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

Gastroduodenopathy (gastropathy) is the appearance of erosions and ulcers in the gastroduodenal region, which develops when medications are taken (ibuprofen, diclofenac, aspirin, aspirin-containing drugs, etc.), and due to irrational nutrition.

Causes of the gastroduodenopathy

The causes of gastroduodenopathy include:

• Heredity.
• Unreasonable nutrition (excessive passion for acute, hot, rough food, uncontrolled use of alcohol, lack of diet, eating food in the dry).
• Bacteria, in particular, Helicobacter pylori.
• Long-term use of medicines.
• Addiction to smoking.
• Infections in the intestine.
• Chronic infections of the oral cavity and nasopharynx.
• Stressful situations.

[1], [2]

Risk factors

The risk factors for gastroduodenopathy include:

• Peptic ulcer (peptic form) and its complications in the anamnesis.
• The presence of bleeding from the gastrointestinal tract of any genesis.
• Admission of anticoagulants and / or NSAIDs.
• Severe concomitant diseases.
• Mature and advanced age.
• High dosage of drugs.
• Parallel administration of corticosteroids.
• Diseases of the cardiovascular system.

[3], [4],

Pathogenesis

Gastroduodenopathy includes two completely different diseases of gastritis and duodenitis. These diseases have different pathogenetic mechanisms, but there is much in common, and therefore they are rarely found individually and in most cases are combined in many patients.

Both pathologies can be attributed to acid-dependent conditions, developing with an imbalance of aggressive and protective factors affecting the gastric mucosa and intestines. One of these aggressive factors is the Helicobacter pylori bacteria. It affects the occurrence of chronic gastritis. In the development of chronic duodenitis, its role has not been proven. In the development of the latter, the acidity factor and enzymatic imbalance are of great importance.

Most likely, there is a common pathogenic process leading to the development of gastritis and duodenitis. In this connection, gastroduodenitis is considered as one whole.

[5], [6]

Symptoms of the gastroduodenopathy

Symptomocomplex gastroduodenopathy is very similar to the symptomatology of various intestinal and gastric diseases. They include:

• bouts of nausea;
• pain in the stomach;
• feeling of raspiraniya in the stomach;
• an unpleasant aftertaste in the mouth;
• loss or decrease in appetite;
• reflux;
• heartburn;
• diarrhea or constipation.

The first signs of gastroduodenopathy are unexpected, often on an empty stomach, sharp pains in the upper abdomen, like pain, nausea and vomiting.

[7], [8], [9]

Forms

Manifestations of gastroduodenopathy can be classified according to different signs. Some manifestations of gastropathies are not diagnoses - these are conclusions after the GI tests. Let us consider these states in more detail.

[10]

Erythematous gastroduodenopathy

Erythematous gastroduodenopathy is not a disease, but a conclusion in endoscopic examination. Note reddening of the gastric mucosa and its vulnerability. It is most often observed with superficial gastritis. Erythematous gastroduodenopathy is divided into focal and widespread.

The causes of erythematous gastropathy are:

• irrational nutrition;
• lesions of the stomach with mycotic infection and pathogenic microorganisms;
• disorders of metabolic processes;
• damage due to the use of irritants (alcohol, drugs)
• stressful situations
• hereditary factor
• bad habits.

[11], [12]

Hyperemic gastroduodenopathy

Hyperemic gastroduodenopathy, like erythematous, is not a diagnosis. This is the conclusion that the doctor makes during endoscopy. It indicates that redness, bruising and swelling of the gastric mucosa occur during examination.

Erosive gastroduodenopathy

Erosive gastroduodenopathy is a defective area (erosion) on the surface of the mucous membrane of the stomach or intestine.

Erosive gastropathy can develop when:

• injuries;
• burns;
• stress;
• aggressive effects of drugs, such as aspirin, prednisolone;
• abuse of alcohol-containing beverages;
• diabetes mellitus,
• sepsis,
• severe conditions, which are accompanied by renal, cardiac or hepatic insufficiency.

Erosive gastropathy is a consequence of insufficient supply of blood to the mucous membrane of the stomach, excessive release of hydrochloric acid. The emergence of erosion contributes to the infection of the gastrointestinal tract with microbes (Helicobacter pylori), reflux from the intestine into the gastric lumen.

Defects on the mucosa are asymptomatic or occur:

• hungry pains in the stomach,
• sour belch,
• heartburn,
• heaviness in the right hypochondrium,
• bloating,
• gastric bleeding.

Erosions are revealed during gastroscopy (examination of the gastric mucosa with the help of an endoscopic probe).

Erosions are divided into acute and chronic. The size of acute ulcers is 1-2 mm. When eliminating the damaging factor, heal no more than seven days. Chronic erosions in appearance resemble acne, with a diameter of 3-7 mm, with a medial depression.

Erosive gastroduodenopathy accompanies different diseases and its therapy is determined by the main diagnosis.

[13]

Congestive gastroduodenopathy

The appearance of congestive gastroduodenopathy is a consequence of motor and intestinal motility disorders.

Stagnant gastroduodenopathy is manifested by the fact that the food contained in the stomach and intestines is partially processed. Due to a lack of enzymes and weak motility of the gastrointestinal tract, the mucous membrane gradually undergoes atrophic changes. In this case, the food lump (chyme) can not fully move further along the digestive tract.

With congestive gastroduodenopathy, duodenal-gastric reflux arises - throwing a food lump from the duodenum into the stomach, the so-called "belching." These phenomena are especially dangerous because in the different parts of the gastrointestinal tract there are specific enzymes and active substances, and when they get to other places, they affect the mucous membranes, which leads to the appearance of gastritis and peptic ulcer.

Symptomocomplex of this pathological condition is erased or remains unnoticed due to the underlying disease. Provoking factors - smoking, alcohol consumption in large quantities, peptic ulcer, infection with bacteria Helicobacter pylori.

The complex of therapeutic measures is complicated. The general recommendation, as for all diseases of the gastrointestinal tract, is diet. From the diet excluded - fatty, spicy, spicy, smoked, salty foods; used - vegetables, fruits, lean pork, beef, rabbit, chicken. Of cereal products - buckwheat, oatmeal, limited manna and rice.

[14], [15], [16]

Catarrhal gastritis

Catarrhal gastroduodenopathy occurs due to the throwing of gastric or intestinal contents into the esophagus. Normally, the esophagus is an alkaline medium. The contents of the stomach has an acidic environment, which adversely affects the upper parts of the digestive tract. The main causes of reflux:

• Incorrect food.
• Diseases of the digestive system.
• Increase in intra-abdominal pressure (wearing tightly fitting clothing, torso torso forward after eating, pregnancy and increased body weight.
• Weakening of the lower esophageal sphincter.

The painful process is not always noticeable. Disease, before the appearance of more serious lesions of the mucous membrane does not manifest itself. Symptoms of catarrhal esophagitis are so vague that it is difficult to determine the disease from it.

Symptoms of catarrhal esophagitis:

• There is a burning sensation behind the sternum, which occurs after eating.
• Disturbs heartburn after a sharp or dry food. Sometimes it is a sensation of scratching in the throat or sadness.
• An eructation and a nausea.
• Pain in the chest zone, resulting from spasm of the muscles of the esophagus.
• The strong secretion of saliva is manifested as a protective reaction to the ingestion of the contents of the stomach, which has an acidic environment in the esophagus.

To diagnose catarrhal gastroduodenopathy it is necessary to undergo a complex of studies:

• X-ray of the esophagus;
• acidity level monitoring;
• esophagoscopy;
• Ezofagomanometry (studies of the motor function of the organ).

The main in the treatment of catarrhal gastritis is diet and nutrition.

[17], [18], [19]

Focal and diffuse gastroduodenopathy

During the study of the gastric cavity with the use of an endoscope, focal and diffuse areas of pathological changes in the mucosa can be detected. One of the violations of the integrity of the mucosa is focal or diffuse (common) erythematous gastroduodenopathy. The focal variant is diagnosed if the process has a local distribution. When changes capture a large area of the mucous membrane, they talk about diffuse pathology. This means that the color of the mucous membrane of the stomach is colored bright red. In a healthy state, its color is pink with a shade of gray. A red shade of the mucosa indicates that the cells experience the process of acute inflammation. Can be diagnosed with superficial gastritis.

[20], [21],

Superficial gastroduodenopathy

The most common pathology is superficial gastritis and superficial duodenitis.

Superficial gastritis precedes the initial stage of gastritis, making itself felt not by significant manifestations. Timely appointed and adequately conducted treatment will help get rid of the disease, otherwise it becomes chronic.

It depends on the department in which this pathology has appeared: antral; foundation; surface and pangastrit.

Superficial duodenitis is an inflammation of the duodenum, in which the folds of the mucosa thicken, there may be swelling of the internal organs.

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

Flows wavy. The stages of exacerbations alternate with remission and gradually change into more severe forms.

Periods alternate until superficial duodenitis becomes chronic.

To prevent the ulcer process will help therapy of superficial gastritis, which involves the use of medicines and rational nutrition. Excellent complement them with alternative methods.

Atrophic gastroduodenopathy

This is a common name for pathologies in the GI tract. It manifests itself in the form of atrophic gastritis or duodenitis.

Atrophic gastritis is a pathology characterized by loss of full-fledged working capacity by secretory glands, which stop in sufficient volume the production of gastric juice components. The glands turn into more simple functional units that produce mucus instead of gastric secretions. Usually, these processes occur against the background of a decreased pH of the stomach.

The danger of atrophic gastritis is that it can cause oncological processes in the digestive tract.

Atrphic duodenitis usually occurs with necrosis of intestinal villi and thinning of the mucous membrane. Violation of the secretion, pacreosimine, somatostatin, motilin, etc. Causes a disruption in the activity of the lower parts of the digestive tract, which affects the entire body. Patients with chronic duodenitis have asthenic, psycho-emotional and vegetative changes.

[22], [23], [24], [25]

Diagnostics of the gastroduodenopathy

Diagnosis of gastroduodenopathy consists of careful collection of anamnesis, examination of the patient, the appointment of laboratory tests and the necessary studies. An exact diagnosis can be made by a gastroenterologist when receiving the results of the examinations.

The list of diagnostic studies may include:

• esophagogastroduodenoscopy,
• fluoroscopy,
• study of gastric secretion,
• Ultrasound examination.

[26], [27]

Analyzes

In order to diagnose a gastroenterologist can recommend a general analysis of blood, feces, urine. Additionally, a test is required for the presence of Helicobacter pylori.

Determination of biochemical indicators of blood makes it possible to evaluate the work of internal organs and features of metabolic processes.

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

[28], [29],

Instrumental diagnostics

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

pH-metry. Helps assess the extent of acid, bicarbonate and mucus secretion by gastric cells.

Manometry and electrogastroenterography. The next step is the need to clarify whether the norm of gastric motility and digestive tract. The food gradually moves along the various parts of the gastrointestinal tract in a certain direction and at the required speed, and its grinding and mixing takes place. 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 a stomach ulcer or duodenal ulcer.

With certain diseases of the gastrointestinal tract, it is possible to designate radiation diagnostic methods - ultrasound, scintigraphy or radiographic methods.

Treatment of the gastroduodenopathy

Therapy of gastroduodenopathy depends on the neglect and prescription of pathological processes. In some situations, this is a complex and time-consuming process that requires care from the doctor and compliance with prescriptions by the patient.

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

Carrying out drug therapy, doctors can prescribe medications: De-Nol, Creon, Omeprazole, Omez, Trimedat. When manifesting a bacterial infection, antibiotics are recommended.

Treatment of gastroduodenopathy begins with a correction of nutrition.

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

In order to eliminate heartburn appoint antacid agents, for example, Fosfalugel. These drugs have a short-lived effect, but are effective.

Therapeutic measures are carried out at home. Duration of treatment for gastroduodenopathy varies - from a week and longer.

The course of treatment must be completed. Gastroduodenopathy, left untreated, may result in gastric and intestinal bleeding.

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

Vitamins

Complex vitamin preparations will be indispensable for the recovery of the body with gastroduodenopathy.

Diseases of the gastrointestinal tract of chronic nature lead to a lack of pyridoxine (Vit. B6), which leads to disturbance of metabolic processes, there are attacks of nausea and vomiting, changes in the nervous system, the risk of damage to the mucous membrane of the digestive tract increases, which can lead to bleeding. The most effective in this case will be vitamin B6. It is found in legumes and grain bread. In addition to it for normal operation of the stomach and intestines, the body will need:

Niacin (vitamin PP), which helps to normalize the production of gastric secretions. It will help reduce diarrhea. Products: meat, fish, cereals contain niacin. Can be realized in the pharmacy network as part of such drugs as nicotinic acid, Vitaplex N, and others.

Vitamin A (retinol acetate), helps prevent the emergence and development of infectious diseases. Retinol acetate contains bread, butter, cereal, sour-milk products.

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

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

Physiotherapeutic treatment

Physiotherapeutic procedures contribute to the healing process. After therapy with drugs of gastroduodenopathy, diadynamic currents can be prescribed; galvanization on 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; sessions.

During partial remission, patients are recommended to undergo treatment with: hirudotherapy; electrosleep; magnetotherapy.

The recurrent course of gastroduodenopathy involves the use of: reflexotherapy; phytopreparations and homeopathic remedies.

For children, doctors recommend using a combination of medication and physiotherapy procedures. If possible, take rehabilitation courses in special sanatoriums. In our time there is no clear scheme for the therapy of gastroduodenopathies, which gives a positive effect. Medicines are prescribed by the doctor, taking into account the clinical manifestations and the results of laboratory tests.

Herbal Treatment

In the therapy of gastroduodenopathy, alternative medicine offers its own treatment methods. Basically it is herbal teas. Here are some of them:

1. Infusion of flax. Flax seed (1 tablespoon) chop 0,5 liters of boiled water. Put on fire and boil for 15 minutes. Remove from heat. Insist 1 hour. Drink infusion should be three times a day for 0.5 tbsp. 1 hour before meals. The course of therapy is 1 month. Then you need to break 10 days and repeat the course.
2. Prepare the herb collection. Take by pinch: chamomile, St. John's wort, celandine. Take 1 tablespoon. Mixture and pour 2 liters of boiling water. Take three times a day for 30 minutes. Before meals.
3. It is necessary to prepare a collection of: chamomile, yarrow and St. John's wort. Grasses should be taken in equal proportions. 1 tbsp. Mixture pour 1 tbsp. Boiling water. Insist. Take as specified in the recipe above. The course of treatment is 10 days.
4. Prepare the herbal collection of leaves of nettle, plantain, St. John's wort, chamomile flowers in equal proportions. Dried raw materials to grind in a coffee grinder. 2 tablespoons mixture pour 0.5 liters of boiling water in a thermos and insist overnight. Take a quarter cup three times or four times a day before meals. Course of treatment 1-1,5 months.

Homeopathy

Among homeopathic remedies, there are many drugs used for various gastroduodenopathies. A homoeopathic remedy and its dosage is prescribed by a homeopathic doctor.

When acute inflammation of the stomach is prescribed:

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

As spasmolytic drugs use Nux vomica, Spascupreel, Gastricumeel. The last medicine on the list reduces pain, but in addition, it has a sedative effect. Argentum nitricum is also used as a sedative in erosive inflammation.

Complex preparations - Iris versicolo, Kalium bichromicum, Acidum sulfuricum contribute to an increase in appetite, positively affect the mucous membrane of the stomach and intestines.

Sulfur helps the digestion process.

Operative treatment

The surgical method of treatment is resorted to in extreme cases - with bleeding (gastric, intestinal).

In case of bleeding, the patient is urgently treated with fibrogastroscopy. When the cause of bleeding is established, then an emergency operation is performed.

Diet with gastroduodenopathy

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

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

Of products with gastroduodenopathy recommended:

• Soups (cereals and vegetables on broth) are wiped.
• Porridge (from buckwheat, oatmeal, rice cereal), boiled or grated.
• Lean meat.
• Cutlets for a couple.
• Low-fat boiled fish, black caviar.
• Scrambled eggs.
• Kefir, yogurt, milk.
• Bread stale (white, gray).
• Wiped vegetables, fruits (boiled, raw).
• Juice, tea with sugar.
• Marmalade.

[30], [31], [32]

Prevention

Preventive measures for gastroduodenopathy include:

• fractional balanced eating,
• prevention of diseases of the oral cavity, nasopharynx,
• reduction of stressful situations,
• adherence to the daily routine,
• walks in the open air.

[33],

Forecast

The prognosis for not advanced stages of gastroduodenopathy is favorable. If there was hyperemia on the mucosa caused by the Helicobacter pylori bacterium, then antibiotic treatment is performed. In the early stages, the disease is well curable.

If gastroduodenopathy is caused by external factors (stress, inadequate nutrition, addiction to alcohol), the improvement of the patient's condition will be helped by a lifestyle correction.

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