Gastritis in the elderly
Last reviewed: 23.04.2024
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Gastritis in the elderly is less pronounced than in young people, although the disease is more severe: it is often accompanied by a sharp deterioration of the condition, severe intoxication, symptoms of cardiovascular insufficiency up to the collapse. Complaints and a clinical picture of a chronic gastritis at people of elderly and senile age are less expressive, than at young, quite often proceeds latently.
[What causes gastritis in the elderly?
Acute gastritis in the elderly develops due to the intake of poor-quality infected foods, mistakenly using strong solutions of acids or alkalis, improper and long-term use of medicines (salicylates, reserpine, corticosteroids, cardiac glycosides).
Among the causes of the development of chronic gastritis can be identified exogenous and endogenous. Exogenous factors - a violation of diet, the use of poorly processed rough food, long-term use of medications. Endogenous causes include neurovegetative disorders, neuroreflexive effects in diseases of other organs, lesions of the pituitary-adrenal system, chronic infectious diseases, metabolic disorders, hypoxia of stomach tissues in chronic cardiovascular, respiratory, renal insufficiency, allergic diseases.
Lesion of the gastric mucosa with chronic gastritis: superficial (initial phase), with lesions of glands without atrophy (intermediate phase) and atrophic (terminal phase). In contrast to the young, in the elderly and old people the most common is atrophic bacterial (type B).
How is gastritis manifested in the elderly?
Gastritis in the elderly is acute. Characterized by the syndrome of gastric discomfort - nausea, vomiting, belching with air or eaten on the eve of food, pain mainly in the upper abdomen (epigastric angle, nadpupochnaya area), sometimes with irradiation in the right and left hypochondrium. In severe cases, there is an increase in heart rate, a decrease in blood pressure.
Features of chronic gastritis in the "third age":
- prevalence of dyspeptic syndrome over pain syndrome;
- more secretory deficiency of the glands of the stomach;
- wave-like course without significant weight loss;
- presence of not only gastric, but also intestinal dyspepsia; The disease is characterized by low symptomatology. Patients often complain of a feeling of heaviness and fullness in the epigastric region, sometimes mild pain after eating. There is bloating, belching, rumbling in the abdominal cavity, general weakness, constipation, sometimes changing diarrhea. In this case, the aggravation of the disease is associated with a change in the nature of nutrition, the use of whole milk, meat or spicy foods, alcohol, medicines.
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How is gastritis treated in the elderly?
During the first days should refrain from eating. In the following days, a diet is prescribed, chemically, mechanically and thermally sparing, in small portions. An abundant drink is recommended (unsweetened tea, slightly alkaline mineral waters, broths of dogrose and herbs). With frequent vomiting, it is necessary to fight with dehydration, control hemodynamics and water balance. It is advisable to carry out control and correction of homeostasis: transfuse water-salt solutions, plasma. High doses of vitamins (C - 300 mg, PP - 100 mg per day), antispastic and sedative therapy are shown. If necessary, use means that normalize the activity of the cardiovascular system.
One of the main components of the complex treatment of chronic gastritis is the correct diet, sleep, work and rest. Food is taken at least 5 times a day in a warm form. The diet should contain a normal amount of table salt, extractive nitrogenous substances, an increased amount of vitamins, especially ascorbic (500 mg / day) and nicotinic (50-200 mg / day) acids. For the elderly, especially those living alone, the observance of the terms and conditions for storage of foodstuffs, the rules for taking medications is of special importance.
Depending on the safety and functionality of the secretory apparatus of the stomach, it is advisable to prescribe substitution therapy (gastric juice, acid-pepsin, abomin) to replenish the secretory function of the stomach. To stimulate appetite and juice release, apply plantaglucid, a thousand-gramme, infusion from the leaves of plantain, dandelion roots, etc.
Since chronic gastritis in the elderly is a progressive inflammatory process, the complex of medicinal treatment includes substances that have anti-inflammatory effects: infusion or chamomile extract, bismuth preparations (De-Nol), course use of oxacillin, ampicillin, furazolidone, trichopole.
To improve metabolic processes in the stomach wall, such multivitamin preparations as undevit, panegsavit, decamewith, vitamin B (0.05 g 3 times a day) and ascorbic acid (500 mi per day for 12-20 days), methyluracil ( on 0,5-1,0 g i 3 times a day).
The complex of metabolic therapy includes co-carboxylase, anabolic steroids (methandrostenolone 5-10 mg 2-3 times a day, retaboyil 500 mg intramuscularly once every 1-2 weeks) and preventive courses of cyanocobalamin.
To normalize the motor-evacuation disorders, appoint a cerukal or raglan, inside 1 tablet 3 times a day for 5 minutes before meals or parenterally 1-2 mg for 2-3 weeks, and also use a motilium that does not have a side effect on the central nervous system.
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