Erosion of the stomach and duodenum
Last reviewed: 23.04.2024
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Erosion of the stomach and duodenum - superficial defects that do not go beyond the tunica muscularis of the gastric mucosa and duodenum, and heal without scarring.
Causes of erosions of the stomach and duodenum
The main etiological factors of erosions of the stomach and duodenum are:
- infection of the mucous membrane with Helicobacteria;
- psychoemotional stressful situations (G. Selye's adaptation disease with erosive-ulcerative lesions of the gastroduodenal system);
- the use of rough, spicy, hot food and alcohol;
- the intake of salicylates and other NSAIDs, as well as glycocorticoids, reserpine, digitalis, and certain antibiotics;
- stasis in the portal vein with cirrhosis of the liver or thrombosis of the portal vein (erosion in the esophagus and stomach is formed, chronic erosion is more often observed with alcoholic, and acute - with viral cirrhosis of the liver);
Causes of erosions of the stomach and duodenum
Pathogenesis of erosions of the stomach and duodenum
Under the influence of etiological factors, the following mechanisms for the development of erosions of the gastroduodenal zone are included:
- decrease in the activity of protective factors of the mucosa of the gastroduodenal region. Protective factors include gastric mucus, optimal circulation in the wall of the stomach, cellular regeneration, the inhibitory effect of gastrointestinal hormones on gastric secretion (primarily hydrochloric acid formation), saliva, alkaline panic creatine juice. Of particular importance are the disruption of mucus production and the slowing down of the regeneration of the gastric epithelium, which reduces the resistance of the gastric mucosa and contributes to the development of erosion;
Pathogenesis of erosions of the stomach and duodenum
Classification of erosions of the stomach and duodenum
The acute include flat erosion, the epithelialization of which does not exceed 2-7 days; to chronic - erosion, not subjected to reverse development for 30 days or more.
Types of erosions of the stomach and duodenum
The clinical picture of erosions of the stomach and duodenum
Patients suffering from erosions of the stomach and duodenum complain of pain in the epigastric region, occurring 1-1.5 hours after eating, heartburn, nausea, eructation, and often vomiting. At objective research of patients it is possible to note weight loss (at long existence of erosions) which is caused by appetite decrease, sometimes refusal of meal in connection with fear of occurrence of pains and vomiting. When palpating the abdomen, you can identify local tenderness in the epigastric region. Thus, a characteristic feature of erosions of the gastroduodenal region is ulcerative-like clinical symptomatology.
Symptoms of erosions of the stomach and duodenum
FEGDS makes it possible to distinguish between mature and immature chronic complete erosion. Immature full erosions are those that have only a corolla of hyperemia on top. Mature erosions are considered if there are signs of desquamation and necrosis. Immature erosions are observed in the phase of remission, mature - in the phase of exacerbation.
Erosion of the stomach should be carefully differentiated with an erosive-ulcerative form of cancer, for which it is necessary to conduct a biopsy from suspicious areas of the mucosa with subsequent morphological examination.
[What tests are needed?