Gastritis with low acidity: atrophic, chronic, erosive

One of the main components of gastric juice is hydrochloric acid, without which the process of complete digestion of food is impossible. Its concentration in the gastric juice is determined by the acidity of the stomach. The acidity level is measured by pH units, the norm of basal acidity in the body of the stomach is from 1.5 to 2рН. Both excess and inadequate acidity bring to the body a feeling of discomfort in the epigastric zone and contribute to the occurrence of gastritis, a serious chronic stomach disease.

Hypoacid gastritis begins to develop due to the dysfunction of the gastric glands, which for some reason develops insufficiently to break down the food that enters the stomach, hydrochloric acid and enzymes. In this case, the course of natural chemical processes of food digestion is disrupted, which is accompanied by specific clinical manifestations and can lead to pathologies of the gastrointestinal tract.

[1], [2], [3]

Epidemiology

In countries with well-developed medical statistics, chronic gastritis of all types accounts for up to 90% of cases of gastric pathologies in adult patients. Presumably about 4/5 of the cases of chronic gastritis are associated with Helicobacter pylori, the likelihood of infection is the same for the male and female part of the population. More common is hyperacid gastritis, much less common hypoacid. This gastric pathology, in general, is observed in patients of adulthood, systematically neglecting a healthy lifestyle and abusing harmful habits. Although sometimes there are episodes of the development of hypoacid gastritis in childhood and adolescence. Before adolescence, girls are more likely to get sick, in the pubertal period, morbidity rates among adolescents of both sexes are equalized.

[4], [5], [6], [7], [8]

Causes of the gastritis with low acidity

To date, it is not known for certain what causes insufficient secretory activity of the gastric glands. It is assumed that this is due to the genetic defect of the repair of the mucosal epithelium of the stomach, which was damaged as a result of the action of the endogenous or exogenous stimulus. Therefore, the existence of such a disease in close relatives in itself is a risk factor for the onset of chronic hypoacid gastritis.

Also, gastritis with high acidity (hyperacid), not treated properly, can after a while be replaced by gastritis with acid deficiency. This is because in the constantly inflamed stomach due to the excess of hydrochloric acid, most of the parietal cells (producing this acid itself) are gradually dying off, the acidity is normalized, and then it begins to decrease. If this process is not stopped, an anacid gastritis will occur, when sulfuric acid is practically not produced (basal acidity> 6 pH).

So, in people with a genetic predisposition to disorders of the process of restoring the gastric mucosa, a gastritis with a low acidity is formed under the influence of additional external and internal circumstances. Risk factors for this disease:

• regular preference for unhealthy (too greasy, fried, spicy, sweet, rough and heavy for digesting food);
• regular non-compliance with the mode of food intake - food on dry and on the go, starvation compensated by overeating;
• alcohol abuse, smoking and other bad habits;
• the administration of NSAIDs, glucocorticosteroids, non-steroidal anti-inflammatory drugs, cytostatics, antibacterial and other medications;
• accidental ingestion of irritant or toxic substances;
• diseases of the thyroid gland, neurosis-like disorders, immunity disorders, intolerance of certain products;
• chronic pathologies of other digestive organs (hepatitis, pancreatitis, colitis);
• sinusitis, rheumatic diseases, renal and hepatic insufficiency and other foci of chronic infection;
• parasitic infestations, bacterial or fungal infection of the gastric mucosa;
• improper treatment of acute gastritis, premature interruption of treatment or non-compliance with the diet can lead to chronic diseases.

Not the last role in the formation of the disease is given to a negative emotional situation during a meal.

[9]

Pathogenesis

Reduced acidity of gastric juice is characteristic of chronic forms of gastritis, acute forms of hypoacid gastritis are extremely rare. The mechanism of development of this disease has not been fully studied to the present. Previously it was believed that the chronic form is a consequence of repeated acute inflammation of the gastric mucosa. However, this assumption was not confirmed by convincing facts. Currently, the prevailing opinion is that chronic gastritis is an independent disease.

For normal digestion in the stomach should be present enzymes that split the incoming food into it. The main digestive enzyme is pepsin, it is synthesized and works exclusively in an acid medium. Further qualitative assimilation of food in the intestine is possible only after neutralization of hydrochloric acid. The stomach is divided into two zones, acid-forming (its body and the bottom, covered with covering or parietal cells) and its antral section, the epithelial cells of which secrete a mucous mass that neutralizes hydrochloric acid. Lining cells secrete acid evenly and constantly, so the decrease in acidity occurs only when they decrease quantitatively. Reduced acidity of gastric juice provokes serious digestive disorders. In particular, it negatively affects the work of the intestine and pancreas, which secrete enzymes depending on the pH level. If the acidity index of gastric juice exceeds 2.5, the process of protein digestion is disrupted, which may subsequently lead to the development of autoimmune pathologies, allergies and idiosyncrasies to certain products. With reduced acidity, the necessary minerals (iron, zinc, magnesium, calcium) and vitamin B12 are practically not assimilated. As a result, anemia develops.

Hydrochloric acid has a pronounced disinfecting property, it disinfects the food that has entered the body; and also with a lack of acid, the digestion process is delayed, the prolonged presence of un-digested food in the stomach causes it to rot. Deficiency of hydrochloric acid leads to the multiplication of pathogens, in turn, causing a variety of diseases.

In the pathogenesis of the disease an important role is played by the perforation of the barrier located above the cells of the epithelial surface of the stomach, formed from the mucous secretion and the cover of the mucus-forming epithelium. This can be due to the receipt of rough, poorly chewed food, or due to ingestion of corrosive or poisonous substances. With a decrease in the number of cells, the main gastric glands that contain them gradually become atrophic, which can lead to atrophic gastritis.

The development of chronic gastritis is also facilitated by a disruption in the renovation of the gastric mucosa and its trophic, as a result of the disease, the slimming processes and the recovery of the epithelial cells of the glands of the mucous membrane are slowing down. Often this contributes to inadequate blood supply, which develops against the backdrop of other chronic diseases (hypertension, diabetes mellitus).

Not the last role in the pathogenesis of the disease is attributed to the inadequacy of the formation of gastric mucus, which protects the epithelial cells from damage. Patients with atrophy of the gastric glands exhibit pronounced biosynthesis disorders of various mucus-forming components, which is caused by a decrease in the number of cells forming mucus. But the methods of studying the formation of gastric mucus are not yet sufficiently advanced to draw an accurate conclusion about the primacy of this factor in the development of chronic gastritis.

Inflammation of the mucosa with gastritis with acid deficiency is characterized by some features. The autoimmune or bacterial lesion is primarily affected by the fundus (body and bottom) of the stomach, where the largest number of cells is located. Inflammation is usually insignificant, however, the atrophic process begins almost immediately and very quickly progresses. To compensate for the underproduction of hydrochloric acid, the production of gastrin increases. Not digested food, located in the stomach, activates the synthesis of this hormone. A direct relationship between the degree of atrophic changes in the gastric mucosa and the level of gastrin in the blood was revealed.

Renewal of mucosal cells is replaced by an overgrowth of connective tissue, cells of which are unable to produce hormones, enzymes and hydrochloric acid necessary for digestion. Gradually, the stomach tissues are replaced by an intestinal type of tissue. The degree of atrophic changes is estimated as follows:

• light - destructive changes affected 1/10 of the number of parietal cells;
• average - from more than 1/10, but less than 1/5;
• heavy - over a fifth of the gastric glands.

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

Symptoms of the gastritis with low acidity

For a long time, hypoacid gastritis can be asymptomatic. The first signs of reduced acidity are manifested as a feeling of overflow and heaviness in the epigastric zone after eating. And the food is not necessarily abundant, sometimes such symptoms appear after a light snack. Nausea with gastritis with low acidity, belching, giving out rotten eggs, heartburn, perhaps a sense of metallic taste in the tongue and hypersalivation are all indispensable attributes of this disease caused by acid and enzymatic deficiency. The stomach loses its ability to digest food more or less, which provokes the activation of fermentation processes.

Almost always the work of the intestine (diarrhea or constipation) is disrupted, often enough about the presence of acid deficiency resembles pain under the ribs. Pain syndrome appears after eating, almost immediately, however - and may be absent. Pain with gastritis with acid deficiency is caused not by spasm of the musculature of the stomach, but by its stretching. Typical dull, aching pain, the degree of expression of which is directly proportional to the quantity and quality of food consumed. Overeating and eating spices increases painful sensations.

It is very likely that the development of putrefactive bacteria in the stomach, which lacks the necessary disinfection, will lead to excessive gas production, flatulence and bloating.

Patients with hypoacid gastritis often want something sour, so they intuitively try to compensate for the deficiency of hydrochloric acid. However, this usually does not bring relief.

Secondary symptomatology, arising on the background of problems with the work of the stomach, should induce to consult a gastroenterologist. Deterioration of the process of digestion and assimilation of accepted food leads to deficiency of proteins, vitamins and minerals. This is manifested in dryness and brittle hair and nails, iron deficiency anemia, which in turn causes increased fatigue, weakness, reluctance to move. Lactose intolerance, lowering of blood pressure, weight, tachycardia, dizziness after eating can be observed. Occurrence of secondary symptoms speaks of the development of Achilles - such a significant decrease in the secretory function of the lining cells, that the presence of hydrochloric acid and pepsin is practically not determined in gastric juice.

Gastritis with low acidity in children

The most common cause of gastritis in a child is non-compliance with diet and diet. The manifestation of the disease in many cases falls on the first years of schooling, when the rhythm of the child's life, his diet, changes, the school starts to increase the load on the child.

In pre-school children, acute gastritis can cause any food, since the formation of the gastrointestinal tract occurs only to seven years. In addition, the content of hydrochloric acid in the children's stomach is low, as is its activity. Therefore, even a small number of bacteria can infect a child's body. The motor activity of the children's stomach also does not differ in intensity, therefore the food is mixed for a long period of time and can gradually cause irritation of the epithelial surface of the stomach.

Symptoms of acute gastritis in a child are accompanied by different intensity pains in epigastrium, nausea and vomiting. The duration of the acute period is two to three days, the main therapeutic measures are dietary nutrition and general restorative therapy. In the vast majority of cases, acute gastritis in children is accompanied by increased production of acid. If a child has a decreased acidity with acute gastritis, then this can speak of some slow chronic process and it is desirable to carefully examine it.

Causes of developing chronic gastritis in a child can become diseases of the liver, pancreas, intestines; food allergy; neuroendocrine disorders; a variety of chronic infections; long-term drug therapy; presence of parasites. We can not discount the hereditary factor. Also, acute inflammation can flow into a chronic form, which can contribute to incorrect treatment, premature interruption of it or non-compliance with dietary intake.

Gastritis is divided into primary (autonomic disease, localized directly in the stomach) and secondary (the consequence of some other disease that causes inflammation of the gastric mucosa). The second variant is more common in children.

In children, acid deficiency manifests itself as blunt, diffuse, abdominal pains that appear after eating any food. Pain syndrome, usually medium or mild, the reaction to palpation in the epigastrium is painful.

Frequent symptoms are nausea and vomiting, occurring two or three hours after eating, a decrease in appetite, an aversion to certain dishes, in particular milk porridges.

Body weight indices in some children suffering from chronic hypoacid gastritis are below normal, however, many children do not lag behind their peers either in weight or in growth. Most small patients with this diagnosis are easily excitable and emotionally unstable.

For childhood, superficial gastritis is predominant, glandular lesions can be observed without atrophy. If there is an atrophic process, then the degree of its severity is moderate.

Correct and consistent treatment of the child, as a rule, ends with the restoration of all impaired functions of the gastric glands.

[15]

Forms

Acute gastritis with a low acidity is extremely rare. It is usually accompanied by overproduction of hydrochloric acid. Acute inflammation develops as an immune response to any damage to the epithelium of the stomach. The cells of the immune system fulfill their function of eliminating the antigen, and this entire process results in a pronounced inflammatory reaction. Acute gastritis in a patient with a decreased secretory function of the gastric glands can rather be interpreted as an exacerbation of asymptomatically occurring chronic hypoacid inflammation, provoked by external stimuli.
 

Morphological classification distinguishes the following types of acute gastritis:

Catarrhal (simple) - the most common, occurring when ingested in the stomach of pathogenic microorganisms with poor-quality food (so-called food intoxication), as a reaction to certain medicines and food. This inflammation of the superficial gastric epithelium, its defects at which are insignificant, the repair occurs quickly after elimination of the stimulus.

Erosive - the consequence of penetration into the cavity of the stomach by corrosive substances (alkalis, acids of high concentration, salts of heavy metals), in which deep destruction of its tissues is possible.

Phlegmonous - purulent inflammation, provoked by a foreign body (acute bone, for example, fish), damaged the wall of the stomach and infected the site of damage by pyogenic bacilli. It can be a complication of an ulcer or stomach cancer, some infectious diseases. This species is characterized by such symptoms as fever and severe pain in the epigastric zone.

Fibrinous (diphtheria) is a rare type of gastritis caused, for example, by infection of blood or poisoning with mercury chloride. The last three types of gastritis require immediate medical attention.

With proper diagnosis and treatment, acute inflammation, depending on the species, lasts no more than a week, but the final cellular renewal of the mucosal epithelium occurs much later. Premature termination of treatment and non-compliance with the diet can lead to chronic diseases.

The principles of classification of chronic forms of gastritis are ambiguous and do not take into account such an important functional symptom of the disease as evaluation of the secretory activity of the gastric glands. Previously widely used classification, which distinguished the following types of gastritis:

• type A - autoimmune, when the body begins antibodies to parietal cells, localized, usually in the body of the stomach;
• type B - caused by Helicobacter with primary localization in the antral part;
• type C - chemical-toxic;
• pangastrit (mixed type A and B).

This systematization is used up to now, but its modern interpretation distinguishes such basic types of the disease: superficial (atrophic), atrophic and its special forms.

Chronic gastritis with initially reduced production of sulfuric acid is not as common as with excessive (normal). The course of this disease is often characterized by the absence of disturbing symptoms. Exacerbation of gastritis with low acidity is periodically replaced by a prolonged remission, when almost all the symptoms disappear.

Relapses of the disease can be seasonal, and more often - provoked by non-compliance with dietary rules, alcohol consumption, smoking, long-term drug therapy. Exacerbations are characterized by brief painful attacks, nausea after eating, a feeling of overflow and pressure in the epigastric region, heartburn, which speaks of the dysfunction of natural gastric valves and gastroduodenal reflux (also found in patients with low acidity). Exacerbations may be accompanied by dyspeptic symptoms: diarrhea or constipation, alternating with each other, rumbling in the upper abdomen, flatulence.

Infection with Helicobacter pylori, usually usually causing a hyperacid gastritis, upsets the natural cycle of recovery of the gastric mucosa. The old covering cells, dying, are not replaced in time on time, the renewal of the glandular epithelium is broken, the epithelial cells are gradually atrophied and replaced by a connective tissue. This, in the first place, affects the reduction in the production of pepsin and hydrochloric acid, so necessary for the complete digestion of food.

Over time, develops atrophic gastritis with a low acidity, which is characterized by a significant decrease in the surface of the gastric mucosa, and, accordingly, the number of functioning parietal (parietal) cells. Atrophy of the gastric glands is accompanied by proliferation of cells of the epithelial cover, muscle layer and connective tissue.

This type of gastritis can be more or less pronounced, depending on the degree of atrophy. The formation of atrophic gastritis occurs during the progression of any of its forms, including due to autoimmune damage to the covering cells. Due to their atrophy, the acidity gradually decreases to practically zero level (anacid gastritis). Prolonged insufficient secretion of gastric juice leads to a loss of ability to digest food. The condition, when gastric juice is completely devoid of pepsin and hydrochloric acid (achillium), is the final stage of the inflammatory process, both with reduced and with increased acidity - achilles gastritis. With this pathology, the symptoms of digestive disorders prevail in symptoms: belching with air or rotten eggs, the feeling that a stomach full of food is "standing", nausea. Soreness is not characteristic, however, after an hour and a half, painful, not very intense pains may appear. When the inflammation is localized in the pyloric part of the stomach or gastroduodenitis, the pain syndrome is brighter. A person's appetite worsens (up to anorexia), constantly unpleasant aftertaste in the oral cavity, there may appear in dystrophic or inflammatory lesions (gums, tongue), vomiting on an empty stomach, achilles diarrhea alternating with constipation.

Erosive gastritis with low acidity - hemorrhagic inflammation of the mucous epithelium. Its chronic form can be the result of prolonged drug therapy, alcohol abuse, the consequence of Crohn's disease or banal ARVI. Reduced secretion of gastric juice leads to circulatory disorders, thinning of the vascular membranes, and, as a result, increased permeability and bleeding. In some cases, the cause is not established - idiopathic erosive gastritis. This form of the disease often initially asymptomatic. Later, the patient begins to worry about signs of blood loss - frequent dizziness, weakness, desire to lie down, sit down, palpitations, with increased hemorrhagic manifestations - bloody vomiting, black stains (tarry).

Antral gastritis with a low acidity occurs due to autoimmune lesions of the cells of the gastric glands. Another factor is the prolonged parasitization of Helicobacter pylori. In the pyloric part of the stomach, hydrochloric acid is neutralized in a digested lump of food before it enters the duodenum. Inflammation of the mucosa of this part of the stomach leads to the formation of sites of atrophy with the growth of connective tissue there, insufficient neutralization of hydrochloric acid and subsequent lesions of the small intestine. In the pyloric (antral) part of the stomach develops rigorous gastritis. There is a deformation of this part - the lumen narrows, because of the edema of the mucous membrane and tissues located under it, thickening of the serous cover and spasms of the muscle tissue. At the initial stages, the symptomatology is not pronounced, but with the development of the disease there are very severe pains in the upper abdomen after an hour and a half after eating, later - fasting pain. Typical manifestations are nausea and vomiting, since food can not overcome the narrowed lumen of the antral section, weight loss due to lack of appetite.

Hypertrophic gastritis is a benign tissue overgrowth. The defeat of the tissues of the inner surface of the stomach can affect not only the mucous membrane, but also the muscle layer. In the stomach there is excessive mucus formation on the background of insufficient production of hydrochloric acid. Hypertrophic gastritis can occur with alternating exacerbations and remissions over many years. The patient periodically feels discomfort in the upper abdomen and nausea. Characterized by frequent diarrhea. Neoplasms are single (focal hypertrophic gastritis) and multiple (diffuse). This form of gastritis is treated ambiguously, basically, several of its sub types are distinguished: giant hypertrophic gastritis (often considered as a separate disease), granular or cystic, warty, polypous. Polyposis proliferation of epithelial tissue can occur asymptomatically or in rare cases manifest as recurrent bleeding. It is assumed that the polyps grow as a result of inflammatory hyperplasia of the gastric mucosa against a background of widespread atrophic gastritis. Polyps of the stomach may become malignant.

The earliest stage of chronic hypoacid gastritis is a superficial gastritis with a decreased acidity. This form of the disease is characterized by a normal thickness of the stomach, occasionally with a slight thickening and mild dystrophy of the mucosa. Slime formation is already increased, there is a slight decrease in the production of pepsin and hydrochloric acid, however, there are still no total changes. But it is from this stage that the progression of the disease begins. There is no symptomatology, mainly gastritis at this stage is detected by chance. Superficial gastritis does not require specific therapy. At this stage of the disease, diet, alternative means and restorative measures are avoided.

[16], [17], [18], [19], [20]

Complications and consequences

Gastrites with low acidity are less common than hyperacid gastritis, but the consequences that they can cause are much more serious. This, for the most part, sluggish diseases with mild symptoms throughout a long period. However, a low level of acidity of gastric juice can provoke significant complications in the digestive system, especially the intestine and pancreas. The presence of a normal level of acidity provides an antiseptic effect of gastric juice. Deficiency of acid weakens its bactericidal properties, together with pepsin deficiency worsens the digestion of food. It is not sufficiently decontaminated, and pathogenic microorganisms, together with the remains of unquenched food, cause fermentation, decay and disturb the natural biocenosis in the stomach. This promotes exacerbations in the form of inflammation of the gastric mucosa. Against the background of acid deficiency, proteins are not broken down, vitamins and mineral components are not digested, which contributes to a decrease in immunity, the development of intolerance to certain food products, and the risk of development of the most dangerous complications of disorders of co-metabolism - ulcers and stomach cancer, pernicious anemia.

[21], [22]

Diagnostics of the gastritis with low acidity

The physical diagnosis of the patient is relatively modest in the recognition of gastritis with reduced acidity. Symptomatic differences of gastritis with increased and decreased acidity can only lead to the assumption of the presence of one form or another. The leading place in the diagnosis of this pathology is taken by analyzes and instrumental diagnostics: esophagogastroduodenoscopy with biopsy of the gastric mucosa and intragastric pH-metry with a single / multichannel probe or radio capsules.

Esophagogastroduodenoscopy is perhaps the main diagnostic method that allows to identify both the form of chronic gastritis-surface, atrophic, hypertrophic, localization of the process, and the period of clinical course-relapse or remission. The role of gastroscopy in differentiating gastritis from peptic ulcer and stomach cancer is now indispensable.

The exact diagnosis is established by a histological examination of the biopsy specimens of the coolant taken during esophagogastroduodenoscopy. These studies make it possible to evaluate the morphological changes in the mucous membrane of the antral and fundal parts of the stomach, since the nature of these changes with different forms of gastritis differs significantly. Changes in the mucosa are usually uneven, so biopsies are taken repeatedly and several times from the same mucosal zone.

The study of biopsy specimens makes it possible to detect heliobacteriosis and the degree of colonization of the gastric mucosa.

Endoscopic pH-metry is performed during gastroscopy, with the usual procedure being extended by approximately five minutes.

With contraindications or other reasons for not being able to perform intragastric sounding, urine is analyzed for uropepsinogen, although this method is likely to have errors in the results of the analysis. To recognize the disorders in the production of acid in gastric juice can be based on the content of serum gastrin, the basal level of which with insufficient acidification should be increased, and with antral atrophic gastritis - significantly reduced.

To clarify the peculiarities of acid formation disorders with gastritis, it is possible with the help of: histochemical study of the ultrastructure of the main and parietal cells, the morphology of the underlying glands of the coolant with the calculation of their proportional correspondence, determination of the G cell density in the mucosa of the antral stomach. These studies make it possible to clarify the mechanisms of disturbances in the formation of pepsins and hydrochloric acid by changing the number of cells synthesizing digestive enzymes and acid, the growth or contraction of the region of the base glands, etc. Also, the motor activity of the stomach and the formation of mucus are studied.

Recently, Helicobacter pylori infection has been diagnosed by detecting antibodies to this bacterium in patients.

The role of X-ray diffraction, although not the main one in the diagnosis of gastritis with low acidity, but it can be useful in determining special forms of the disease, for example, polyposis gastritis, and also when differentiating chronic gastritis from other chronic gastric pathologies.

[23], [24], [25], [26]

Differential diagnosis

Symptoms characteristic of hypoacid gastritis are inherent in other diseases of the gastrointestinal tract. Differential diagnosis based on the results of a comprehensive examination of patients with suspected chronic gastritis makes it possible to distinguish it from other diseases of the stomach, intestines, esophagus, pancreas. In this case, it is necessary to take into account the fact that the presence of chronic gastritis in any form does not exclude a patient from another, more serious disease. It is not enough to limit ourselves only to the study of the functioning and morphology of the stomach. Patients with chronic gastritis are prescribed additional ultrasound diagnostic examination of the abdominal cavity organs, x-ray examination of the gallbladder, and also investigation of its functioning. Based on indications, duodenal sounding, X-ray and endoscopic examination of the thick, sigmoid and rectum, bacussis on dysbiosis and other examinations, which will be appointed by the attending physician. As a result of a comprehensive survey, various diseases disappearing behind the symptoms of chronic gastritis, for example, chronic cholecystitis or colitis, dyskinesia of the gallbladder and large intestine, hernia of the esophageal opening of the diaphragm and others.

Differential diagnostics allows to exclude malignant neoplasms, pernicious anemia, conditions associated with deficiency of vitamins caused by other causes (spru, pellagra) in case of gastritis with insufficient acid formation. The absence of hydrochloric acid and pepsin in elderly people can be of a functional nature, in which destruction of the gastric mucosa is not detected.

A complete history allows you to more accurately assess the patient's condition and choose the most appropriate treatment tactics.

Treatment of the gastritis with low acidity

Therapeutic regimens for patients with chronic hypoacid gastritis are prescribed individually, taking into account the degree of acid deficiency, morphological and functional changes in the state of the stomach, concomitant diseases. The goal of the treatment is to reduce the manifestations of inflammation, transfer of the patient to the phase of remission, inhibition of atrophic changes, the maximum possible recovery of secretory and motor gastric activity.

As a rule, treatment is carried out on an outpatient basis, but in the case of severe symptoms of exacerbation, and if a thorough examination is necessary, it is advisable to hospitalize the patient in a hospital.

In the treatment of acute gastritis with low acidity, great importance is attached to adherence to dietary diets and diet. During the exacerbation of gastritis, food should be consumed five or six times a day, be moderately warm and machine-treated. The purpose of dietary nutrition is to reduce the load on the lining of the stomach. With the fading of acute symptoms, food becomes less sparing. In addition to the diet, drugs that stimulate the activity of the gastric glands are prescribed. Enzymatic and acid deficiency is compensated by the following drugs: Acidin-pepsin, Pepsidil, Panzinorm. These drugs contribute to the process of digestion of food. The first two drugs are used for hypoacid gastritis up to the complete absence of pepsin and hydrochloric acid (achillium).

Acidin-pepsin is taken orally with food or after its administration three times or four times a day, dissolving two tablets in half a glass of water.

Pepsidil is taken orally with food three times a day, after measuring one or two tablespoons of the solution, preferably through a tube.

Contraindicated in high acidity and allergy to its ingredients.

Pansinorm is used for atrophic gastritis, inflammation of the gallbladder, reduced function of the pancreas. Take orally with food three times a day. Contraindicated in hepatitis, absence of outflow of bile, obstruction of the gastrointestinal tract, allergies to the components of the drug.

If acute gastritis develops in a patient with chronic pancreatitis, then medication presupposes the appointment of Pancreatin or Festal, nausea, vomiting and heartburn is stopped with Cerucal or Reglan.

In chronic gastritis with low acidity, table No. 2 is recommended. The menu should include a variety of products that activate acidification, enhance appetite, providing a full meal: low-fat fish or meat broths and soups cooked on them; steamed, boiled and steam fat-free meat, fish, vegetable dishes; crumbly porridges boiled on the water; juices from fruits and vegetables; greenery. The duration of compliance with dietary norms of nutrition in case of chronic hypoacid inflammation of the stomach is individual (from one month to several years).

It excludes dishes that are long digested, irritating the mucous membrane of the stomach and provoking increased fermentation in the intestines: fatty, sharp, smoked, salted, cold drinks, fresh bread, cabbage and grapes in large quantities. Patients with this form of gastritis often have intolerance to fresh "sweet" milk, under these circumstances it is recommended to use sour-milk products.

The choice of dietary table is based on the presence of concomitant diseases. Table number 4 appoint with frequent diarrhea, table number 5 - in diseases of the pancreas.

The use of drugs is due to the degree of disruption of the production of hydrochloric acid. In the treatment of gastritis with low acidity, agents that promote acid formation are introduced:

• juice of plantain, which is taken on a tablespoon three times a day for a quarter of an hour before eating;
• plantaglucide (a granular preparation from a plantain extract) - half or one teaspoon of granules is dissolved in a quarter of a glass of water and taken twice or thrice a day for half an hour before meals.

Romazulon - a drug from the flowers of chamomile or Rotocan (chamomile, yarrow, calendula) - is included to eliminate inflammation, excessive gas formation and flatulence, anesthesia, disinfection and acceleration of epithelialization.

Patients with Achilles are given substitution therapy:

• gastric juice natural, which is taken during or after meals one or two twice or thrice a day;
• Acidin Pepsin, Pesidil.

As part of the substitution treatment, polyenzyme drugs are also prescribed, if necessary: Panzinorm, Pancreatin, Festal, Digestal, Pankurmen, Mezim forte. They are taken orally one or two tablets three times a day with food.

If the state of health improves and the symptoms of acidic and enzymatic insufficiency are eliminated, the dosage of substitutive polyenzymatic drugs decreases; with the normalization of well-being and the absence of manifestations of digestive disorders, these remedies can be canceled by the doctor. However, in cases of severe forms of anacid gastritis, burdened with chronic pancreatitis and enterocolitis, substitution enzyme therapy can be continuous, and often - permanent.

In the treatment of chronic gastritis include drugs that stimulate blood circulation in the gastric mucosa:

• subcutaneous injections Aloe extract by 1 ml, but not more than 4 ml per day,
• Methyluracil tablets - one tablet at a meal three or four times a day;
• Pentoxyl, a stimulant for the formation of leukocytes, is taken orally after eating one tablet three times a day;
• Vitamins B6, B9, B12, A, PP, vitamin-mineral complexes (depending on the degree of mucosal atrophy and the patient's condition).

These medications are prescribed by the doctor individually, depending on the diagnostic results. Course treatment with these funds is carried out throughout the month, usually in winter or spring.

If the course of chronic anatomic gastritis is accompanied by a lack of appetite and a noticeable weight loss, anabolic steroid hormones are used:

Retabolil - intramuscular injection with the drug (25-50 mg of oily solution) is administered every two to three weeks, the course of treatment is eight to ten injections. Contraindicated in malignant neoplasms of the mammary glands, prostate. With caution is prescribed for dysfunction of the liver and kidneys, insulin-dependent diabetes mellitus (with the simultaneous use may require a reduction in the usual dose of insulin).

Therapy of hypoacid gastritis does not do without gastroprotectors - drugs that have enveloping and astringent properties that have a bactericidal and anti-inflammatory effect on the atrophied mucosa.

De-nol, the active ingredient of which the bismuth subcitrate has versatile efficacy. Its astringent properties are due to the ability to precipitate proteins, forming with them chelate compounds that perform a protective and purifying function. The protective film is formed selectively on the affected parts of the mucosa, facilitating their recovery.

This drug is also included in the treatment of infectious gastritis caused by Helicobacter pylori, by eradication of these bacteria - the standard international tactic of exposure to the source of infection.

Bismuth subcitrate is active against Helicobacter pylori, inhibiting the activity of enzymes in its cells. Interrupting the development of vital reactions, and destroying the structure of the cell membranes of bacteria, leads to their death. The active substance of the drug, due to its good solubility, penetrates deeply into the mucous layers, destroying the bacteria under them. At the moment, no strains of Helicobacter pylori, bismuth-resistant subcitrate were detected. However, the drug is able to reduce the acidity of the stomach and inactivate pepsin, which is not enough for gastritis with low acidity. Nevertheless, if Helicobacterium infection is confirmed, then complex treatment is carried out using the following schemes:

1. Dosage of drugs: De-Nol - one tablet half an hour before meals; Clarithromycin - 0.5 g; Amoxicillin - 1g. All drugs are taken twice a day, the duration of therapy is one to two weeks.
2. Dosage of drugs: De-Nol - one tablet for half an hour before meals twice a day; Tetracycline - 0.5 g four meals a day; Metronidazole - 0.5 g three times a day, Omega (omeprazole, nolpase) according to the standard international protocol for the eradication of Helicobacter pylori.

In cases of detecting Helicobacteriosis, it is necessary to destroy the infection, for this purpose, the proton pump inhibitors (omeprazole, nolpase) and antibiotics are included in the therapeutic complex. Proton pump inhibitors are withdrawn from the therapeutic regimen solely when the basal acidity index of gastric juice is> 6. Despite the fact that these drugs tend to reduce the production of stomach acid by hydrochloric acid, it has been established in the tests that eradication of Helicobacter pylori in cases of insufficient acid formation stops the development of atrophic processes and prevents the development of malignant neoplasm of the stomach. After the completion of treatment and elimination of infection, there was an improvement in the renewal and recovery of cells in the gastric mucosa.

Antibiotics for gastritis with reduced acidity, as well as with increased acidity, included in the treatment complex, are also necessary for the destruction of the source of infection. Given that eradication of Helicobacter pylori is carried out with drugs that reduce the production of hydrochloric acid, in gastritis with a low acidity, it is very important to determine the species of this bacterium and its sensitivity to a certain type of antibacterial drugs in order to treat quickly and effectively.

In specific cases, the therapeutic regimen of treatment can be adjusted by the doctor, taking into account the results of diagnostic studies, bapsides for sensitivity and the general condition of the patient.

In complex therapy, an absolutely natural medicine Iberogast, representing an alcoholic solution of extracts from medicinal plants: chamomile flowers, herb Iberian bitter and celandine, angelica officinalis roots and licorice nude, caraway seeds and thistle, melissa leaf medicinal and peppermint leaves . The herb collection is selected in such a way that the Iberogast cleanses the muscles of the digestive tract of the tract and tones up their smooth muscles, without affecting its normal motor activity. It has been experimentally established that the preparation inhibits the multiplication and development of six heliobacteria, and its action is selective: in zones of the stomach and intestines with a weak motor activity of smooth muscles, due to Iberian bitter muscle tone increases, reducing flatulence and sensation of severity. In areas with increased tone, this drug has an antispasmodic effect, regulating motor activity and normalizing the motor activity of the gastrointestinal tract.

Hilak forte is a medicinal preparation consisting of metabolites of E. Coli, streptococci and lactobacilli in an aqueous solution of the nutrient medium. Absolutely natural medicinal product that regulates the balance of the biocenosis of the gastrointestinal tract. Metabolites of microorganisms inhabiting the environment of the stomach and intestines contribute to the natural regeneration of the normal balance of the microflora of the gastrointestinal mucosa, and biosynthetic lactic acid and its buffer salts normalize both inadequate acid formation and excess. Restoration of the normal ratio of microorganisms promotes the qualitative reproduction and assimilation of vitamins of group B and K.

The drug is prescribed for chronic disorders of digestive functions caused by various causes. Its use by infants, pregnant and lactating women is entirely acceptable.

Hilak Forte drops are taken orally, diluting in some liquid, but not in milk, three times a day with food or before eating. Children up to a year are prescribed from 15 drops to 30; over a year - from 20 drops to 40; adult patients - from 40 drops to 60. With the onset of therapeutic effect, the daily dosage is reduced by half.

Contraindicated with allergies to ingredients, to date no side effects have been fixed.

Joint use with antacid medicines is undesirable because of the possible neutralization of lactic acid.

In the treatment regimen, at the discretion of the attending physician, preparations can be included:

• for relief of dyspeptic disorders: Polyphepanum, Almagel - from diarrhea; Motilium, Cerucal - eliminating vomiting; Espumizan - stopping the phenomenon of flatulence; Motilak, Ganaton - activators of intestinal motility; But-Shpa, Papaverin - relieving spasms of the musculature; antihistamines and sedatives.

Physiotherapeutic treatment is contraindicated in relapses of the disease, polyposis gastritis, rigid antral gastritis.

From physiotherapeutic procedures for gastritis with low acidity, a doctor can prescribe UHF therapy, high-frequency magnetotherapy, diadynamics, drug electrophoresis with calcium preparations or novocaine, galvanization, ozoceritherapy and paraffin therapy.

Alternative therapies

With non-infectious gastritis with low acidity, folk treatment can be effective, but it should be noted that treatment with alternative drugs should be started in the early stages of the disease, it will be long and the medications will have to be repeated on a regular basis. Still it is necessary to keep to a diet. The diet includes: lean meat and fish, vegetables - stewed, boiled, steam; fat-free cottage cheese, kefir, yogurt; not sharp grades of cheese; scrambled eggs; porridge; yesterday's bread; fresh vegetables, fruits and berries (sour or sweet and sour); coffee, tea, juices. Take small meals at least five times a day, chewing carefully. Exclude alcohol and do not smoke. Such a diet and diet will contribute to the gradual activation of parietal cells and the normalization of acid formation.

The most well-known alternative agent used for uncomfortable sensations in the stomach is the flax seed. It contains polysaccharides, vegetable proteins (over nutrient superior to soybeans), cellulose is a mucus-forming component that envelops the inner surface of the stomach. Also in these seeds contain vegetable fibers (lignans) - which provide antioxidant and antiseptic action, Omega acids, phytohormones and vitamins E, Groups B and D, provitamin A. Thanks to this rich composition, the flax seed can anesthetize, disinfect, protect the surface and help it restore, strengthen blood vessels and improve blood circulation. Such a wide range of action opens the possibility of applying flax seed with gastritis with reduced and zero acidity. Its properties allow unobstructed progress on the thinned walls of the stomach lump of food, without damaging them and significantly reducing soreness. For treatment to be effective, it is necessary to tune in to prolonged treatment. You will have to take a daily prepared decoction of flax seed for two months before every meal every day. The recipe for the preparation of infusions from flax seed is usually published on the pharmacy box, but it is possible to use other methods of preparing the infusion:

• 10 g of flax seeds to boil with boiling water in the volume of one liter, cork and stand until the morning in a warm place, drain, drink half a glass, then after a third of an hour to eat;
• five grams of seeds pour boiling water in a volume of 0.2 liters, insist two or three hours, periodically shaking, drain, drink a tablespoon before each meal;
• 70g of seeds pour a liter of steep boiling water, after two hours drain, cool, drink 250 ml, after which an hour later take food;
• flax seeds to grind in a coffee grinder, and then brew with boiling water (based on a teaspoon of seeds - a glass of water), mix well to get a thick jelly, drink ¾ cup, after which half an hour to eat;
• make a mixture of flax seeds, thyme, chamomile, bear's eye, coriander and tansy in equal proportions, chop as much as possible, two tablespoons of herbal mix to brew 1 / 2l of steep boiling water, after several hours to filter through gauze, drink 1/3 cup before eating .

You can prepare for breakfast porridge from flax flour or grinded on a coffee grinder seeds: pour in a bowl of two or three tablespoons of flour and pour boiling water or boiling milk (if there is no intolerance), you can milk with water in equal parts, add sugar or slightly add, cover . In five minutes the porridge is ready.

On the Internet you can buy a portioned packaged ready-made Linseed Cocktail, recommended by a sick gastritis. According to the instructions, the duration of treatment is ten days, provided daily three times a day.

You can make it at home: brew with steep boiling water (0.2 liters) one or two tablespoons of flax seed, insist until morning. In the morning, add a teaspoon of honey and beat in a mixer (blender).

In alternative medicine with gastritis it is recommended to use flaxseed oil as a soft agent for inflammation, disinfectant, analgesic and healing. You can buy ready-made flaxseed oil. It is obtained by cold pressing, while it retains all the valuable qualities and can be used for medicinal purposes. Flaxseed contains up to 48% of the oil component.

Oil from flaxseed is consumed in an empty stomach on a tea spoon (you can drink it with warm water) for three months. It is effective even in case of erosive damage to the gastric mucosa.

You can simply consume oil in food, filling them with salads, vinaigrettes, mashed potatoes, adding to yoghurts. It is not contraindicated for children.

If desired, it is possible to make oil from flax seed at home. To do this, you need to grind the seeds and pour them into a screen, covered with gauze. Then hang the sieve, substituting a bowl from below. Flour in a sieve to pin down something heavy. Bending his weight begins to squeeze the oil into a bowl. Once it ceases to stand out, squeeze the gauze and pour from a bowl into a container of glass for storage.

There, no less than flax has some contraindications, especially hypersensitivity, besides this - intestinal obstruction, gallstones, infectious inflammatory processes in the liver, acute esophagitis and enterocolitis. Do not get carried away by products from flax seeds to asthmatics, endocrinology patients, pregnant and lactating women, and people prone to increased bleeding.

Bee products, in particular honey and propolis, are effective in treating both acute and chronic inflammations of the gastric mucosa. These products are not toxic, have a wide spectrum of action and a rich vitamin-mineral composition. Anti-inflammatory, antiseptic and analgesic properties of propolis and honey are known for a long time, with the longest application they do not cause intoxication and dysbiosis, are able to regenerate the mucous membrane of the stomach, increase immunity and normalize the acidity of gastric juice.

The easiest way, if there is no intolerance, take a tablespoon of honey 10 minutes before eating, you can dissolve it necessarily in cold water and drink. Dosage should not exceed 150 grams of honey per day, given that 30 g of thickened and 35 g of liquid honey are placed in a tablespoon. During treatment, you can not use other sweets except honey, the duration of apitherapy from one and a half months to two.

You can make an emulsion of honey, cocoa juice and propolis tincture 10%. Dosage: one tablespoon three times a day for one to two months. Breakfast, lunch and dinner an hour after receiving the emulsion. This preparation is prepared as follows: stir 78g of lime or acacia honey with 15ml of freshly squeezed juice from the leaves of the colanchoe and with seven milliliters of alcohol propolis tincture (10%). This mixture is kept on a water bath for about half an hour, continuously stirring - the water temperature is 45 ° C.

At a gastritis with the lowered acidity simultaneous reception of grassy infusions and spirituous tinctures of propolis is recommended.

1. The herbal collection is made of equal parts of mint leaves, plantain and triple leaf watch, chamomile and calendula flowers, roots of ayr and dandelion, well ground and mixed. Then three tablespoons of herbs brew ½ liter of boiling water in a thermos, close and insist for two or three hours. Start taking 40 minutes before eating with half a glass of infusion. After 20 minutes after taking infusions, drink 20 drops of alcohol propolis tincture (20%) diluted in 15 ml of water. After another 20 minutes you can eat. The treatment procedure is repeated three times a day for a month. If necessary, you can extend the course for another two weeks, but no more.
2. With hypoacid gastritis with frequent diarrhea and increased gas production, the following treatment option is recommended. Make a decoction of the herbal collection of crushed and mixed in equal proportions of flowers of calendula and chamomile, leaves of plantain and nettle, yarrow and St. John's wort as follows: brew 1/2 liters of boiling water two tablespoons of mixture, simmer at low heat for five to seven minutes, leave for an hour and a half, drain. The reception begins with a tincture of propolis alcohol (10%) - 40-50 drops to drip into ¼ cup of water and swallow 40 minutes before the start of the meal, then after 20 minutes to drink half a glass of broth, after another 20 minutes you can eat. The procedure of administration is repeated 3-4 times a day for a month. If necessary, you can extend the course for another two weeks, but no more.

You can prepare a water tincture of propolis and drink it half a cup every day. Only you need to consider that this medicine needs to be updated every week, for a month it will have to be cooked four times. The solution is prepared in proportions of 20g propolis - 100ml water in enamel ware (can be made of stainless steel). Propolis should be kept in the freezer before cooking, so it is easier to grind it. Grate a small piece of propolis in a selected pot, pour water and simmer in a water bath at a temperature of 80 ° C for about an hour. Ready tincture should be a rich brown color, with a deep pleasant balsamic flavor. How to cool - drain. Keep it better in a container of dark glass, with a low, but a plus temperature, without light, you can in the fridge.

Prolonged use of propolis drugs can lead to an overdose, fraught with a weakened immune system and nervous system disorders, such as dizziness, drowsiness. People who are aware of their allergies to bee products, particularly honey, should not use these methods of treatment. In addition, honey is contraindicated in people with insulin-dependent diabetes.

With acid deficiency, very handy fresh berries of sea-buckthorn will come in handy . They are collected when the first frosts pass and the taste becomes slightly sour. It is good to freeze them for the winter in the freezer in small portions and use it, making compote, mors, tea, sauce. Berries can be rubbed with sugar, boiled jam. With insufficient acid formation, they are useful in any form. Seabuckthorn not only regenerates the gastric epithelium, but also contributes to the normalization of the synthesis of hydrochloric acid. With gastritis with a low acidity it is good to make tea from dried sea-buckthorn berries. Brew three tablespoons of berries 1/2 liters of boiling water and leave for ten minutes. It can be drunk without restrictions, however, it is contraindicated for people with high acidity, like fresh berries.

Sea-buckthorn oil, which has an enveloping, analgesic and restoring effect, is used for the treatment of erosive gastritis with any acidity. It envelops the mucous epithelium of the stomach and creates a protective film, preventing the progression of the disease and the spread of erosive damage.

Sea-buckthorn oil is sold in pharmacies, however, if these berries grow in the country, it makes sense to do it at home. The required ingredients for this process are sea-buckthorn berries and any unrefined vegetable vegetable oil of cold pressing. From the berries you need to squeeze the juice, and the cake is covered with vegetable oil in a ratio of 1: 1. This mixture is kept in a cool, sheltered from sunlight for two weeks, shaking the container with it as often as possible. Then the oil is filtered, squeezed and poured for storage in a glass container of dark color. For forty days, drink an hour before meals three times throughout the day on a tablespoon. The healing process can not be interrupted, which must be taken into account when determining the required volume of cooking oil.

Oil from berries of sea-buckthorn is contraindicated in acute and chronic inflammatory diseases of the pancreas, gall bladder and liver. The use of fresh berries is undesirable both with hyperacid gastritis, and with stones in the urinary organs, as well as a tendency to diarrhea.

In medicine (folk and official) with conservative therapy of gastritis, herbal medicine is widely used, both in the form of pharmaceutical preparations, for example, Romazulon - a drug from camomile flowers, and prepared decoctions and infusions. Medicinal chamomile is used in almost all herbal mixes. Her flowers are included in many herbal mixtures used for secretory disorders of the digestive glands, gastritis, ulcerative lesions of the gastrointestinal tract. It helps to eliminate the edema of the gastrointestinal mucosa, activates the outflow of bile, eliminates excessive gassing.

The active component of chamomile flowers is chamazulene, which has a wide range of medicinal qualities - regenerating, analgesic, anti-inflammatory and anti-allergic. Essential oil from the flowers of this plant is rich in glycosides and acids (ascorbic, palmitic, oleic, linoleic, stearic), flavonoids and coumarins, gum, provitamin A, and also - potassium, copper, zinc, selenium. Heating on a direct fire destroys hamazulene, therefore it is recommended to prepare herbal infusions in a water bath.

To the curative qualities of chamomile manifested in full, taking infusion, it is desirable to lie down, periodically turning over to the left, then to the right side.

In addition to the already mentioned infusions with chamomile, you can prepare the following funds.

1. Make a mixture of the following ingredients:

• a sheet of peppermint - 20g;
• grass sporishi and marshweed swamp, chamomile flowers and yarrow - for 15g;
• seeds of dill and cumin, valerian root - 10 g;
• cones of hops - 5g.

All grind, mix well, brew with a liter of boiling water and put in a preheated oven, leave there for 10-12 hours. To drain, in the morning to drink on an empty stomach a glass of infusion and continue to drink a glass every two hours, until the infusion does not end.

2. Make herbal mixture, taking in equal proportions, chamomile, wormwood, peppermint, sage, yarrow, grind and mix well. Two teaspoons of herbal mix brew a glass of boiling water for half an hour, strain, drink three meals throughout the day, warming up slightly each serving. The first portion to drink on an empty stomach.

Chamomile medicinal and mixed infusions with it are contraindicated in the absolute absence of acidity of gastric juice.

Orange marigolds or calendula are a storehouse of various bioactive components. The main ones are carotene and carotenoids, which impart a bright carrot color to the petals of the flower. And the regenerating, anti-inflammatory and antiseptic properties of this plant have long been used for medicinal purposes. Extracted marigold flowers produce a tableted keraflon paraffin, shown with gastritis and gastric ulcer for restoration and renovation of the mucous membrane. They are taken after eating 100-200 mg three times a day.

At home, you can prepare honey medicinal infusions from marigold:

• three tablespoons of flowers to brew ½ liter of boiling water at night (about eight hours), in the morning strain, mix with three tablespoons of light honey;
• for half a liter of water take three tablespoons of calendula flowers and two - chamomile, pour boiling water and insist six hours, strain to mix with four tablespoons of lime honey.

Such infusions take 100ml an hour before meals three or four times a day.

It is not recommended to use calendula at a lowered arterial pressure or heart rate. Pregnant calendula can provoke a miscarriage.

Aloe juice stimulates the musculature of the stomach and the production of gastric juice, which is necessary for acid deficiency. It removes inflammation, destroys pathogenic microflora, anesthetizes and eliminates constipation. For the preparation of juice are suitable leaves of aloe, age not less than three years. Leaves cut off and put in the fridge for a couple of weeks. Then squeeze the juice from the leaves and take it on a teaspoon three times a day for half an hour before eating. Since the aloe juice is bitter to the taste, you can stir it with honey or sugar. Duration of treatment is three weeks. A lot of juice should not be squeezed out immediately, it is desirable to prepare it before use or once a day.

Aloe juice can be found in the pharmacy, take it the same way.

Contraindicated this natural stimulant only when it is intolerant.

Ivan-tea or kaprej narrow - leaved well removes an inflammation and envelops a mucous membrane of bodies of a gastrointestinal tract. His leaves contain carotene and vitamin C, which in this plant is more than in oranges three times. Kipray is effective in disorders of metabolic processes and hematopoiesis, these properties of it with chronic gastritis with low acidity are very valuable. This drink can eliminate diarrhea due to astringent and antibacterial qualities.

Tea, brewed from the leaves of this plant, stimulates the restoration of the damaged mucous membrane of the stomach, has a strengthening and toning effect on the body. Prepare ivan-tea with hypoacid gastritis as follows: 60g of leaves pour a liter of water, bring to a boil, after half an hour filter. Drink before each meal 150 ml until the complete disappearance of discomfort in the stomach. Contraindicated with a tendency to thrombosis.

In pharmacies you can always buy a Gastric Harvest, such fees are also offered in online stores. In the annotation to them indications, contra-indications and a way of preparation are indicated. Produced as a mixture of herbs for decoctions and infusions, and sachets for brewing.

For example, the pharmacy collection in a packaged form, consisting of chamomile flowers and marigolds, yarrow and St. John's wort, hips and fennel. This collection stimulates the production of gastric juice and, accordingly, the appetite, helps to reduce inflammation and bile flow, relieves spasms and relaxes, and also calms the nervous system.

The way of preparation is very simple - to put a bag in a glass, pour boiling water, cover and after 10-15 minutes the infusion is ready for use. Patients with 15 years can drink one-third or half a glass of infusion during meals morning and evening. The duration of the course is not limited, but not less than three weeks.

Gastricidal collection №2 has a more diverse composition and is produced as a mixture for infusion: leaves of nettle, plantain, willow-tea, peppermint, forest strawberry and currant, calendula and immortelle flowers, St. John's wort, wormwood, yarrow and sporicha, hips, corn stigmas and hop cones, dill seeds, valerian roots and diavisila.

Possesses all possible properties: anti-inflammatory and antibacterial, hemostatic and healing, antioxidant and renewing, soothing and inducing appetite and production of gastric juice. Herbal collection is rich in various vitamins, microelements and other nutritional components.

Two tablespoons of vegetable raw materials put in a half-liter bowl and pour over with boiling water, stand for three hours, drain. Drink a glass before three meals a half an hour.

Gastric collection number 3 consists of bark of buckthorn, leaves of nettle and peppermint, roots of valerian and ayr in the ratio of 3: 3: 2: 1: 1. Has a pronounced laxative and anti-inflammatory effect of anthraglycosides and saponins, which abound in the buckthorn bark; exhibits astringent properties (nettle, ayr and buckthorn bark), binding proteins of pathogenic microorganisms and forming a protective film enveloping the mucous membrane; acorin and essential oil of ara promotes the production of gastric juice and increases appetite, vitamins and minerals promote rapid healing and anesthesia, eliminate spasms of the musculature of the gastrointestinal tract and restores its motor activity.

Cooking method:

1. Spread a tablespoon of herbal mixture in enameled dishes, brew 200ml of boiling water, cover with a lid and stand in a water bath at the boiling temperature. Let it brew for three quarters of an hour, drain and wring out in infusion. Top up the boiled water in the infusion to a volume of 0.2 liters. Drink before meals for a quarter of an hour three times a day, heated and shaken before use, in dosage: children of the age group 5-6 years - one tablespoon, 7-9 years - two tablespoons, 10-14 years - one third of the glass, patients 15 years and older - half a glass.
2. Two sachets should be put in glass or enameled utensils, boil a glass of boiling water, cover and sustain a quarter of an hour. Drink before meals for a quarter of an hour twice a day, pre-heating before use, in dosage: children of the age group 5-6 years - two tablespoons, 7-9 years - a third glass, 10-14 years - half a cup, patients 15 years and older - glass.

Take 20 to 25 days, with an interval of ten days can be repeated.

People with a low acidity of the stomach are encouraged to stimulate its production before meals:

• drinking as much as a sip of water with half a teaspoon of light honey dissolved in it;
• half a glass of infusion or a decoction of dried rosehips;
• a third of a glass of freshly squeezed carrot juice;
• apricot juice, and also - having eaten some fresh or dried fruits of apricot;
• eating 20-25 berries of fresh grapes, a handful of blueberries (by the way, it is good to use in all kinds - pies, vareniki, compotes);
• eating a freshly crushed fresh cucumber, a salad of fresh turnips with vegetable oil.

Of food products, good stimulants for the production of gastric juice are beans, stewed (boiled) cabbage, dietary meats.

It must be remembered that treatment by any alternative means is carried out, after consulting with a doctor, in the absence of allergy to the ingredients of phytopreparations. It is not recommended to use independently alternative means for the syndrome of "acute abdomen" or wash down with infusions, decoctions, therapeutic teas or capsules, dilute the powders of medicines.

Homeopathy can give a stable and good result, but homoeopathic medicine should be prescribed by a homeopathic physician, individually, since there are more than thirty drugs used only with acute gastritis.

For example, Antimonium crudum (Antimonium croudum) is used in cases of acute inflammation, as well as exacerbations of digestive disorders. A characteristic feature of patients who are prescribed this drug is overeating and grumpy temper. They do not tolerate heat and other people's touches.

Carbo vegetabilis - with gastritis associated with food poisoning, accompanied by flatulence and stomach upset; Ipecacuanha (Ipecacuana) - this medication is treated, mainly, superficial gastritis.

With chronic hypoacid gastritis, Arsenicum album (Arsanikum album), Bryonia (Brionia), Mercurius solubilis (Mercurius solubilis) is often prescribed.

In order to properly prescribe the drug, and its use has brought improvement in the patient's condition and prolonged remission, it is necessary to take into account a multitude of factors and symptoms, possibly at first glance, not related to the disease.

Among the complex homeopathic preparations of Heel brand there are several, intended for the treatment of gastritis:

• Gastricumel, tablets sublingual, in their composition often used homeopathic preparations prescribed for various symptoms of gastritis of different severity and localization (Argentum nitricum, Arsenicum album, Pulsatilla, Nux vomica, Carbo vegetabilis, Antimonium crudum). One tablet should be kept under the tongue until completely dissolved. The drug is taken 30 minutes before meals or an hour after. In acute conditions, you can take one piece every quarter of an hour, but the daily dose should not exceed 12 tablets. The course lasts two or three weeks. Repeated course - as prescribed by the doctor. Possible use of children from the age of three, pregnant and lactating women under the supervision of a doctor. Sensitization is not excluded. A combination with other medicines is possible.
• Nux vomica-Homaccord (Nux vomica-Homaccord) - the homeopathic drops, consisting of the following components: Nux vomica (gag walnut), is indicated for inflammation of the mucous epithelium of the digestive organs from top to bottom, as well as to eliminate the effects of substance abuse;
  Bryonia (white perestupen), is indicated for chronic gastritis, accompanied by excessive gas production, diarrhea, pain; Lycopodium (clavate buoyant) - a means for therapy of the liver, bile excretory system, absence of intestinal muscle tone and constipation, and also - depressive state;
  Kolotsintis (bitter gourd) - a remedy to relieve spasms of digestive organs, inflammation and intoxication, which has a laxative effect. A single dosage for adults is 10 drops, diluted in 0.1 g of water. Drink, holding in your mouth, thrice a day. Children up to two years old - three drops per appointment; from two to six - five. Take a quarter of an hour before a meal or an hour after. Pregnant and lactating women should not be used. Allergic reactions are possible.

Operative treatment

Surgical intervention with gastritis with low acidity is an extreme measure. However, if the patient has severe symptoms of gastric bleeding, he can not be stopped and to establish its cause, an urgent operation is prescribed. Its conduct may consist of stitching areas with bleeding that has opened, partial or complete removal of the stomach.

The risk factor for gastric bleeding is hypertrophic gastritis, which occurs with the growth of neoplasms (polyps, warts, cysts). Giant hypertrophic gastritis (Menetriae's disease) is described in two variants - hyperplastic polyps and multiple plasty adenomas.

Surgical intervention is indicated for patients with non-curable pain syndrome, abnormal decrease in albumin biosynthesis, bleeding and constriction of the pylorus. After the removal of the part of the stomach in which the neoplasm is localized, the patient often undergoes clinical improvement: the pain passes and the albumin production is restored. Although partial gastrectomy is used more often, however, in severe cases, complete removal of the stomach is justified, because with it the pathological mucous membrane is completely removed and malignancy of neoplasms is prevented. Most postoperative lethal cases have been reported in patients after subtotal (partial) gastrectomy. High mortality is associated with the complexity of creating a tight joint between normal and hyperplastic mucosa.

After surgical treatment, such complication as gastritis of stomach stump is not excluded. It can be caused by different reasons, both medical errors and irresponsibility of the patient. Gastritis stomach stump is treated mainly by therapeutic methods, as an extreme measure - a total gastrectomy is performed.

Exercise for gastritis with low acidity

The physical activity of patients with acid deficiency stimulates the production of hydrochloric acid, as well as pepsin, the main digestive enzyme. Exercises should be performed at a moderate speed, the pulse should not be more than 150 beats per minute. The intake of food should be arranged so that between it and the physical exercises has passed not less than an hour and a half.

With hypoacid gastritis, breathing exercises are useful. Change in intra-abdominal pressure with deep rhythmic inspiration and exhalations stimulates blood vessels and improves blood supply to the stomach. They favor the processes of microcirculation and exercises that strengthen the musculature of the abdominal part. Unhurried walks are very useful in this pathology.

Starting to practice gymnastics, you need to master several exercises, gradually expanding their circle and increasing the number of repetitions. It is impossible to overexert, it is necessary to increase the load a little, listening to your body.

Treatment of an exacerbation of a gastritis with the lowered acidity can be combined with trainings giving to an organism a small physical activity which will accelerate process of a cupping of symptoms of relapse. From the treatment complex, you can choose exercises that are performed from a sitting or lying (on the back) position, and do them to the best of their ability, avoiding sudden movements. With an improvement in the state of the load, you can gradually increase, and also - master the exercises that are performed lying on the side and standing. After 6-8 weeks after relapse of the inflammatory process, it is possible to include exercises that do lying on the stomach.

During the period of remission, medical training is continued for preventive purposes.

This complex of exercises is addressed to people who suffer from chronic inflammation of the gastric mucosa with acid deficiency, who have had ten or more days of exacerbation. Each exercise is done approximately ten times, you can start with five times or less, gradually adding their number, while - being led by well-being. Breathing is recommended at a rate of 4 × 4 (four seconds of inhalation, a pause, four seconds of exhalation, a pause).

1. Starting position: standing, legs - shoulder width apart, arms lowered along the body:
   • inhaling, slowly inhale, raise his head and look at the ceiling, exhaling - lower his head and look under his feet;
   • smoothly, without lowering, turn your head as far as the right shoulder (inhalation), then - left (exhalation);
   • breathing is arbitrary - the rotation of the hands stretched to the sides of the hands forward, then - back;
   • inhaling - slowly raise your hands through the sides upwards, exhaling - just lowering down.
2. The starting position is standing:

• put your feet slightly wider than shoulders, arms at waist: breathing in - bend back, pulling back elbows, exhaling - move elbows forward and bend over back;

• feet together, breathing arbitrary: with hands down, bend the knee and pull the heel off the floor as much as possible, becoming on the toe of the left leg, then - on the right;
• feet together, breathing is arbitrary: we roll from toe to toe with two legs at the same time.

3. Sit on a chair, knees bend at right angles, put feet on the floor, hands on waist, breath arbitrary:

• to tilt the body left-right;
• a half-minute "walking", with the highest possible rise of the knees.

4. Stand with your left side to the back of the chair, sticking to your back, perform the swings with your right foot: breathing in - forward, exhaling - back, then - the same for the other leg.
5. Lie on your back, hands on the waist:

• inhale - lifting his head and shoulders, look at the toes of the feet - exhalation - the starting position;
• breathing in, raising his left hand, while bending his right leg, not taking his feet off the floor, exhaling - take the starting position;
• breathing in - raise the straightened right leg, exhaling - let down, then - left.

5. Lie on your back, slightly lift the trunk, emphasis on the elbows: breathing in - lift the straightened right leg, exhaling - let down, then - left.
6. Lie on your back, hands down along the trunk, breathing arbitrary: bending your legs, one minute to twist the pedals of the bike.
7. Sit on the floor, stretch your legs, hands - in the back rest: breathing in, bend over, lifting the pelvis, exhaling - return to its original position.
8. Stand on all fours:

• breathing in - raising his head, exhaling - lowering, pulling her towards her between her hands with her right foot, bending her back upwards, then her left;
• breathing in - raise your left hand to the side and up, exhaling - to lower back;
• breathing in - raise the basin, unbending the knees, tilting the head (hill) - exhalation;
• inhale - arched back arched, lowering his head, exhaling - to bend his back, lifting his head.

6. Lie on your stomach, lift the body parallel to the plane of the floor, the emphasis on the forearms, located in front of each other in parallel and the toe of the feet, stand in this position, looking in front of you, calmly and deeply breathing as much as you can.
7. Lie on your back and do a few full of deep breaths and exhalations, trying to breathe the peritoneum.

Immediately the whole complex in full volume is not necessary, it is necessary to conform with the capabilities of your body.

Contraindications for therapeutic gymnastics are: exacerbation of peptic ulcer, hemorrhagic gastritis, stenosis of the stomach, severe nausea with frequent vomiting, acute pain.

[27], [28], [29], [30], [31], [32]

Prevention

The most important thing in preventing gastritis, like most other diseases, is the rejection of bad habits and a healthy lifestyle.

You need to monitor your diet, try to eat quality foods, eat regularly, do not go hungry for a long time and do not overeat. Learn not to rush for food and thoroughly chew food. Already at the time of chewing gastric juice starts to separate, in addition the food is partially disinfected by saliva, even Helicobacteria can not reach the stomach, having perished yet in the mouth. Office workers, who spend a lot of time in the sitting position, should try to lead a more lively lifestyle, moderate exercise will promote the activation of all natural processes in the body.

The first signs of digestive disorders should be an occasion to consult a doctor. When diagnosing acute gastritis, timely treatment and careful compliance with medical prescriptions will help the patient restore the damaged mucous membrane of the stomach quite quickly, and adjusting habits towards a healthy lifestyle will not face gastrointestinal diseases.

People who know that they have low acidity, and especially with an anatomic gastritis, as an preventive measure of aggravation of atrophic processes, annual endoscopic examination is recommended.

[33], [34], [35], [36], [37], [38], [39], [40]

Forecast

Inflammation of the gastric mucosa with reduced production of hydrochloric acid, in general, not a dangerous disease, if not ignore the symptoms and start treatment in time. Patients for a long time, almost the whole life, are able to work. If you eat right, leave bad habits and maintain your health, this disease does not limit human capabilities.

However, in case of neglect of the symptoms, it is possible to wait for complications in the form of atrophy, hypertrophy, erosion and bleeding, and also to face the need for surgical intervention.

[41], [42], [43], [44]