Gastroduodenopathy: erythematous, congestive, erosive, hyperemic, superficial, chronic

Gastroduodenopathy (gastropathy) is the appearance of erosions and ulcers in the gastroduodenal region, developing as a result of taking both medications (ibuprofen, diclofenac, aspirin, aspirin-containing drugs, etc.) and as a result of poor nutrition.

Causes gastroduodenopathies

Causes that provoke the occurrence of gastroduodenopathy include the following:

• Heredity.
• Unhealthy diet (excessive consumption of spicy, hot, coarse foods, uncontrolled alcohol consumption, lack of a diet, eating dry food).
• Bacteria, in particular Helicobacter pylori.
• Long-term use of medications.
• Addiction to smoking.
• Infections in the intestines.
• Chronic infections of the oral cavity and nasopharynx.
• Stressful situations.

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Risk factors

Risk factors for gastroduodenopathy include:

• Peptic ulcer disease and its complications in the anamnesis.
• The presence of bleeding from the gastrointestinal tract of any origin.
• Taking anticoagulants and/or NSAIDs.
• Severe concomitant diseases.
• Mature and old age.
• High dosage of medications.
• Concurrent administration of corticosteroids.
• Diseases of the cardiovascular system.

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Pathogenesis

Gastroduodenopathy includes two completely different diseases: gastritis and duodenitis. These diseases have different pathogenetic mechanisms, but they also have much in common, which is why they rarely occur separately and in most cases are combined in many patients.

Both pathologies can be attributed to acid-dependent conditions that develop with an imbalance of aggressive and protective factors affecting the mucous membrane of the stomach and intestines. One of these aggressive factors is the Helicobacter pylori bacterium. It affects the occurrence of chronic gastritis. Its role in the development of chronic duodenitis has not been proven. In the development of the latter, the acidity factor and enzymatic imbalance are of great importance.

It is most likely that there is a common pathogenic process that leads to the development of gastritis and duodenitis. In this regard, gastroduodenitis is considered as a single entity.

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Symptoms gastroduodenopathies

The symptom complex of gastroduodenopathy is very similar to the symptoms of various intestinal and gastric diseases. These include:

• attacks of nausea;
• pain in the stomach area;
• a feeling of fullness in the stomach;
• unpleasant taste in the mouth;
• loss or decrease in appetite;
• reflux;
• heartburn;
• diarrhea or constipation.

The first signs of gastroduodenopathy are sudden, often on an empty stomach, sharp, contraction-like pains in the upper abdomen, nausea and vomiting appear.

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Forms

Manifestations of gastroduodenopathy can be classified by different signs. Some manifestations of gastropathy are not diagnoses - they are conclusions after examination of the gastrointestinal tract. Let's consider these conditions in more detail.

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Erythematous gastroduodenopathy

Erythematous gastroduodenopathy is not a disease, but a conclusion of an endoscopic examination. Redness of the gastric mucosa and its vulnerability are noted. Most often observed with superficial gastritis. Erythematous gastroduodenopathy is divided into focal and widespread.

Causes of erythematous gastropathy are:

• poor nutrition;
• stomach lesions caused by mycotic infections and pathogenic microorganisms;
• metabolic disorders;
• damage due to the intake of irritants (alcohol, drugs)
• stressful situations
• hereditary factor
• bad habits.

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Hyperemic gastroduodenopathy

Hyperemic gastroduodenopathy, like erythematous gastroduodenopathy, is not a diagnosis. It is a conclusion made by a doctor during an endoscopic examination. It indicates that during the examination there is redness, bruising and swelling of the gastric mucosa.

Erosive gastroduodenopathy

Erosive gastroduodenopathy is a defective area (erosion) on the surface of the gastric or intestinal mucosa.

Erosive gastropathy can develop with:

• injuries;
• burn;
• stress;
• aggressive effects of drugs, such as aspirin, prednisolone;
• abuse of alcoholic beverages;
• diabetes mellitus,
• sepsis,
• severe conditions accompanied by renal, cardiac or hepatic failure.

Erosive gastropathy is a consequence of insufficient blood supply to the gastric mucosa, excessive secretion of hydrochloric acid. The occurrence of erosions is facilitated by infection of the gastrointestinal tract with microbes (Helicobacter pylori), reflux from the intestine into the gastric lumen.

Defects on the mucous membrane are formed asymptomatically or occur:

• hunger pains in the stomach,
• sour belching,
• heartburn,
• heaviness in the right hypochondrium,
• bloating,
• gastric bleeding.

Erosions are detected during gastroscopy (study of the gastric mucosa using an endoscopic probe).

Erosions are divided into acute and chronic. Acute ulcers are 1-2 mm in size. When the damaging factor is eliminated, they heal in no more than seven days. Chronic erosions resemble pimples in appearance, 3-7 mm in diameter, with a median depression.

Erosive gastroduodenopathy accompanies various diseases and its treatment is determined by the underlying diagnosis.

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Congestive gastroduodenopathy

The appearance of congestive gastroduodenopathy is a consequence of impaired motility of the stomach and intestines.

Congestive gastroduodenopathy is manifested by the fact that the food contained in the stomach and intestines is partially processed. Due to the lack of enzymes and weak motility of the gastrointestinal tract, the mucous membrane gradually undergoes atrophic changes. At the same time, the food lump (chyme) cannot fully move further along the gastrointestinal tract.

With congestive gastroduodenopathy, duodenogastric reflux occurs - the throwing of a food lump from the duodenum into the stomach, the so-called "belching". These phenomena are dangerous primarily because in different parts of the gastrointestinal tract there are their own specific enzymes and active substances, and when they get into other places, there is an effect on the mucous membranes, which leads to the appearance of gastritis and peptic ulcer disease.

The symptom complex of this pathological condition is erased or remains unnoticed due to the underlying disease. Provoking factors are smoking, drinking alcohol in large quantities, peptic ulcer disease, infection with Helicobacter pylori bacteria.

The complex of therapeutic measures is complex. The general recommendation, as for all gastrointestinal diseases, is a diet. Fatty, spicy, smoked, salty food is excluded from the diet; vegetables, fruits, lean pork, beef, rabbit, chicken are used. Of cereals - buckwheat, oatmeal, semolina and rice are limited.

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Catarrhal gastroduodenopathy

Catarrhal gastroduodenopathy occurs due to the reflux of gastric or intestinal contents into the esophagus. Normally, the esophagus is alkaline. The stomach contents are acidic, which has a detrimental effect on the upper digestive tract. The main causes of reflux are:

• Improper nutrition.
• Diseases of the digestive system.
• Increased intra-abdominal pressure (wearing tight clothing, bending the torso forward after eating, pregnancy and excess body weight.
• Weakening of the lower esophageal sphincter.

The painful process is not always noticeable. The disease does not manifest itself in any way until more serious lesions of the mucous membrane appear. The symptoms of catarrhal esophagitis are so vague that it is difficult to determine the disease.

Signs of catarrhal esophagitis:

• A burning sensation appears behind the breastbone, which occurs after eating.
• Heartburn after spicy or dry food bothers me. Sometimes it is a scratching or sore throat sensation.
• Belching and nausea.
• Pain in the chest area resulting from spasm of the muscles of the esophagus.
• Strong salivation occurs as a protective reaction to the entry of stomach contents, which have an acidic environment, into the esophagus.

To diagnose catarrhal gastroduodenopathy, it is necessary to undergo a series of tests:

• X-ray of the esophagus;
• acidity level monitoring;
• esophagoscopy;
• esophagomanometry (study of the organ's motor function).

The main treatment for catarrhal gastroduodenopathy is diet and balanced nutrition.

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Focal and diffuse gastroduodenopathy

During the examination of the gastric cavity using an endoscope, focal and diffuse areas of pathological changes in the mucous membrane can be detected. One of the violations of the integrity of the mucous membrane is focal or diffuse (widespread) erythematous gastroduodenopathy. The focal variant is diagnosed if the process has a local spread. When changes affect a large area of the mucous membrane, they talk about diffuse pathology. This means that the color of the gastric mucous membrane is bright red. In a healthy state, its color is pink with a shade of gray. The red tint of the mucous membrane indicates that the cells are experiencing an acute inflammatory process. A diagnosis of superficial gastritis can be made.

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Superficial gastroduodenopathy

The most common pathologies are superficial gastritis and superficial duodenitis.

Superficial gastritis precedes the initial stage of gastritis, making itself known by minor manifestations. Timely prescribed and adequately carried out treatment will help to get rid of the disease, otherwise it becomes chronic.

Depending on the section in which the pathology appeared, the following are distinguished: antral; fundal; superficial and pangastritis.

Superficial duodenitis is an inflammation of the duodenum, in which the folds of the mucous membrane thicken and swelling of the internal organs may occur.

Superficial duodenitis manifests itself as a consequence of existing diseases: gastric ulcer, inflammation of the gastric mucosa, small intestine. As a separate disease, superficial duodenitis occurs rarely.

It proceeds in waves. The stages of exacerbation alternate with remission and gradually develop into more severe forms.

The periods alternate until superficial duodenitis becomes chronic.

Therapy of superficial gastritis, which involves the use of medications and rational nutrition, will help prevent the ulcer process. Traditional methods complement them perfectly.

Atrophic gastroduodenopathy

This is a general name for pathologies in gastrointestinal diseases. It manifests itself as atrophic gastritis or duodenitis.

Atrophic gastritis is a pathology characterized by the loss of full functionality of the secretory glands, which stop producing gastric juice components in sufficient quantities. The glands turn into simpler functional units that produce mucus instead of gastric secretion. Usually, these processes occur against the background of reduced pH of the stomach.

The danger of atrophic gastritis is that it can lead to the development of oncological processes in the gastrointestinal tract.

Atrophic duodenitis usually occurs with necrosis of intestinal villi and thinning of the mucous membrane. Disruption of secretin, pacreozymin, somatostatin, motilin, etc. production causes disruption of the activity of the lower parts of the gastrointestinal tract, which affects the entire body. Patients with chronic duodenitis have asthenic, psycho-emotional and vegetative changes.

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Diagnostics gastroduodenopathies

Diagnosis of gastroduodenopathy consists of a thorough collection of anamnesis, examination of the patient, assignment of laboratory tests and necessary studies. A gastroenterologist can establish an accurate diagnosis upon receipt of the examination results.

The list of diagnostic studies may include:

• esophagogastroduodenoscopy,
• fluoroscopy,
• study of gastric secretion,
• Ultrasound of the abdominal cavity.

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Tests

In order to make a diagnosis, a gastroenterologist may recommend a general blood, stool, and urine test. Additionally, a test for the presence of Helicobacter pylori is necessary.

Determining biochemical parameters of blood makes it possible to evaluate the functioning of internal organs and the characteristics of metabolic processes.

A coprogram allows you to determine a violation of the acidity of the stomach pH and the presence of inflammatory processes in other parts of the gastrointestinal tract.

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Instrumental diagnostics

When examining a patient for gastroduodenopathy, various diagnostic procedures, including instrumental ones, can be used.

PH-metry. Helps to assess the degree of secretion of acid, bicarbonates and mucus by gastric cells.

Manometry and electrogastroenterography. The next step is to find out whether the motility of the stomach and digestive tract is normal. Food gradually moves through various sections of the gastrointestinal tract in a certain direction and at the required speed, and it is also crushed and mixed. Using the above studies, you can get answers to these questions.

Endoscopy or endoscopy combined with pH-metry is prescribed if the patient is suspected of having a stomach or duodenal ulcer.

For some gastrointestinal diseases, radiation diagnostic methods may be prescribed – ultrasound, scintigraphy or X-ray methods.

Treatment gastroduodenopathies

Therapy for gastroduodenopathy depends on the severity and duration of the pathological processes. In some situations, this is a complex and lengthy process that requires the doctor to be attentive and the patient to follow the instructions.

In severe cases, hospitalization of patients with severe pain and bleeding from various parts of the gastrointestinal tract, erosive forms of gastroduodenitis is indicated.

When conducting drug therapy, doctors can prescribe the following medications: De-Nol, Creon, Omeprazole, Omez, Trimedat. In case of manifestations of bacterial infection, antibiotics are recommended.

Treatment of gastroduodenopathy begins with nutritional correction.

In case of gastroduodenopathy with increased acidity, drugs are used that inhibit the secretory function of the stomach.

To eliminate heartburn, antacids are prescribed, for example, Phosphalugel. These drugs have a short-term effect, but are effective.

Treatment is carried out at home. The duration of treatment for gastroduodenopathy varies - from a week and longer.

The course of treatment must be completed. Gastroduodenopathy that is not fully treated may result in gastric and intestinal bleeding.

Treatment of gastroduodenopathy in children should be comprehensive, taking into account the causes of the disease, changes in other parts and systems of the body. It is necessary to conduct psychotherapy sessions, especially in adolescents.

Vitamins

Complex vitamin preparations will be indispensable for restoring the body in case of gastroduodenopathy.

Chronic gastrointestinal diseases lead to a deficiency of pyridoxine (vit. B6), which results in metabolic disorders, nausea and vomiting, changes in the nervous system, and an increased risk of damage to the gastrointestinal mucosa, which can lead to bleeding. The most effective vitamin in this case is vitamin B6. It is found in legumes and grain bread. In addition to it, for the normal functioning of the stomach and intestines, the body will need:

Niacin (vitamin PP), which helps to normalize the production of gastric juice. It will help reduce diarrhea. Products: meat, fish, cereals contain niacin. It can be sold in pharmacies as part of such drugs as nicotinic acid, Vitaplex N, etc.

Vitamin A (retinol acetate) helps prevent the occurrence and development of infectious diseases. Retinol acetate is found in bread, butter, cereals, and fermented milk products.

Folic acid, softens inflammation of the mucous membranes. Found in large quantities in cabbage, liver and spinach.

Vitamin B12 (cyanocobalamin). Deficiency of cyanocobalamin in the body causes anemia, which negatively affects the functioning of various parts of the stomach and intestines in gastroduodenopathy.

Physiotherapy treatment

Physiotherapeutic procedures contribute to the recovery process. After drug therapy for gastroduodenopathy, the following may be prescribed: diadynamic currents; galvanization of the epigastric region; calcium electrophoresis.

Improvement of the secretory-motor work of the stomach is achieved with the help of: diadynamometry; micro- and high-frequency wave therapy; inductothermy; electrosleep sessions.

During the period of partial remission, patients are recommended to undergo a course of treatment using: hirudotherapy; electrosleep; magnetic therapy.

Recurrent gastroduodenopathy requires the use of: reflexology; herbal preparations and homeopathic remedies.

Doctors recommend that children use a combination of medication and physiotherapy. If possible, undergo rehabilitation courses in special sanatoriums. Nowadays, there is no clear treatment regimen for gastroduodenopathy that would produce a positive effect. Medicines are prescribed by a doctor taking into account the existing clinical manifestations and laboratory test results.

Herbal treatment

In the treatment of gastroduodenopathy, traditional medicine offers its own methods of treatment. These are mainly herbal teas. Here are some of them:

1. Flax infusion. Grind flax seed (1 tbsp.) and pour 0.5 l of boiled water over it. Put on the fire and boil for 15 minutes. Remove from the fire. Leave for 1 hour. Drink the infusion three times a day, 0.5 tbsp. 1 hour before meals. The course of therapy is 1 month. Then take a 10-day break and repeat the course.
2. Prepare a herbal mixture. Take a pinch of each: chamomile, St. John's wort, celandine. Take 1 tbsp of the mixture and pour 2 liters of boiling water. Take three times a day 30 minutes before meals.
3. It is necessary to prepare a collection of: chamomile, yarrow and St. John's wort. Take the herbs in equal proportions. Pour 1 tbsp of the mixture with 1 tbsp of boiling water. Infuse. Take as indicated in the recipe above. The course of treatment is 10 days.
4. Prepare a herbal mixture of nettle leaves, plantain, St. John's wort, and chamomile flowers in equal proportions. Grind the dried raw materials in a coffee grinder. Pour 2 tbsp of the mixture into 0.5 l of boiling water in a thermos and leave overnight. Take a quarter of a glass three or four times a day before meals. The course of treatment is 1-1.5 months.

Homeopathy

Among homeopathic remedies, there are many preparations used for various gastroduodenopathy. A homeopathic remedy and its dosage are prescribed by a homeopathic doctor.

For acute inflammation of the stomach, the following is prescribed:

Cephaelis ipecacuanha. The drug reduces pain and vomiting. Arnica montana has a similar effect.

Nux vomica, Spascupreel, Gastricumeel are used as antispasmodics. The last medicine in the list reduces pain, but also has a calming effect. Argentum nitricum is also used as a calming agent for erosive inflammations.

Complex preparations - Iris versicolo, Kalium bichromicum, Acidum sulfuricum help to increase appetite, have a positive effect on the mucous membrane of the stomach and intestines.

Sulfur helps the digestive process.

Surgical treatment

Surgical treatment is used in extreme cases – in case of bleeding (gastric, intestinal).

In case of bleeding, the patient is urgently given fibrogastroscopy. When the cause of bleeding is established, emergency surgery is performed.

Diet for gastroduodenopathy

Dietary nutrition for gastroduodenopathy is very important. The recommendations are as follows:

• food should be warm;
• it is necessary to chew food thoroughly;
• eat at least five times a day.

Recommended foods for gastroduodenopathy:

• Soups (cereal and vegetable in broth) pureed.
• Porridge (made from buckwheat, oatmeal, rice), boiled or mashed.
• Lean meat.
• Steamed cutlets.
• Lean boiled fish, black caviar.
• Soft-boiled eggs.
• Kefir, yogurt, milk.
• Stale bread (white, grey).
• Pureed vegetables, fruits (boiled, raw).
• Juice, tea with sugar.
• Marmalade.

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Prevention

Preventive measures for gastroduodenopathy include:

• fractional balanced meals,
• prevention of diseases of the oral cavity, nasopharynx,
• reducing stressful situations,
• adherence to the daily routine,
• walks in the fresh air.

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Forecast

The prognosis for non-advanced stages of gastroduodenopathy is favorable. If hyperemia caused by the Helicobacter pylori bacterium occurs on the mucous membrane, then antibiotic treatment is carried out. In the early stages, the disease responds well to therapy.

If gastroduodenopathy is caused by external factors (stress, poor nutrition, alcohol abuse), lifestyle changes can help improve the patient’s condition.

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