Atrophic gastritis or more correct medical name atrophy of the gastric mucosa - This is an irreversible process in which the death of cells in the gastric mucosa that produce gastric juice and hydrochloric acid occurs. Atrophy also includes the gradual replacement of stomach cells with connective tissue and cells similar in structure to the cells of the intestinal mucosa.
Atrophy of the gastric mucosa is a dangerous condition for health, since over time and especially in the presence of additional risk factors, it can lead to the development of stomach cancer.
Causes of atrophic gastritis
There are more than ten different causes, each of which can lead to atrophy of the gastric mucosa. Most often, this condition is the result of a long course of inflammation, against the background of chronic gastritis.
Chronic gastritis is a common disease (found in up to 30% of the population in various populations), which has a chronic and recurrent course, manifested by inflammation of the gastric mucosa and confirmed by morphological examination.
The causes of the development of chronic gastritis are:
- presence of Helicobacter pylori infection (H. pylory);
- inflammation caused by an autoimmune process, when your own immune system damages the cells of the gastric mucosa;
- long-term use of medications, such as non-steroidal anti-inflammatory drugs (NSAIDs);
- doudenogastric reflux, when the contents of the duodenum, including bile, are thrown into the stomach;
- prolonged contact with harmful substances during work;
- exposure to radiation;
- the presence of other chronic diseases, for example, celiac disease, Crohn's disease, sarcoidosis;
- food allergies;
- endocrine disorders;
- other infections (except H. pylori), fungi, parasites.
That is, in most cases, atrophy of the gastric mucosa is the result of the most common (80%) chronic gastritis caused by Helicobacter pylori infection, or autoimmune gastritis, which occurs in 1-2% of cases. This article discusses in detail the atrophy associated with these two causes.
Folk remedies and diet
Diet is a prerequisite for stomach treatment
Diet is an integral part of treatment. Since the gastric mucosa is affected, all food should be light, prepared without the use of oil, in order to reduce the load on the sore stomach. Coarse fibers should be excluded. It is advisable that the food be finely chopped or twisted. It is necessary to monitor the temperature of food. You will have to give up everything hot and cold. Dishes should only be warm.
All products containing spices, seasonings, carcinogens, large amounts of salt, smoked foods, carbonated and alcoholic drinks, canned food, cream cakes, chocolate, homemade and store-bought pickles are prohibited. Fried foods and fatty meats should also be excluded from the diet. Meat dishes should be lean and steamed. Boiled vegetables are better. Low-fat and non-acidic dairy products are allowed. You can use pureed soups made from vegetables, without meat broths or frying. Drinks allowed are non-acidic natural mousses and jelly, still mineral water, and weak tea. \
Remember that medicinal mineral water, which is sold in pharmacies, cannot be drunk unlimitedly. This is a medicine containing a certain amount of substances and minerals. The dosage is determined by the doctor.
Try in every possible way to increase your appetite to prevent exhaustion. Let the dishes be served beautifully; they should look attractive to you even without spices and mayonnaise. As an additional treatment, your doctor may prescribe herbal teas or tinctures of herbs that improve digestion. So, for atrophic gastritis, a mixture of calamus rhizome, honey and cognac, as well as St. John's wort, plantain, yarrow, peppermint, cumin, flax seed, sage, dill is useful. Natural blueberries, ground with sugar, will help restore the gastric mucosa. You need to take a teaspoon on an empty stomach in the morning. But the berries must be fresh. Jam will not give the desired effect, since most vitamins are destroyed during heat treatment.
What happens to mucosal cells during atrophy?
The gastric mucosa consists of three layers. The top layer covering the entire inner surface of the stomach is formed from cells that produce mucus to protect against the aggressive effects of gastric juice. Beneath it is the most important layer, called the “lamina propria of the stomach.” It contains the glands of the stomach, which produce substances that form gastric juice - hydrochloric acid, pepsin, hormones (internal Castle factor). The third layer contains muscle cells, the main task of which is to ensure the mobility of the gastric mucosa to move food along.
Atrophy of the gastric mucosa affects the upper layer and the lamina propria of the stomach and is an almost irreversible process that can be slowed down if the causes of inflammation are eliminated.
The gastric mucosa is exposed to an aggressive environment, so its cells are completely renewed every three days. The inflammatory process, which develops as a result of the influence of external factors, for example, a bacterial infection or internal causes, for example, the reaction of the immune system, disrupts the process of renewal (regeneration) of cells of the gastric mucosa, including the cells of the gastric glands that produce gastric juice. As a result, the cells of the stomach glands die and are replaced by connective tissue cells, as well as cells similar in structure to intestinal cells.
This process can be diagnosed using histological examination of samples of the gastric mucosa. If only a decrease in the number of cells of the gastric glands is detected, then they speak only of atrophy of the gastric mucosa. If intestinal cells are found in the test sample, then a diagnosis of atrophy with intestinal metaplasia is established. Metaplasia is the appearance of cells that are atypical for a given organ.
Complications
The main cause of complications is the chronic form of the disease. If signs of chronic gastritis appear, but the patient does not consult a doctor, the following complications may occur:
- anemia;
- atrophic gastritis;
- leptic ulcers;
- benign or malignant tumors on the mucosa.
The only way to restore health is to promptly consult a qualified doctor who will give recommendations on how to treat gastritis. Taking pills for gastritis on your own is not recommended, so as not to provoke an exacerbation of the disease and its transition to a severe form. The likelihood of complications depends on what patients with chronic gastritis eat.
How to correctly diagnose gastric mucosal atrophy?
To diagnose atrophic gastritis, FGDS (gastroscopy) with the collection of at least 5 biopsies (small fragments of mucous membrane) from different parts of the stomach. The number of biopsy samples is determined by the structure of the stomach, since atrophy in different sections develops at different rates, and therefore it is necessary to take samples from all five sections.
The diagnosis is established by a morphologist after a histological examination. Based on this study, treatment is selected and the frequency of examinations is determined for the timely detection of the oncological process.
Also, to assess the severity of atrophy, determination of the activity of the secretory function of the stomach using a laboratory blood test is used - Gastropanel (link).
Diagnosis of Helicobacter pylori infection is carried out using biopsy specimens and a 13C-urease breath test .
For autoimmune gastritis, laboratory diagnostics are carried out using a blood test to determine antibodies to stomach cells and internal Castle factor.
Diagnosis
First, the gastroenterologist listens to the patient’s complaints, studies the medical history, and performs palpation.
If necessary, the doctor can refer for diagnostics (methods are chosen individually):
- pH measurement to assess the secretory activity of parietal cells;
- study of gastric enzyme activity;
- gastrography to study the motor function of the stomach;
- endoscopy - allows you to examine the mucous membrane;
- fibrogastroduodenoscopy - shows thinning of the mucous membrane;
- ultrasound examination - reveals smoothing of the folds of the stomach;
- biopsy followed by histological analysis.
bacterial analysis to determine the presence of the bacterium Helicobacter pylori;
Atrophic gastritis associated with Helicobacter pylori infection
After infection with the bacterium Helicobacter Pylory, inflammation and chronic non-atrophic gastritis develop in the gastric mucosa. At the beginning of the disease, the glands of the stomach produce a sufficient amount of gastric juice. If left untreated, inflammation becomes more active and spreads to all parts of the stomach, leading to mucosal atrophy) and partial replacement of stomach cells with intestinal cells (intestinal metaplasia).
Symptoms
At the onset of the disease, gastritis is asymptomatic. As atrophy progresses, symptoms appear associated with a decrease in the production of hydrochloric acid and other components of gastric juice:
- loss of appetite,
- belching of air or rotten belching;
- nausea;
- feeling of heaviness and fullness in the stomach;
- bad breath; salivation, unpleasant taste in the mouth;
- rumbling, bloating;
- intolerance to certain foods;
- unstable stool;
- dull, aching pain that intensifies after eating;
- weight loss.
Treatment
Eradication (destruction) of Helicobacter Pylory is the first stage of treatment for this variant of atrophic gastritis.
Directions for treatment in the presence of a chronic disease
When infected with Helicobacter pylori, the only cure is eradication of the infectious agent. The functions performed include preventing the spread of infection, preventing the possibility of bacteria becoming unsusceptible to antibiotics, reducing the duration of the course of therapy and the number of drugs and the risk of side symptoms.
Antibiotics like tetracyclines and penicillins and medications based on metronidazole, proton pump inhibitors, bismuth agents, and the like are used as tools that prevent the spread of bacteria or the exacerbation of chronic moderately atrophic gastritis
Autoimmune atrophic gastritis
With this type of chronic gastritis, stomach cells are damaged by antibodies produced by the body's own immune system. In this case, chronic inflammation develops, leading to atrophy of the gastric glands and a decrease in the production of hydrochloric acid and internal Castle factor, which ensures the absorption of vitamin B12. A significant decrease in the production of intrinsic factor of Castle can cause anemia B12-deficiency anemia (pernicious anemia) - a disease characterized by impaired hematopoiesis.
Symptoms
The symptoms of autoimmune atrophic gastritis are similar to the symptoms of atrophy caused by Helicobacter pylori infection.
Additionally, anemia develops; autoimmune gastritis can often be accompanied by other autoimmune diseases.
Treatment
There is no specific treatment for autoimmune gastritis; treatment with corticosteroids is used only in exceptional cases.
Prevention
In a conversation with Dr. Boldyreva, we asked a question about the possible prevention of gastritis. According to her, the occurrence of this disease can indeed be prevented. However, for this it is important to adhere to proper nutrition - try to consume fatty and rough foods as little as possible. The same applies to alcohol, which has a detrimental effect on the entire gastrointestinal tract.
In addition, the doctor recommended avoiding stress, because problems with the nervous system primarily affect the stomach. Also, special attention should be paid to physical activity, because a sedentary lifestyle has never made anyone healthier.
Therefore, if unpleasant sensations appear in the stomach area, there is no need to delay treatment. It is better to immediately contact a professional, find the cause of the pain and cure it as soon as possible.
When to see a doctor
You should consult a doctor if you feel severe pain with gastritis of the stomach, since exacerbation of gastritis can cause a serious deterioration in health with an increase in the area of mucosal damage and transition to an ulcerative state. Gastritis is especially dangerous if there is increased acidity, since the juice tends to corrode the mucous membrane of the organ, resulting in the formation of ulcers. If, based on a number of signs, the patient has identified an exacerbation of gastritis, the symptoms of which are nausea to vomiting, complete loss of appetite, fever up to 39 degrees Celsius and severe pain, you should make an appointment with a specialist as quickly as possible.
Gastritis, the symptoms and treatment of which may vary in adults, is diagnosed by a gastroenterologist. The Center for Modern Medicine JSC "Medicine" (academician Roitberg's clinic) in Moscow offers diagnostic and treatment services for all types of gastritis using modern medical devices and drugs. More complete information on the topic “gastritis and its treatment in adults” can be obtained by clicking on the link. Our clinic is located at 2nd Tverskoy-Yamskaya Lane, building 10, a 5-minute walk from the Mayakovskaya metro station.
