the treatment is conservative.
• acute ulcerative gastritis - has much in common with erosive gastritis, manifests itself in the disorder of the functionality of the mucosa. The eruptions of the stomach that have arisen earlier gradually turn into a ulcerative pathology of muscle tissues. This disease, in addition to alimentary disorders, can be triggered by some infectious diseases: diphtheria, pneumonia, hepatitis, typhus, etc.
• acute superficial gastritis - it is also called "antral" gastritis. This is a hypersecretory disease, an inflammatory process with an increase in the acidity of gastric juice. May develop as a result of infection of the mucous membrane with a bacterial infection. With this form of gastritis, the cells of the superficial epithelium of the gastric membrane are mainly affected.
• acute infectious gastritis - develops in the presence of infectious foci in the body (measles, influenza, typhus, pneumonia). The clinical picture of an infectious gastritis is presented by the expressed phenomena of a dyspepsia and depression of secretory function of a stomach.

Symptoms of acute gastritis

The main signs of an acute form of gastritis:

• Dyspeptic manifestations (appetite disorders, flatulence, stool disruption);
• heartburn, an unpleasant eructation;
• sharp pain and a feeling of heaviness in the site of the projection of the stomach;
• tenderness when feeling the epigastric region;
• violation of salivation;
• attacks of nausea, up to vomiting (contents of the stomach, mucus, bile, or even blood);
• signs of anemia (increased fatigue, drowsiness, pale skin, dizziness, headache);
• increase in temperature from 37 to 39 C;
• presence of a dirty gray coating on the surface of the tongue.

An acute attack of gastritis usually manifests itself within 5-10 hours after direct irritation of the mucous by some damaging factor. Therefore, the appearance of initial symptoms should already be the reason for contacting the doctor.

The temperature for acute gastritis varies from subfebrile (37-38 ^o C) to febrile (38-39 ^o C). The appearance of high temperatures can be a consequence of the attachment of severe infectious complications. Therefore, in such cases, you should immediately call a doctor.

Acute pain with gastritis can be prolonged, not stopping for several days. Usually, such pain is accompanied by a feeling of heaviness in the stomach, nausea, acidic eructation. As the acute stage of the process changes into a chronic one (in the absence of proper treatment), the pain becomes noisy, sluggish.

During gastritis, soreness usually appears a short time after eating (15-20 min) and can last about 2 hours. The pain is more pronounced if there were sharp meals, pickled, soda, or spirits among the food you eat.

Sometimes soreness can be provoked by emotional stress, smoking, inflammation of nearby organs.

Acute gastritis in children

The most common development of an acute form of gastritis can be observed in childhood from 5 to 12 years - this is the time of active growth and the formation of the child's systems and organs.

The inflammatory response of the gastric mucosa may be primary and secondary. Factors of development of the primary disease can be a pathological effect on the stomach wall of bacteria and toxic substances, drugs, as well as inaccuracies in nutrition and allergy to certain products.

Secondary lesions with gastritis can follow other pathologies: acute respiratory viral infection, diphtheria, septic infection, renal insufficiency, measles.

The main signs of gastritis in a child may be general weakness, nausea, salivation, symptoms of intoxication, pain in the projection of the stomach. The pulse is faster, the pressure can be slightly reduced.

To general clinical symptoms may be added signs of poisoning, disorders of kidney function, bloating.

The severe course of the acute form of gastritis is manifested by the shock state of the child, collapse, up to the perforation of the gastric walls and the development of peritonitis.

If symptoms of acute gastritis are present, it is recommended to consult a doctor immediately, without giving the child any food and any medications beforehand, so as not to lubricate the picture of the disease.

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Complications of acute gastritis

Postponed and untreated acute gastritis, especially with a second disease, can go into a chronic form.

If gastritis is caused by poisoning, it is possible to develop cicatricial changes along the esophagus and in the stomach cavity. Restoration of the mucous membrane after exposure to toxic agents is not always possible. In severe situations, in the first few days after poisoning, it is possible to develop a shock state, perforation of the walls of the stomach, bleeding and the transition of inflammatory pathology into the abdominal cavity (peritonitis).

With severe form of gastritis (especially in childhood) it is possible to develop general intoxication, a disorder of the heart activity.

[9], [10], [11], [12], [13], [14], [15]

Diagnosis of acute gastritis

In addition to questioning, examination and palpation of the patient, various instrumental methods of investigation are frequently used: esophagogastroduodenoscopy, PH-metry of the stomach environment, fluoroscopy, PDC, etc.

• Laboratory research. General blood test, biochemistry, general urine analysis, feces, fecal occult blood test, Helicobacter pillory infectious agent determination, blood on pepsin and pepsinogen, immunity study.
• X-ray examination. Determine the presence of ulcers of the mucosa, degenerative processes, hernia of the esophagus, malignant neoplasms, polyps,
• PH-metric of gastric contents. Evaluate the state of the secretory function, the balance of the gastric environment (empty stomach environment should be PH 1.5-2.0).
• Method of electrogastroenterography. Determine the motor and evacuation capacity of the digestive tract.
• Ultrasonic method of investigation. Determine whether there is lesion of the gastric walls, as well as concomitant pathologies (cholecystitis, hepatitis, duodenitis).

[16], [17]

Treatment of acute gastritis

Treatment of the main group of patients is carried out on an outpatient basis.

Medical activities are selected by the doctor individually, it depends on the causes and stages of the disease.

First aid for acute gastritis should be aimed at eliminating the factor that triggered the inflammatory reaction in the mucosa. Therefore, the patient should be vomited, or, with a possible infectious or toxic etiology of the disease, rinse the stomach with a weak solution of baking soda, saline solution.

After this, the patient is not allowed to take any food for the first few days. It is allowed only the use of warm drinks in the form of sweetened tea, broth of wild rose, alkaline mineral water (without gas).

Nutrition for acute gastritis

Nutrition for acute gastritis depends on the stage of the disease. 2-3 days after the beginning of treatment, the patient is prescribed a diet consisting of mashed cereal cereals, mucous soups, starchy acidic jelly, boiled eggs.

After about a week, the patient is prescribed a diet number 5a, which provides for the use of mechanically and chemically sparing food.

What can you eat with acute gastritis?

• Mucous soup based on semolina, barley, oatmeal, rice cereal, chopped buckwheat.
• Wiped low-fat cottage cheese.
• Boiled low-fat meat (chicken, turkey, veal).
• Low-fat fish (boneless fillet cooked in a double boiler).
• Pounded vegetables (carrots, sweet potatoes, potatoes, zucchini).
• Bread dried white.
• Garnish from cereals, ground in a blender, can be added with milk (in proportion to water 50/50).
• Broth of dogrose, chamomile.

To eat it is necessary fractional, 5-6 times a day.

A strict diet for acute gastritis usually lasts 7-12 days.

What is forbidden for gastritis?

• Fresh bread, buns and black bread.
• Macaroni from hard varieties or undercooked.
• Fried dishes, including sour cream, pancakes, pancakes.
• Filled broths, cabbage soup and borsch.
• Fatty meat, poultry, fish, lard, smoked and canned foods.
• Scrambled eggs, scrambled eggs, hard and processed cheese.
• Cabbage, pickled and canned vegetables, turnips, garlic, onions, horseradish, grapes.
• Sour representatives of berries and fruits.
• Carbonated water.
• Chocolate, coffee drinks, cocoa.
• Fast food and semi-finished products.
• Too hot dishes and ice cream.

Menu with acute gastritis (example):

• Breakfast. Liquid milk rice porridge with a small amount of butter, tea with milk, white cracker.
• Snack. Baked sweet apple without skin, broth of dogrose, cracker.
• Dinner. Mashed vegetable soup, oat jelly, white cracker.
• Snack. Tea with chamomile, cottage cheese (mashed through a sieve).
• Dinner. Chicken brisket steamed, mashed potatoes, tea.
• A cup of milk or fresh yogurt.

Recipes for acute gastritis can be very diverse, but they must be combined with a general condition:

• food should not be salty, peppery, oily, hot, cold, sour, rough;
• all the ingredients should be reduced to the maximum, therefore in the menu are preferred rubbed porridges, soups-mashed potatoes, a variety of soufflé and puddings;
• food should not consist of indigestible particles (peels of fruits and vegetables, coarse fiber);
• food should not contain alcohol and other irritating substances in the stomach.

In addition, we should add that with gastritis categorically not allowed overeating and chaotic absorption of food: should be observed diet and rest.

Treatment of acute gastritis with drugs

Initially, you can alleviate the pain with a warm warmer or compress on the epigastric region. It is also important to comply with bed rest.

In the future, the doctor will decide on the use of the following drug treatment:

• detoxication therapy - drip of saline, glucose or vitamins;
• analgesic therapy - the use of anticholinergics (platyphylline, atropine), spasmolytic (baralgina, papaverine), narcotic analgesics;
• antiallergic therapy - is used for allergic etiology of the disease, antihistamines are used. These drugs include fenkarol, diazolin, tavegil, suprastin, diprazine, dimedrol. All these drugs can be used inside (in tablets, capsules, syrups) or rectally in the form of candles. With significant allergic manifestations, injecting drugs are used;
• Hemostatic therapy - with bleeding from erosions and ulcers; used blockers of histamine receptors (Zantac intravenously 100 mg, then inside twice a day for 150 mg, either Kwamatel, Losek intravenously 40 mg, then 20 mg twice a day); Simultaneously prescribe Sucralfate 6 mg;
• antibacterial therapy - is prescribed for infectious etiology of the disease; antibiotics are applied depending on the sensitivity of the bacterial flora, as well as adsorptive drugs (activated charcoal, sorbex).

By the way, the main principle in the therapy of gastritis, provoked Helicobacter pylori, is its destruction in the cavity of the stomach. To do this, use a variety of medications, and among them an important place is occupied by antibiotics. Scientific experiments have shown that the bacterium Hp is more sensitive to penicillin derivatives: amoxicillin, carfecillin, ampicillin, and methicillin. However, it is also established that these antibacterial agents do not kill all bacteria: about 20% of the microbes remain active and continue to have a detrimental effect on the walls of the stomach. It should also be taken into account that the effect of antibiotics decreases somewhat in the acidic environment of the stomach.

In this regard, the specialists set out to find similar means that destroy helicobacter pylori by 100%, even in the aggressive acidic PH of the stomach. The output was the use of combined treatment of penicillin derivatives with derivatives of nitronidazole (tinidazole, metronidazole) and tetracyclines (doxycycline). In advanced stages, it is possible to combine drugs with derivatives of the nitrofuran series (furadonin, furazolidone) - these drugs are used relatively rarely because of their high toxicity.

Currently, anti-Helicobacterial therapy of gastritis actively uses De-nol medication - a colloidal tricium bismuth dicitrate, highly soluble in water and acid-proof gastric juice. The main property of the drug is the destruction of the Helicobacter pillory, since the de-nol bismuth active substance is toxic for a given type of bacteria. Ions of bismuth penetrate through the mucous layer of the gastric walls, fill all the cavities and folds of the organ and destroy the pathogen. The drug rarely has side effects, usually these are manifested only with prolonged use: dyspeptic disorders, dark plaque in the tongue, darkening of stool, in severe cases of overdose - encephalopathy.

In the antimicrobial therapy of acute gastritis, the following drug regimens are most commonly used:

• use of De-nol in a daily dosage of 480 mg divided into 4 doses (for 28 days), metronidazole in a daily dosage of 2 g divided into 4 doses (for 10 days) and amoxicillin in a daily dose of 2 g divided into 4 doses (in a week);
• use of De-nol in a daily dose of 480 mg divided into 4 doses (28 days), tinidazole 2 g per day, divided into 3 doses (during the week), oxacillin 2 g per day, divided into 4 doses (for 10 days ).

De-nol is used for half an hour before a meal, the rest - after a meal.

Sometimes, at the doctor's discretion, after a few months, the course of preparations is repeated.

Lowering the acidity of the PH of the stomach is stopped by the appointment of enzymatic agents (to improve the digestion of food pieces). Such preparations are festal, enzyme, mezim, panzinorm, they are used on 1 tab. With food intake.

If the acidity, on the contrary, is increased, the use of such agents is not recommended. In such cases, drugs can be prescribed that neutralize the aggression of the gastric environment and inhibit secretory activity: magnesium oxide, almagel, phospholugel, calcium carbonate are indicated. Here are a few more popular and effective products with increased acidity:

• Maimagel - consists of magnesium hydroxide and aluminum with menthol. It is taken for 2-3 tsp. Up to 4 times a day before or after meals;
• Maalox, an analog of the diamond, consists of magnesium hydroxide and aluminum. Take 1-2 tablets immediately after eating (chew or dissolve in the mouth);
• gastralugel - has in its composition a licorice and silica. The drug is used in the amount of 1-2 tablets at meal time;
• alumag - an analog of maalox, but with a lower dosage of active substances, take 3-4 tablets each. At one time.

Duration of treatment, as well as the possibility of using additional medicines is determined by the doctor in each case.

Treatment of acute gastritis with alternative means

Treatment with the help of alternative medicine must necessarily be agreed and approved by the attending physician.

The following variants of mixtures of herbs are offered:

• with gastritis with insufficient secretion of gastric juice - wormwood, ayr, cumin mixed in equal parts, insist and take half a glass for half an hour before any meal;
• with dyspeptic disorders - fennel, root of aira and valerian, mint, chamomile, mix in equal parts, take a decoction over a glass after dinner and at night;
• with gastric spasm - fruits of anise, fennel, caraway and mint infuse in boiling water, drink in small sips during the day;
• with increased acidity - to drink lime or mint tea, freshly squeezed carrot or potato juice is also helpful in half a cup before each meal;
• with bloating - the broth of St. John's wort, fennel, mint.

Since gastritis often causes disorders of the intestinal and gallbladder functions, it will be useful to use medicinal herbs such as chamomile, centaury, plantain. Also anti-inflammatory effect has sage, oak bark, thyme, yarrow.

Prevention of acute gastritis

Prevention of acute inflammation of the gastric mucosa is based on a complex of some activities:

• getting rid of bad habits (drinking, smoking);
• balanced regular meals using quality and fresh products, without overeating and hunger strikes. Food should be chewed well, avoid eating in a hurry and dry;
• refusal of excessively salty and spicy food, fast food, preservatives and dyes, soda and fried foods;
• development of stress resistance, active sports, hardening of the body.

Acute gastritis is a very common disease. This is mainly due to our lifestyle and malnutrition. In the modern rhythm of life, we often do not find time to cook fresh food, eating normally and slowly, enjoying the taste and process. We grab food on the run, eat fast food or sandwiches, instant noodles or canned food. We forget to take care of our health exactly until the moment when the body screams in pain.

Acute gastritis is a warning before the transition of the disease into a chronic form. And, if we draw the appropriate conclusions and streamline our nutrition, the disease will recede and will not happen again.