Many people do not perceive the diagnosis of "superficial gastritis" seriously - they say, it is an easy degree of gastritis, which can pass by itself. But the fact is that this is not quite so: under certain circumstances, the surface process in a short time can become complicated and transform into a serious pathology - for example, in peptic ulcer disease.
So what is the essence and insidiousness of superficial gastritis, and how does this disease differ from the usual inflammation of the gastric mucosa?
The superficial inflammatory process, which affects the mucous tissues of the stomach, is found in almost 70% of people after 26-28 years. In this case, the older the person, the more likely it is that he has gastritis.
In men, this disease is more often associated with improper and monotonous nutrition, as well as with the presence of bad habits.
Women often "get" a superficial gastritis after all the changes in diet associated with starvation and limited diets for weight loss.
In children, the disease is due to hereditary pathology, or impaired nutrition.
Causes of the superficial gastritis
More than 80% of diagnosed gastritis is due to the development of a specific Helicobacter pylori bacterium that enters the digestive tract from the outside. However, this bacterium does not always affect the gastric mucosa: this requires a favorable situation for the microorganism. Such circumstances may serve as external causes, inappropriate lifestyle, chronic infectious pathologies in other organs. Indeed, many people have a bacterium called Helicobacter, and they do not develop gastritis.
Thus, we can name the main cause of superficial gastritis, which is a combination of two circumstances:
presence of Helicobacter bacteria in the digestive system;
prolonged and regular irritation of the gastric mucosa.
Mucous tissue can be irritated by the following factors:
with prolonged or incorrect intake of medicines (non-steroid anti-inflammatory drugs, hormonal and sulfanilamide agents);
with regular disturbances in nutrition, the use of mechanically unacceptable food (for example, food "dry");
with alcohol abuse, with frequent smoking;
when salt and spices are misused;
with the frequent use of sweet carbonated drinks, including power engineers;
at non-observance of working conditions of work (inhalation of poisons, a dust, evaporations, harmful chemical substances).
Among other things, you can also name some additional risk factors, which are:
disorders of metabolic processes, anemia;
cardiological, pulmonary diseases;
diseases of the endocrine system (pathology of the thyroid gland, pancreas);
Superficial gastritis in children can be triggered by malnutrition (hobby for fast food, chips, chewing gum, etc.), poisoning with poor-quality products, salmonella, rotavirus infection, parasitic diseases.
The above risk factors over time cause a malfunction in the digestive system. At the first stage, there is a violation of gastric secretion, then a disorder of normal peristalsis, which is associated with excessive production of enzymes, is added. After this, processes of inflammation and dystrophic changes are triggered.
At the initial stage of gastritis, that is, with superficial gastritis, pathological processes affect only the epithelial layer of mucous tissues. If the disease progresses further, in view of the lack of proper treatment or wrong way of life, the inflammation also spreads to the glandular part of the digestive tract - mucosal atrophy arises. Atrophic changes in the beginning are also superficial, and can accompany the course of superficial gastritis.
Symptoms of the superficial gastritis
Gastritis of the surface type does not occur suddenly. Its development is gradual, with the growth of pathological signs. Periodically observed exacerbations: they usually are short and at first can disappear independently.
Do not ignore the first signs of the disease:
feeling of discomfort, bloating in the area of the projection of the stomach;
the appearance of heartburn, soreness (pain is uninfluenced, unstable, more often after eating);
nausea in the intervals between meals;
dullness of hunger;
in some cases - a burp with an unpleasant odor, a sensation of foreign taste in the oral cavity;
during relapse, the pain becomes more severe.
For superficial gastritis, a change in the acidity of the gastric environment is characteristic, which can both increase and decrease. Increased acidity is accompanied by severe pain attacks (especially at night), sour taste in the mouth, dyspeptic disorders. Deficiency of acidity tends to develop atrophy, and similar processes occur quickly and are barely noticeable for the patient. Some patients pay attention to an inexplicable loss of weight and appetite, paroxysmal nausea and vomiting, the so-called "empty" burp (more often in the morning). Language is often covered with a light bloom.
After involvement in the process of the duodenum, pain moves to the epigastric zone: often it accompanies a feeling of hunger, the use of sharp and hot dishes. This condition is characterized by disorders of the stool, after which the pain weakens or disappears.
Is superficial gastritis dangerous?
In its own way, any disease is dangerous, especially if it is associated with inflammation of the internal organs. Superficial gastritis is no exception. We must not forget that the inflammatory process tends to spread, so that the damage to the surface tissues can soon go to the next deeper tissues. Of course, in itself, superficial gastritis is not harmful to life. Its danger lies in the development of complications and aggravation of the disease, which, in the absence of proper treatment, necessarily transforms into a more complex pathology. Therefore, it is impossible to ignore the disease: it is better, easier and faster to cure the beginning process than to later deal with severe consequences.
If pains with superficial gastritis become permanent, pulsating, independent of food intake, one should suspect the development of complications.
Superficial gastritis in children
Unfortunately, the development of gastritis in childhood is not uncommon. The peak incidence falls on the age category from 5 to 6 years, as well as from 9 to 12 years, which can be associated with periods of rapid development of the child's body.
Inflammation of superficial mucosal tissue in children is most often associated with the following causes:
infection with pathogenic flora Helikobakter;
improper intake of medicines;
malnutrition (low-quality food, overeating);
viral and infectious diseases;
Superficial acute gastritis in childhood can easily go deeper into tissues, down to necrosis. Therefore, at the first sign of lesions of the digestive tract in a child, it is necessary to take urgent measures, applying for medical help.
In order to more accurately characterize the diagnosis in medicine, it is conventionally divided the surface gastritis into stages.
Light superficial gastritis, or superficial gastritis of 1 degree, is characterized by the spread of inflammatory tissue changes to the mouth of the pyloric glands. At the same time, the number of atrophied cells is minimal.
Moderate surface gastritis, or superficial gastritis of the 2nd degree, is accompanied by inflammatory phenomena not only of superficial, but also of medium glandular tissues. The number of atrophied cells is increased, in comparison with a gastritis of 2 degrees.
The expressed superficial gastritis, or a superficial gastritis of 3 degrees, represents defeat of all mucosa of a gastric wall up to a muscular layer. The number of atrophically altered cellular structures is sharply increased.
In addition to separation by stages, there are other options for classifying surface gastritis. Thus, a chronic, recurrent course is isolated, as well as an active course of the superficial inflammatory process.
Chronic surface gastritis often develops as a consequence of an incomplete acute form of the disease. But in some cases, it can occur on its own, as a result of an improper diet, which does not correspond to the possibilities of the stomach. Symptoms of a chronic form of gastritis are often atypical, hidden and may not cause suspicion in the patient. The secretory function of the digestive system in chronic course may remain the same. For a chronic form, there are periodic exacerbations that can be perceived by the patient as the onset of an acute disease.
Exacerbation of superficial gastritis in most cases proceeds, as usual acute inflammatory process. The characteristic signs of exacerbation are unpleasant eructations, nausea to vomiting, increased gas formation, sharp pain in the stomach, discomfort and a feeling of heaviness in the epigastrium.
Active surface gastritis is a phase of an active inflammatory process, which is usually observed in the initial stage of the disease, as well as during an exacerbation. With prolonged activity of the inflammatory reaction, pathology can after some time pass from the surface tissues to the deeper layers. In this case, gastritis ceases to be superficial: there is a full inflammatory process in the stomach with all the ensuing adverse effects.
Superficial antral gastritis
The so-called gastritis B, in which there is a superficial lesion of the mucosa in the antrum, the last point of food passage through the stomach.
Unpleasant sensations inside the stomach: heaviness, discomfort, rumbling, raspiranie.
Complex treatment: H 2 -receptor blockers, anti-Helicobacter pylori preparations, bismuth-based drugs. Monotherapy is not welcome.
Superficial fundal gastritis
Gastritis type A, or autoimmune gastritis, which develops under the action of antibodies to parietal cells of the stomach.
In addition to the usual clinical picture of superficial gastritis, there is a development of pernicious anemia.
Astringent and anti-inflammatory drugs of mainly plant origin, drugs for stabilizing tissue metabolism, means for accelerating reparative processes.
Focal superficial gastritis
Focal (fragmentary) lesion of gastric mucosa.
Nausea and a feeling of heaviness, regardless of food intake, loss of appetite.
Spasmolytic drugs, enzymes, phytopreparations against the background of dietary nutrition.
Common superficial gastritis
Superficial inflammatory lesion of the entire gastric mucosa.
Pain and cramping in the stomach, dyspepsia, increased release of gases.
Diet, taking enveloping and anti-inflammatory drugs, antibiotic therapy.
Superficial atrophic gastritis
Atrophic changes in the mucosa, often against a background of reduced gastric secretion.
Feeling of heaviness, dull tenderness after eating, exhaustion, lack of appetite, diarrhea.
Anti-inflammatory, enzymatic and reconstructive therapy aimed at the regeneration of mucosal tissue structures.
Superficial catarrhal gastritis
Catarrhal gastritis is a medical term that is used to describe a normal nutritional, or food, superficial gastritis caused by abnormal eating behavior.
Acute pain above the navel, a sense of heaviness, the appearance of an unpleasant taste in the oral cavity.
The main point of treatment is stabilizing the patient's diet. In addition, adsorbents and enzyme preparations are prescribed.
Superficial gastritis with erosions
There is a superficial lesion of the mucosa with the formation of small wounds, which gradually turn into erosion.
Vomiting with blood veins, feces with blood elements, constipation or diarrhea, changes in the work of the intestine.
Antibiotics, antacids, blockers of histamine receptors, regenerative drugs (Trental, Iberogast).
Distal superficial gastritis
The second name is superficial antrum gastritis, which captures the pyloric part of the stomach (distal third), located in front of the transverse line.
Heartburn, the urge to vomit, burning and soreness behind the sternum.
Antacids and enzyme preparations with anti-inflammatory action.
Superficial hyperplastic gastritis
A rare type of superficial gastritis, in which there is a pronounced proliferation of epithelial tissue with the formation of thickened flaccid folds and outgrowths.
Often occurs without obvious symptoms, only after a time there are signs such as vomiting, diarrhea, bleeding mucosa.
Nutrition with an abundance of proteins, stabilization of the motor and secretion, regular observation by a doctor.
Superficial erythematous gastritis
Against the background of a superficial lesion, most often there is an erythematous exudative gastritis, which appears under the influence of an allergic factor (food allergy). It is accompanied by the accumulation of eosinophils inside the mucous membrane.
Stool disorder, pain in the area of the stomach (during or after a meal).
Diet, antacid and antihistamines.
Superficial hemorrhagic gastritis
The disease is identical to erosive superficial gastritis and is accompanied by mucosal hemorrhage in the upper parts of the digestive tract.
Typical signs are dark tar-like stool and vomiting with blood particles.
Antibiotics, haemostatic agents. In severe cases - surgical intervention.
Superficial Helicobacter Gastritis
The disease is associated with infection with the Helicobacter bacteria. It quickly passes into a chronic form, therefore it requires urgent medical measures.
It does not differ from usual superficial gastritis.
The main treatment is the use of antibiotics, which are active against Helicobacter.
Superficial gastritis with high acidity
It represents the initial stage of almost any gastritis, which is accompanied by an increase in the level of acid in the stomach.
Heartburn, acidic eructation, increased gas formation, indigestion.
The main treatment is the normalization of nutrition and the use of antacids.
Small-focal superficial gastritis
Superficial inflammation, affecting the mucous selectively, small individual islets.
Pain in the epigastric region, decreased craving for food, indigestion.
Complete complex treatment of gastritis against a background of sparing diet.
Mixed superficial gastritis
It is a simultaneous combination of various types of superficial gastritis. Most often consists of 3 or 4 variants of the disease.
Combines the symptoms of different types of gastritis at the same time.
Treatment is complex.
Complications and consequences
If superficial gastritis is not treated, or it is treated incorrectly, then eventually the inflammatory process will spread to all tissues of the stomach down to the muscular layer. Small changes in superficial mucous tissues are transformed into atrophy and the development of pangastritis - the defeat of the entire gastric organ.
Covering the stomach, the inflammation will go further, into the 12-colon. The patient will have signs of an acute form of duodenitis. Subsequently, the process will change its course to chronic.
In addition, the development of peptic ulcer disease, the appearance of bleeding erosions, which significantly complicate the dynamics of the disease.
If the patient does not receive adequate treatment at this stage, then the inflammatory reaction can cover the intestines, which will increase the risk of bleeding and the formation of adhesions.
Diagnostics of the superficial gastritis
Diagnostic manipulations can be divided into several consecutive stages.
Collection of anamnesis, clarification of clinical data on the disease, examination of the patient - this information allows you to establish a preliminary diagnosis and determine the scheme for further diagnostic studies.
Laboratory tests include:
taking blood for general clinical analysis, biochemistry;
taking urine fluid for general analysis;
taking feces for a general study, to determine the latent blood, the detection of Helicobacter bacteria.
Instrumental diagnostics are the main methods for diagnosing surface gastritis:
The endoscopic method is a direct examination of the gastric mucosa through an endoscope. This procedure is very informative, as it allows to see the extent of the lesion, to clarify the location of the focus with the altered mucosa, to assess the likelihood of malignancy of the process. To assess the likelihood of oncology, the doctor takes a tissue element on a biopsy - examining a portion of the mucosa for structural changes in the tissue;
The respiratory-ammonia method is one of the ways to determine the presence of a Helicobacter infection in the stomach. The patient is offered to take a special preparation consisting of urea with a normal isotope composition, after which the ammonia content in the exhaled air is measured using an analyzing device;
ultrasound diagnosis of internal organs - this is the well-known method of ultrasound, with which you can assess the state of the entire digestive system;
the method of measuring the reaction of the gastric environment is the so-called pH-metry, which gives an idea of the possible shifts in acidity in the stomach;
Radiography of the stomach with the use of contrast is an informative method capable of "seeing" the neoplasm, erosion and ulcers inside the gastric cavity;
The method of gastroenterography is a method that allows assessing the peristalsis of the digestive tract. Gastroenterography helps to determine the presence of gastroduodenal reflux.
Treatment of the disease appoints a doctor-gastroenterologist, based on the results of the studies. All procedures and taking medications the patient can carry out at home, since inpatient treatment is possible only in case of complications in the form of ulcerative process.
Conservative therapy involves the taking of certain medicines, as well as an auxiliary restorative treatment.
If the presence of Helicobacter infection in the body is proven, then antibiotic therapy is prescribed, the duration of which can be 1-2 weeks. The following medicines are used for this purpose:
Metronidazole is an antiprotozoal and antibacterial drug that is taken in the form of 500 mg tablets three times a day. Metronidazole is undesirable during pregnancy. Side effects: taste of metal in the mouth, constipation, sleep disorders.
Sumamed is an antibiotic that shows activity against a vast spectrum of bacteria. The course of taking the drug lasts three days, while using 2 tab. Per day. Side effects: diarrhea, increased gas formation. Caution: the drug may cause allergies.
Hemomycin is an antibiotic-azalide with a bacteriostatic effect. Hemomycin is taken on an empty stomach, 500 g per day at a time. The usual duration of admission is 3 days. Side effects: very rarely - dyspepsia. The drug is considered one of the least toxic antibiotics.
It is obligatory for superficial gastritis to take specific drugs that help restore the gastric mucosa. Such drugs are called histamine-receptor blockers:
Omez - antiulcer with omeprazole. Take 20 mg in the morning on an empty stomach, for 2 weeks. Side effects: dizziness, pain in the muscles and joints, increased sweating. The drug is not used to treat pregnant women.
Famotidine is a drug that inhibits the secretion of the stomach and reduces the activity of certain enzymes. The usual dosage is 0.02 g of the drug twice a day. Among the side effects can be called cholestasis, headache, fatigue. Before using Famotidine, it is advisable to conduct an allergic test.
If a high acidity in the stomach is detected, then the use of drugs with an antacid effect is possible:
Almagel is a means for neutralizing the acid in the stomach. It is taken on 1-2 measuring spoons shortly before meals and at night. Among the contraindications - newborn children and allergic sensitivity. Undesirable actions can manifest as constipation, drowsiness.
Fosfalugel - enveloping and anti-acid drug, which is prescribed for 1 dose up to 3 times a day before meals. Side effects: constipation, decreased appetite.
If the acidity is understated, then resort to the help of enzyme means:
Pepsin is a digestive enzyme. Take 80 mg with food. Continue treatment for at least two weeks. Pepsin is not used in erosive surface gastritis.
Enzistal is a combined enzyme and proteolytic drug. Assign 1 dragee three times a day with food. If necessary, the doctor can increase the dosage.
Bismuth preparations are also prescribed, which reduce the negative effect of gastric acid on its walls, which favors the early healing of the mucosa:
De-nol - antiulcer with astringent effect. Take 2-4 tablets a day. De-nol is well combined with antibiotics and omeprazole. Side effects are rare and consist of dyspeptic disorders or allergies.
Gastrofarm - a remedy for the restoration of the gastric mucosa. Take orally on 1-2 tablets. Three times a day, before meals. Treatment continues for at least a month. The drug is safe and non-toxic to the body, so it can be used in pregnancy.
Alanton is a herbal preparation that accelerates the healing of irritated mucous membranes. Take 50 ml of the finished product up to 6 times a day, before meals. Pregnant to take the remedy is not recommended.
In cases where other diseases of the digestive system are simultaneously detected, additional drugs may be prescribed:
with reflux effect, medicines are used to prevent food masses from entering the stomach from the duodenum (eg, Metoclopramide);
when combined pathology of the pancreas use Creon or other drugs with the appropriate enzymes;
In pediatrics with superficial gastritis, sedatives and herbal remedies can be prescribed.
During the abatement of the inflammatory process, physiotherapy (mud therapy, paraffin), exercise therapy, ozone therapy is appropriate. Recommended health treatment, mineral water inside and in the form of baths.
Do I need to take vitamins and why?
It is proved that the lack of certain vitamins can increase the susceptibility of the digestive system to negative factors. So, for example, vitamin B6 deficiency worsens the condition of gastric mucosa.
Vitamins of group B enter the body with legumes, dark varieties of bread.
The little-known vitamin PP stabilizes the production of gastric secretion, prevents the upset of the stool. Niacin (this is the full name of vitamin PP) can be obtained from meat and fish dishes, cereals.
In addition, there is a kind of universal vitamin that fights against any inflammatory reactions inside the body - it's folic acid. However, the benefit of this substance can be felt only with normal or increased acidity of the gastric secretion, since low acidity and atrophic processes interfere with the absorption of the vitamin.
You can find folic acid in all kinds of cabbage, in dishes from the liver and spinach.
Vitamin A, which is present in sufficient quantities in cereals, oils, carrots, prevents the ingestion of bacteria inside the stomach, including Helicobacter.
The listed vitamins are equally useful if they enter the body with food, or with special multivitamin preparations. Such vitamin complexes should be taken with food, or immediately after it.
With increased secretion of gastric juice, it is useful to use amplipulse therapy and microwave therapy (microwaves). Similar procedures have an anti-inflammatory, analgesic, bacteriostatic, desensitizing, restorative and trophic effect.
If the patient complains of severe pain in the stomach, the doctor may prescribe mud therapy in the form of sulphide, peat, silt, sapropelic mud. Muds are applied to the epigastric region or to the collar zone, approximately 15 minutes, once every two days. Galvano-mud, mud electrophoresis and the Humisol apparatus have a similar effect.
Practically any form of superficial gastritis is useful to treat simultaneously with the use of the corresponding mineral waters and against the background of a competently formulated diet.
Alternative recipes often help to quickly cope with the disease and alleviate the condition during seizures. In addition, such treatment is in most cases more accessible than drug therapy. Nevertheless, to count only on alternative treatment it is not necessary: it is much better, if struggle against a gastritis will be spent in a complex with traditional methods.
Superficial gastritis will be faster, if three times a day for 20-30 minutes before a meal, drink 1 tbsp. L. Freshly squeezed plantain juice.
Useful astringent drugs that protect mucous tissues from all sorts of unfavorable factors. Knitting plant remedies include flaxseed and oats: they can be brewed with boiling water and take 1 tbsp. L. Several times a day.
Such an astringent effect is also observed with the regular use of raw quail eggs. Eggs are broken into a glass and drunk for 4-5 pieces half an hour before a meal.
It is useful to drink on an empty stomach 1-2 tablespoons. L. Sea buckthorn oil, and even better to conduct such a morning ritual regularly, even after recovery.
With superficial inflammation, fresh potato juice helps, but it should be used on an empty stomach after a sharp attack of the disease. A single dose is approximately 100 ml of juice.
Honey with a superficial gastritis can help regardless of the acidity of the gastric secretion. The fact is that with the use of honey before eating, the secretion of juice increases. If you take a few spoonfuls of a good treat 2 hours before meals, then the acid release, on the contrary, decreases.
The recommended amount of bee products per day is up to 150 g, for three to four doses.
When choosing honey for treatment, make sure you get a real and fresh product.
Herbal treatment is very popular with gastric diseases. A lot of plants are known, the action of which allows you to adjust digestion and calm irritated mucous membranes.
With excess acidity, chamomile flowers, St. John's wort, licorice will help.
Reduced secretion can compensate for such herbs as wormwood, sage leaves, berries of mountain ash.
Grass wormwood mixed with yarrow 1: 1. Brew 60 g of the mixture in 0.5 l of boiling water. They consume 200-400 ml per day.
Prepare a mixture of chamomile and yarrow. Insist 40 g of dry raw materials in 0.5 liters of boiling water and take 200-400 ml twice a day for half an hour before meals.
Prepare a collection of leaves of plantain, St. John's wort, mint leaves, rhizome of ayr and cumin seeds. Infusion (2 tbsp mixture per ½ l water) is taken 100 ml 4 times a day 60 minutes after eating.
With pains in the stomach, such plant products as anise, fennel, caraway, mint leaves are good. Tea based on these plants can be drunk a little throughout the day.
Doctors of homeopaths are convinced that the medications they present are not so much acting on the disease as on its causes. That is why homeopathic treatment is often considered successful.
What kind of homeopathic medicines can be used to treat superficial gastritis?
Acidum Sulfuricum in breeding 10, 3, 6 and 12 is prescribed for discomfort in the stomach, nausea and dyspepsia.
Antimonium Crudum in breeding 3 or 6 is used to eliminate the feeling of heaviness in the stomach, in the absence of appetite.
Capsicum Annum 3, 6 or 12 dilutions are used with excess acid in the stomach.
Sodium Phosphoricum 3, 6 or 12 dilutions is recommended for heartburn, acidic eructations and vomiting attacks.
The amount of medication taken is determined individually by a homeopath physician. The listed means can be successfully combined with any kinds of treatment, including with medicines and alternative means.
As a rule, surgical intervention in the surface process is not advisable. The operation is shown only in extreme cases - for example, with the erosive form of the disease, which can no longer be called a surface process.
In addition, surgical treatment is performed with open gastric bleeding, which can not be eliminated with the help of medications, or in cases where it is impossible to determine the cause of bleeding.
It is believed that superficial inflammation is successfully cured by conservative methods, and the surgeon will help only with the development of complications.
Diet with superficial gastritis
Diet is, perhaps, one of the main elements of treatment of patients with superficial gastritis. During interictal periods it is recommended to eat at least five times a day in small portions, while the food is warmed up to a warm state. During an exacerbation doctors advise to pay attention to a dietary table №1а (approximately during 5-6 days) then it is possible to pass to a medical food №1.
The menu should consist of boiled or cooked in a double boiler food, without excess salt, spices, acids.
Take food and liquid separately from each other: this helps to better digest the food mass and the normal production of enzymes.
Variant of the daily menu outside the acute stage:
Breakfast: omelette for steaming, or soft-boiled eggs, or oatmeal without milk.
Lunch: soup or porridge with rice, vegetable side dishes, vegetable or chicken cutlets in a double boiler.
You can prevent the disease, and it's not so difficult to do it. It is enough to adopt the following rules:
in time and correctly treat any diseases of the digestive system, in order to prevent the development of a chronic process;
to abandon bad habits - cigarettes and spirits, which make the gastric mucosa more vulnerable;
to establish nutrition, to eat healthy and fresh food;
ensure a proper rest, especially at night;
avoid mental and physical stress, stress;
periodically to be examined by a doctor, to conduct preventive courses with multivitamin preparations;
Also, regular spa treatment, with the use of beneficial mineral waters, is also welcomed.
The acute phase of superficial gastritis with a competent and timely approach is cured in about 4 days. If therapy is ignored, then the course of the disease can be complicated, up to the development of a chronic inflammatory process, which will have to be combated for life.
Superficial gastritis and the army
Will they recruit a conscript with diagnosed superficial inflammation of the stomach?
Yes, they will, since this disease is not a contraindication to military service. If the acute stage of the illness falls at the time of conscription, then the conscript can be given a small delay, but he will not be released completely from the army.
Superficial gastritis only at first glance seems an easy form of the disease. However, his treatment can not be postponed, because the condition can irreparably deteriorate.
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