Inflammatory changes in the stomach are observed in most people. In some cases, the person is not even aware of the presence of the disease. The high incidence of gastritis is associated with the nature of nutrition. Indeed, such factors as the use of spicy, fatty and fried foods lead to irritation of the gastric mucosa. In addition, one of the causes of gastritis is stress. Since the stomach is innervated by the vagus nerve. Often gastritis develops in people who smoke a lot and drink alcoholic beverages. The symptoms of this pathology are similar to the manifestations of many diseases. Therefore, the diagnosis of gastritis is very important. First, the identification of this disease is necessary for the appointment of treatment. Secondly, diagnosis is needed to distinguish gastritis from other pathologies. Thanks to special studies, it is possible to identify not only inflammation of the stomach, but also its stage.
What is gastritis: varieties
Inflammatory process of the gastric mucosa is called gastritis. The disease can have an acute and chronic course. In the firstIn this case, inflammation occurs under the influence of a provoking factor and is completely treatable. If the pathology is chronic, then there is a thickening of the organ wall and replacement of the mucous membrane with connective tissue. In this case, there are both periods of recovery (remission), as well as periodic exacerbations. Diagnosis and treatment of gastritis depends on the type of inflammation. There are several forms of the disease. Among them:
- Catarrhal gastritis. This form of inflammation is characterized by a mild course. It occurs in most patients. Often, catarrhal gastritis does not have pronounced clinical symptoms, especially in chronic cases.
- Fibrinous inflammation. May develop as a result of damage to the stomach by chemicals (burns with acids, alkalis).
- Phlegmonous gastritis. Occurs with injuries of the abdominal cavity, the spread of infection.
Chronic inflammation can be superficial, erosive, hyperplastic, autoimmune, atrophic, etc. Such forms of gastritis should be diagnosed as early as possible, as they often cause gastric ulcer, GERD, cancer.
What are the methods for diagnosing gastritis?
With timely detection of the disease and treatment, full recovery or long-term remission can be achieved. Diagnosis of gastritis of the stomach includes several stages. The first of these is the collection of complaints and anamnesis. The doctor specifies what symptoms the patient has (duration, localization, nature of pain),when they occur (how long after eating). It is also important to learn about the patient's diet, the presence of stressful situations, and other manifestations of pathology.
The next step in the diagnosis is an objective examination. Attention is paid to the organs of the digestive system. It is important to assess the condition of the tongue, to palpate the abdomen. Gastritis is characterized by discomfort in the epigastric region, as well as in the left hypochondrium. Most often, pain appears 15-40 minutes after eating. Thanks to this, it is possible to understand in which part of the stomach the inflammatory process predominates.
In addition, the diagnosis of gastritis includes laboratory and instrumental research methods. The first include KLA, OAM, analysis of gastric contents, microscopy of organ tissue. Among instrumental studies, FEGDS is of particular importance.
Diagnosis of gastritis by laboratory methods
First of all, if any inflammatory disease is suspected, general blood and urine tests are performed. In acute gastritis (or exacerbation), leukocytosis and a slight acceleration of ESR are observed. If the causative agents of inflammation are bacteria, then neutrophilia occurs in the KLA. With viral inflammation - an increase in the number of lymphocytes. In some cases, analysis of gastric contents is performed. Laboratory diagnosis of gastritis includes the study of biopsy specimens (pieces of tissue taken during FEGDS). This method is carried out only if hyperplastic processes in the stomach are suspected. These include cytology andhistological examination. Also, some patients undergo a urease test. It allows you to detect the presence of Helicobacter pylori. This study is carried out in 2 ways (breath test or microscopy).
Methods of instrumental diagnosis of gastritis
Instrumental methods include X-ray, ultrasound and endoscopic diagnosis of gastritis. FEGDS is considered the "gold standard". Thanks to this procedure, it is possible to determine the nature of inflammation, its localization, the presence of complications (ulcers, hyperplasia). In addition, during gastroscopy, a biopsy of "suspicious" tissue is performed. In some countries, such a study is included in screening programs. This allows you to prevent several pathologies at once. Among them are gastritis, peptic ulcer of the stomach and duodenum, benign tumors and cancer.
X-ray diagnostics is not particularly informative in inflammatory processes. However, it is essential for an accurate diagnosis. An x-ray of the stomach is performed with suspicion of peptic ulcer and its complications. For the purpose of differential diagnosis, ultrasound of the abdominal cavity is also performed. It helps to identify diseases such as pancreatitis, cholecystitis and hepatitis. All of these pathologies can have similar symptoms to inflammation of the stomach.
How to diagnose gastritis in children?
Diagnosis of gastritis in children is the same as in adults. However, it is more difficult to suspect this disease in a child. This is especially true for childrenyounger children who cannot explain what exactly is bothering them. Most often, acute gastritis occurs against the background of poisoning (food poisoning). Chronic inflammation in most cases occurs in middle childhood, in adolescence. This is due to the fact that parents do not control the diet of their child, as he begins to spend a lot of time outside the home. The development of gastritis is facilitated by eating fatty foods (fast food), chips, crackers, etc. Diagnostic methods include x-ray, endoscopic and ultrasound examinations. When washing the stomach, its contents are examined to exclude infectious pathologies. Stool microscopy is also performed. Differential diagnosis is carried out with parasitic invasions, biliary dyskinesia, acute appendicitis. These pathologies are most common in children.
What diseases of the abdominal cavity differentiate acute gastritis?
The most important stage is the differential diagnosis of gastritis. After all, the correctness of treatment and further prognosis depend on it. It should be noted that in acute gastritis, clinical manifestations are more pronounced, in contrast to chronic pathology. Characteristic manifestations are: nausea and vomiting, pain in the upper abdomen, fever, increased heart rate. These symptoms are especially pronounced in young children. Differential diagnosis of acute gastritis is carried out with surgical, infectious and cardiovascular pathologies, gastric ulcer.
Chronic inflammatory process is not as pronounced as acute. Symptoms of gastritis may resemble exacerbation of other pathologies of the gastrointestinal tract. Among them are chronic cholecystitis, pancreatitis, hepatitis, peptic ulcer of the stomach and duodenum. Also, gastritis is differentiated from helminthic invasions. To distinguish inflammation of the stomach from other diseases, it is necessary to conduct FEGDS.
Features of diagnosis in atrophic gastritis
Atrophic gastritis is more dangerous than other forms of the disease. This is due to the fact that it often leads to tumor degeneration of the tissues of the stomach. More often atrophic gastritis develops in the elderly. The clinical feature of this form of the disease is the erasure of symptoms. Sometimes there may be belching, nausea, discomfort in the stomach.
Diagnosis of atrophic gastritis is based on the endoscopic picture. Characterized by thinning of the walls of the stomach, destructive processes, signs of inflammation - edema, hyperemia of the tissue. In this case, it is necessary to conduct a biopsy of the affected areas. Histological examination reveals depletion of the cellular composition, a decrease in elements in size, and functional insufficiency.
The difference between acute gastritis and infectious pathologies
It should be remembered that some food poisoning occurs with the syndrome of gastric dyspepsia, which is also characteristic of acute gastritis. A distinctive feature is the specificity of the disease. Infectious pathologies are always caused by a specific pathogen. They are characterized by rapid developmentsymptoms of intoxication (nausea, fever, headache, general weakness). Often gastritis is combined with enteritis and colitis. That is, in addition to damage to the stomach, inflammation of the intestine occurs. This is manifested by diarrhea, the appearance of pathological impurities in the feces (streaks of blood, pus), pain in the lower abdomen.
How to tell gastritis from appendicitis?
Acute gastritis must be differentiated from appendicitis. After all, at the beginning of the disease, these pathologies have the same manifestations. With appendicitis, pain in the epigastrium, subfebrile body temperature, nausea, vomiting, and lack of appetite are noted. However, the clinical picture begins to change after a few hours. The pain "moves" to the right iliac region, the temperature becomes higher. In young children, it is impossible to distinguish these diseases by the clinical picture, therefore it is necessary to exclude appendicitis in the first place. For this purpose, a CBC and a urinalysis are performed, as well as a check for specific symptoms.
Differential diagnosis between gastritis and myocardial infarction
You should know that a disease such as myocardial infarction can occur atypically. In some cases, its symptoms resemble those of acute gastritis. Therefore, the elderly should first do an ECG. In addition, you need to find out if the patient had pain in the heart area, increased blood pressure, tachycardia.
Treatment of acute gastritis
Diagnosis of gastritis is important for therapeutic measures. dependingdepending on the form of the disease, there may be differences in drug therapy. In acute gastritis, the main method of treatment is diet (table number 1). Etiological therapy is also important. For this purpose, antibiotics are prescribed ("Azithromycin", "Metronidazole"). With an increase in acidity, it is necessary to use medicines "Omez", "Pantoprazole". Enveloping agents are also prescribed. These include drugs "Almagel", "De-nol".
