Acute gastritis

Acute gastritis is an acute inflammatory reaction in the gastric mucosa, provoked by some damaging factors.

ICD-10 code

According to the international classification of diseases, acute gastritis ICD 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.

Other manifestations of the disease include acute gastritis with hemorrhage (K29.0), alcoholic gastritis (K29.2), hypertrophic, granulomatous gastritis (K29.6) and unspecified gastritis (K29.7).

Causes of acute gastritis

Inflammation of the stomach walls can be caused by various factors:

• nutritional errors (eating coarse, spicy, sour, or overly hot foods);
• allergic reactions to any foods (in this case, gastritis is accompanied by other signs of allergy);
• drinking large amounts of strong coffee (especially instant) or alcohol. Strong alcohol and coffee irritate the stomach lining and gradually damage it;
• ingestion of various chemical substances with food (ethyl, methyl alcohol, acetic or other acid, alkaline solutions, heavy metal salts, etc.);
• overdose of medicinal substances, especially over a long period of 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 caused by burns, injuries, surgeries, and the formation of gastric neoplasms;
• infectious lesion of the digestive organs (staphylococcal infection, salmonellosis, dysentery, flu, measles, typhus, etc.);
• metabolic disorders;
• 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 causes include:

• exogenous (external) factors – poor nutrition, eating too much food, eating dry food, drinking alcohol, etc. Gastritis can be provoked by banal poor chewing of food pieces, eating “on the run”;
• endogenous factors (affecting directly within the body) are metabolic diseases (thyroid pathologies, diabetes mellitus), psychogenic causes (stress, emotional tension, which provoke disorders of the secretory functions and motility of the stomach), poisoning (acids, alkalis, high concentrations of alcoholic beverages), etc.

Among acute forms of gastritis, the following course variants can be distinguished:

• Acute erosive gastritis. This is one of the forms of exogenous gastritis. Its symptoms are somewhat different from other types of the 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 symptoms are limited to bleeding alone. Hemorrhage occurs due to the formation of erosive ulcers on the surface of the gastric mucosa. Bleeding can be diagnosed primarily by examining the vomit: as a rule, they can have a brownish or reddish tint.
• Acute hemorrhagic gastritis is the second name for erosive gastritis with obvious signs of gastric bleeding; such terms are often used interchangeably.
• acute catarrhal gastritis - sometimes it is called the term "simple" gastritis, or alimentary. The disease is an acute form of inflammation in the mucous tissue of the stomach, provoked by a violation of eating behavior or stressful situations. The causes of this form of pathology can be overeating, improper diets, dry food, prolonged hunger. Catarrhal gastritis is easy to detect, treatment is conservative.
• acute ulcerative gastritis - has much in common with erosive gastritis, manifests itself in a disorder of the functionality of the mucous membrane. Previously occurring gastric erosions gradually turn into ulcerative pathology of muscle tissue. Such a disease, in addition to alimentary disorders, can be provoked 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 increased acidity of gastric juice. It can develop as a result of infection of the mucous membrane with a bacterial infection. With this form of gastritis, mainly the cells of the superficial epithelium of the gastric membrane are affected.
• acute infectious gastritis – develops in the presence of infectious foci in the body (measles, flu, typhus, pneumonia). The clinical picture of infectious gastritis is represented by pronounced dyspepsia and decreased secretory function of the stomach.

Symptoms of acute gastritis

The main symptoms of acute gastritis:

• dyspeptic manifestations (appetite disorders, flatulence, bowel disturbances);
• heartburn, unpleasant belching;
• sharp pain and a feeling of heaviness in the area of the stomach projection;
• pain when palpating the epigastric region;
• impaired salivation;
• attacks of nausea, up to vomiting (stomach contents, mucus, bile or even blood);
• signs of anemia (increased fatigue, drowsiness, pale skin, dizziness, headache);
• increase in temperature from 37 to 39 C;
• the 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 membrane by some damaging factor. Therefore, the appearance of initial symptoms should already be a reason to contact a doctor.

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

Acute pain with gastritis can be long-lasting, not stopping for several days. Usually such pain is accompanied by a feeling of heaviness in the stomach, nausea, sour belching. As the acute stage of the process passes into the chronic (in the absence of proper treatment), the pain becomes aching, sluggish.

During gastritis, pain usually appears shortly after eating (15-20 minutes) and can last for about 2 hours. The pain is more pronounced if the food consumed included spicy dishes, pickles, soda or alcoholic beverages.

Sometimes pain can be caused by emotional stress, smoking, inflammation of nearby organs.

Acute gastritis in children

Most often, the development of acute gastritis can be observed in childhood from 5 to 12 years old - this is the time of active growth and formation of the child's systems and organs.

The inflammatory reaction of the gastric mucosa can be primary and secondary. The factors in the development of the primary disease can be the pathological effect of bacteria and toxic substances, drugs on the walls of the stomach, as well as nutritional errors and allergies to certain foods.

Secondary gastritis may follow other pathologies: acute respiratory viral infections, diphtheria, septic infection, renal failure, measles.

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

In addition to the general clinical symptoms, signs of poisoning, renal dysfunction, and bloating may be added.

A severe course of acute gastritis is manifested by a child going into shock, collapse, and even perforation of the stomach walls and the development of peritonitis.

If you have symptoms of acute gastritis, it is recommended that you immediately consult a doctor, without giving your child any food or medications in advance, so as not to blur the picture of the disease.

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Complications of acute gastritis

Acute gastritis that has been suffered and not treated, especially if it recurs, can become chronic.

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

In severe forms of gastritis (especially in childhood), general intoxication and cardiac disorders may develop.

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Diagnosis of acute gastritis

In addition to questioning, examining and palpating the patient, various instrumental research methods are often used: esophagogastroduodenoscopy, pH-metry of the gastric environment, fluoroscopy, duodenal ulcer, etc.

• Laboratory tests. Complete blood count, biochemistry, complete urine analysis, stool analysis, fecal occult blood test, determination of the infectious agent Helicobacter pillory, blood for pepsin and pepsinogen, immunity test.
• X-ray examination. Determines the presence of ulcerations of the mucous membrane, degenerative processes, hernias of the esophageal opening, malignant neoplasms, polyps, etc.
• PH-metry of gastric contents. Evaluates the state of the secretory function, the balance of the gastric environment (the environment of an empty stomach should be PH 1.5-2.0).
• Electrogastroenterography method. Determines the motor and evacuation capacity of the digestive tract.
• Ultrasound examination method. Determines whether there is damage to the stomach walls, as well as concomitant pathologies (cholecystitis, hepatitis, duodenitis).

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Treatment of acute gastritis

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

Treatment measures are selected by the doctor individually, depending on the causes and stage of the disease.

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

After this, the patient is not allowed to eat any food for the first few days. Only warm drinks are allowed in the form of sweetened tea, rosehip infusion, alkaline mineral waters (still).

Nutrition for acute gastritis

Nutrition for acute gastritis depends on the stage of the disease. 2-3 days after the start of treatment, the patient is prescribed a diet consisting of strained cereal porridges, slimy soups, starchy non-acidic kissels, boiled eggs.

After about a week, the patient is prescribed diet No. 5a, which requires the consumption of mechanically and chemically gentle food.

What can you eat with acute gastritis?

• A slimy soup made from semolina, barley, oatmeal, rice, and crushed buckwheat.
• Low-fat cottage cheese, pureed.
• Boiled low-fat meat (chicken, turkey, veal).
• Lean fish (boneless fillet, steamed).
• Puree vegetables (carrots, sweet potatoes, potatoes, zucchini).
• Dried white bread.
• Side dishes made from cereals, ground in a blender, can be served with the addition of milk (in a 50/50 ratio with water).
• Rosehip and chamomile decoction.

You need to eat frequently, 5-6 times a day.

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

What is prohibited for gastritis?

• Fresh bread, buns and black bread.
• The pasta is durum wheat or undercooked.
• Fried foods, including cheesecakes, pancakes, and fritters.
• Rich broths, cabbage soup and borscht with cabbage.
• Fatty meat, poultry, fish, lard, smoked and canned foods.
• Scrambled eggs, omelette, hard and processed cheese.
• Cabbage, pickled and canned vegetables, turnips, garlic, onions, horseradish, grapes.
• Sour representatives of berries and fruits.
• Carbonated waters.
• Chocolate, coffee drinks, cocoa.
• Fast food and semi-finished products.
• Too hot food and ice cream.

Menu for acute gastritis (example):

• Breakfast. Liquid milk rice porridge with a small amount of butter, tea with added milk, white rusk.
• Snack. Baked sweet apple without peel, rosehip infusion, cracker.
• Lunch. Strained vegetable soup, oatmeal jelly, white rusk.
• Afternoon snack. Chamomile tea, cottage cheese (strained through a sieve).
• Dinner. Steamed chicken breast, mashed potatoes, tea.
• A cup of milk or fresh kefir.

Recipes for acute gastritis can be very diverse, but they should be united by a common condition:

• food should not be salty, peppery, fatty, hot, cold, sour, or rough;
• all ingredients should be chopped as much as possible, so the menu should preferably include mashed porridges, cream soups, various soufflés and puddings;
• food should not consist of indigestible particles (fruit and vegetable peels, coarse fiber);
• food should not contain alcohol or other substances that irritate the stomach walls.

In addition, it should be added that with gastritis, overeating and chaotic consumption of food are strictly prohibited: a diet and rest regime must be observed.

Treatment of acute gastritis with drugs

Initially, pain can be relieved with a warm heating pad or a compress on the epigastric region. It is also important to stay in bed.

The doctor will then decide on the use of the following medications:

• detoxification therapy – intravenous administration of saline solution, glucose or vitamins;
• analgesic therapy – use of anticholinergic agents (platifillin, atropine), antispasmodics (baralgin, papaverine), narcotic analgesics;
• antiallergic therapy - used for allergic etiology of the disease, antihistamines are used. Such drugs include fenkarol, diazolin, tavegil, suprastin, diprazin, diphenhydramine. All of the listed drugs can be used internally (in tablets, capsules, syrups) or rectally in the form of suppositories. In case of significant allergic manifestations, injection of drugs is used;
• hemostatic therapy - for bleeding from erosions and ulcers; histamine receptor blockers are used (Zantac intravenously 100 mg, then orally twice a day at 150 mg, or Quamatel, Losek intravenously 40 mg, then 20 mg twice a day); Sucralfate 6 mg is prescribed simultaneously;
• Antibacterial therapy – prescribed for infectious etiology of the disease; antibiotics are used depending on the sensitivity of the bacterial flora, as well as adsorbent drugs (activated carbon, sorbex).

By the way, the main principle in the treatment of gastritis caused by Helicobacter pylori is considered to be its destruction in the stomach cavity. For this purpose, various medications are used, and antibiotics occupy an important place among them. Scientific experiments have proven that the Hp bacterium is more sensitive to penicillin derivatives - amoxicillin, carfecillin, ampicillin, mecillin. However, it has also been established that these antibacterial agents do not cause the death of all bacteria: about 20% of microbes retain their activity and continue to have a detrimental effect on the walls of the stomach. It should also be taken into account that in the acidic environment of the stomach, the effect of antibiotics is somewhat reduced.

In this regard, specialists set out to find similar agents that destroy Helicobacter pylori by 100%, even in the aggressive acidic pH of the stomach. The solution was the use of combined treatment with penicillin derivatives with nitronidazole derivatives (tinidazole, metronidazole) and tetracyclines (doxycycline). In advanced stages, a combination of drugs with nitrofuran derivatives (furadonin, furazolidone) is possible - these agents are used relatively rarely due to their high toxicity.

Currently, the drug De-nol is actively used in anti-Helicobacter therapy of gastritis. It is a colloidal tripotassium bismuth dicitrate, which is highly soluble in water and resistant to the action of gastric acid. The main property of the drug is the destruction of Helicobacter pillory, since the active substance of De-nol, bismuth, is toxic to this type of bacteria. Bismuth ions penetrate 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 they appear only with prolonged use: dyspeptic disorders, dark plaque on the tongue, darkening of feces, in severe cases of overdose - encephalopathy.

In antimicrobial therapy for acute gastritis, the following drug regimens are most often used:

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

De-nol is used half an hour before meals, other medications - after meals.

Sometimes, at the doctor’s discretion, the course of medication is repeated after several months.

A decrease in the acidity of the stomach pH environment is stopped by prescribing enzymatic agents (to improve the digestion of food pieces). Such drugs are festal, enzistal, mezim, panzinorm, they are used 1 tablet with meals.

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

• Maymagel - consists of magnesium and aluminum hydroxide with menthol. It is taken 2-3 teaspoons up to 4 times a day before or after meals;
• Maalox is an analogue of Almagel, consists of magnesium and aluminum hydroxide. Take 1-2 tablets immediately after meals (chew or dissolve in the mouth);
• gastralugel - contains licorice and silica. The product is used in the amount of 1-2 tablets during meals;
• Alumag is an analogue of Maalox, but with a lower dosage of active substances, taken 3-4 tablets at a time.

The duration of treatment, as well as the possibility of using additional medications, is determined by the doctor in each specific case.

Treatment of acute gastritis with folk remedies

Treatment with traditional medicine must be agreed upon and approved by the attending physician.

The following options of medicinal plant mixtures are offered:

• for gastritis with insufficient secretion of gastric juice - mix wormwood, calamus, and caraway in equal parts, let it brew and take half a glass half an hour before any meal;
• for dyspeptic disorders - fennel, calamus and valerian root, mint, chamomile, mix in equal parts, take a glass of the decoction after lunch and at night;
• for stomach spasms - infuse anise, fennel, caraway and mint fruits in boiling water, drink in small sips throughout the day;
• if acidity increases, drink linden or mint tea; freshly squeezed carrot or potato juice, half a cup before each meal, also helps;
• for bloating - a decoction of St. John's wort, fennel, and mint.

Since gastritis often causes intestinal and gall bladder dysfunction, it is useful to use medicinal herbs such as chamomile, centaury, and plantain. Sage, oak bark, savory, and yarrow also have an anti-inflammatory effect.

Prevention of acute gastritis

Prevention of acute inflammation of the gastric mucosa is based on a set of certain measures:

• getting rid of bad habits (drinking alcohol, smoking);
• balanced regular nutrition using high-quality and fresh products, without overeating and fasting. Food should be chewed well, avoid eating in a hurry and dry food;
• avoiding overly salty and spicy foods, fast food, preservatives and colorings, soda and fried foods;
• development of stress resistance, active sports, hardening of the body.

Acute gastritis is a very common disease. It is mainly related to our lifestyle and poor nutrition. In today's fast-paced life, we often do not find time to prepare fresh food, eat normally and leisurely, enjoying the taste and the 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 until the moment when the body screams in pain.

Acute gastritis is a warning before the disease becomes chronic. And if you draw the appropriate conclusions and regulate your diet, the disease will recede and will not recur.