Under one name "gastropathy" lies a lot of chronic diseases of the stomach, which are not all sufficiently studied, so there are different classifications and they are conditional. Endoscopic classification of gastropathies is based on three consecutive stages: description, interpretation and final conclusion.
The description makes a visual assessment of the surface of the stomach, the movement and size of its walls, the color of the mucosa, the presence of lesions. Interpretation answers the questions indicated in the direction of the gastroendoscopy, taking into account the clinical diagnosis. For a final conclusion, a biopsy biopsy is taken.
Erimatous gastropathy is a reddening of the gastric mucosa and is detected by endoscopic examination. There are focal, embracing one or several separate areas of the stomach, and common, on the entire surface of the organ or on most of it. Focal gastropathy is asymptomatic, with a more extensive spread of it there are sensations characteristic of gastritis: the severity and pain in the epigastric region, the feeling of overflow of the stomach, eructation, general weakness, heartburn.
Erosive gastropathy is characterized by the appearance of mucosal lesions - erosions. They are subdivided into sharp, 1-2 mm in size, and chronic, from 3 to 7 mm, outwardly similar to pimples with a hollow in the middle. The main cause of erosive gastropathy is the aggressive influence of endogenous and exogenous factors: burns, injuries, drugs, reflux of bile, bacterial invasions. It can flow as asymptomatically, and make itself felt pain in the right upper quadrant, flatulence, and sometimes gastric bleeding.
Congestive gastropathy involves a violation of the motility of the gastrointestinal tract. It is expressed by ulcers and erosions in the lower antral part of the stomach and the upper part of the small intestine. Deterioration of the blood supply of the body comes, mainly from the negative effects of alcohol, nicotine, seeding Helicobacter pylori. This kind of gastropathy often accompanies the pathology of the liver, kidneys, stomach ulcers, burns, pancreatic tumors.
With atrophic gastritis, secretory gland cells degenerate, atrophy and lose their ability to perform their functions. Damaged cells under the influence of autoimmune reactions give birth to their own kind, pathological regeneration takes place and mucus is produced instead of gastric juice. This diagnosis is characterized by a decreased acidity of the stomach, which in itself is not the worst, it can be artificially enhanced. A more dangerous consequence is the emergence of neoplasms, including malignant ones. The term subatrophic gastropathy is considered obsolete, in modern clinical practice is almost not used. He also assumes the initial stage of atrophic gastropathy.
Antral gastropathy affects the antral part of the stomach, whose functions include grinding food to a size of 1.5-2mm and pushing it into the duodenum through the pyloric sphincter. At the location of the pylorus, mucus is released - an alkaline medium that neutralizes the action of hydrochloric acid. In addition, the endocrine gland cells of this department produce hormones gastrin, endorphins, serotonin. Violation of the work of this part of the stomach leads to a decrease in the rate of food movement through the digestive tract, resulting in stagnant phenomena in the stomach, fermentation. The person feels heaviness, pain syndrome. Elderly people are more often affected by this pathology, but it also occurs in young people. The lack of treatment can lead to the formation of an ulcer, which in this place of localization is quite easy to treat.
Catarrhal implies the simplest form of gastropathy, in which inflammation only spreads to the upper layers of the gastric mucosa. It can be accompanied by both increased secretion of gastric juice, and its insufficiency, and the symptoms characteristic of these conditions. The causes of pathology are different, including a violation of diet, food poisoning, chemical, traumatic factors.
For hyperplastic gastropathy is characterized by an excessive increase in the number of cells of the secretory glands, due to which there is a proliferation of tissue and the formation of folds and outgrowths inside the stomach. This form of gastritis is more likely to affect people of young and old age, mostly men. To hyperplastic gastritis include such diseases:
- Menetries syndrome, which is characterized by the appearance of deep immovable folds and the possibility of their spread to the intestinal wall;
- Zollinger-Ellison disease, in which there is excessive secretion of gastrin, leading to the formation of erosions, ulcers and gastrin;
- hypersecretory gastritis.
The term "diffuse" refers to the prevalence of pathological processes on the entire body of the stomach or most of it. Diffuse gastropathy manifests itself in acute form, and in chronic. The cause of its appearance can be any of the above described. Its superficial form - the easiest, not having a symptomatology, is found, as a rule, accidentally during gastropathy. Prolonged chronic leakage causes structural changes in the mucosa and manifests itself as characteristic of gastritis symptoms.
Reflux gastropathy is a variety of damage to the stomach as a result of throwing into it the contents of the duodenum. Most often, this affects his antral department. Bile acids and their salts, pancreatic enzymes and other components, getting through a poorly closed pylorus into the stomach, negatively affect its mucous, causing inflammation, erosion, ulcers. There is such a gastropathy with pains without clear localization, white coating on the tongue, eructation.
Hyperemic gastropathy is caused by an increase in blood flow to the gastric mucosa, while examining gastroendoscopy states redness and bruising, swelling. Focal, sometimes in some small areas, and common, can cover various parts of the body.
Hypertrophic gastropathy is a deep deformation of the walls of the stomach, which affects not only the mucous layer, but also the muscular. In other words, this is the formation of benign tumors. Depending on the type of deformation, polypous gastropathy, warty, granular or cystic and Menetries disease are distinguished. Neoplasms are single and multiple, focal and diffuse. They are more common in males because of their inherent intemperance in drinking alcohol, smoking, fatty and spicy food.
Portal gastropathy is a variety of lesions of mucous and submucosal layers of the stomach caused by vasodilation due to portal hypertension. In the portal vein system, pressure increases and this leads to an expansion of the capillaries, arterioles and veins of the stomach walls and their increased blood filling. There are several degrees of severity of the disease:
- light (on the surface of the mucosa there is a mosaic pattern formed by blood vessels);
- average (appearance of red solid fragments);
- Heavy (fusion of pinpoint hemorrhages in a black-and-brown pattern).
Inflammatory process with portal gastropathy is not observed. Minor gastric bleeding is possible, which in themselves do not lead to irreparable consequences.
Associated gastropathy refers to the pathology caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs). Currently, the intake of NSAIDs is becoming widespread. Is an effective tool in the treatment of the musculoskeletal system, migraines, fevers, for the prevention of vascular diseases, in dentistry and oncology for pain relief. But in addition to a specific focus of the systemic use of drugs can damage the mucous membrane of the digestive organs, cause ulcers and erosion, gastric bleeding, obstruction. Often against the background of the painful sensations of the underlying disease, NSAID-associated gastropathies do not give a significant symptomatology, therefore it is detected already at the stage of complications.
Exudative gastropathy has another name - the disease Menetries, after the name of a French doctor who described it in 1888. This is a fairly rare disease, consisting in the formation of deep folds on the wall of the stomach, whose height can sometimes reach 3-3.5 cm. In this case, there is a decrease in the main and lining cells, and the number of cells producing mucus increases. The causes of the pathology are not well understood. It is believed that the disease can provoke a long-term effect on the mucosa of alcohol, heavy metals, heredity, metabolic disorders. Sometimes exudative gastropathy is considered a benign tumor. Suppose this diagnosis can aching pain in the stomach, arising after eating, loss of appetite, often weight loss, sometimes unpronounced bleeding.
Granular gastropathy got its name due to a visual assessment, which is given by gastroenterologists during endoscopic examination. The walls of the stomach in this pathology are covered with small granular formations (from a few millimeters to a centimeter). The disease develops mainly in men after 40 years. At first, it does not manifest itself in any way, in the future it leads to swelling of the mucous membrane and disturbance of protein metabolism.
Lymphoid or lymphocytic gastropathy is considered a rare disease that occurs against a background of chronic chronic gastritis. It is characterized by the accumulation in the site of damage to the epithelium of the gastric mucosa or duodenum of lymphocytes in the form of follicles. If the chronic course of the disease is caused by the Helicobacter pylori bacterium, there is a sharp increase in the cells of the follicular layer - lymphofollicular hyperplasia, in which the folds of the lymphoid tissue become large. Doctors believe that this is the body's response to the multiplication of bacteria. In addition to biopsy with this diagnosis, fluoroscopy is performed to determine the extent of tissue proliferation and the risk of degeneration into malignant neoplasms.
Jet gastropathy is also called chemical. The most common cause of this disease is reflux of bile and long-term intake of NSAIDs. The effect of these factors on the state of the gastric mucosa has already been described above. It was also observed that it develops in patients who underwent surgery on the stomach.
Ulcerous gastropathy refers to the acute form of the disease. A few hours after the damaging agent enters the interior, the inflammatory process of the mucosa rapidly develops. After some time, the person experiences symptoms characteristic of poisoning: nausea, vomiting, a feeling of raspiraniya in the stomach. Often there is blood in the vomit, and after emptying the stomach, vomiting begins with bile. With such phenomena it is necessary to urgently apply to a medical institution in time to stop the pathological process and avoid serious complications.
Papular gastropathy is characterized by the formation of single papules in different parts of the stomach or multiple, concentrated in one. In medical terminology, this name is eroded. It does not affect the deep layers of the mucosa, and when healing does not leave a muscle scar.
Ureemic gastropathy occurs in patients with chronic renal insufficiency, which affects many human organs, but most often the gastrointestinal tract. It acts as a compensatory mechanism in nitrogenous and electrolyte metabolism when these renal functions are impaired. Due to the cleavage of urea in the stomach, ammonia is formed, which provokes an increased secretion of hydrochloric acid. The consequences of this process is inflammation of the mucosa, the formation of erosion and ulcers, bleeding. Another option is a decrease in acidity due to a loss of sensitivity of the lining cells to gastrin, the development of mucosal atrophy, which is even more dangerous for health.
The word "induce" is interpreted as "influencing". The medical term "induced gastropathy" means the occurrence of a disease under the influence of something. Most often this refers to the involvement of medications at the onset of the pathogenic process. In the special literature there are descriptions of NSAID-induced, aspirin-induced gastropathies, which we have already considered.
Mixed gastropathy occurs as a result of the development of its various forms. Most often, the patient is found to have erosive, superficial, hemorrhagic and hypertrophic gastropathies. As a rule, superficial, which does not affect the deep layers of the mucous membrane, with its chronic course can be aggravated by the formation of erosions and a violation of microcirculation of blood in the vessels and capillaries of the stomach and go into a severe hypertrophic stage.