Gastric dysplasia is a chronic pathology in which the squamous epithelium of the gastric mucosa begins to proliferate, its cells mutate. Then they replace he althy cells, this is already called metaplasia. Dysplasia is the replacement of one tissue by another as a result of a mutation. The process can occur in almost any organ. The stomach is no exception.
The word itself means wrong development. The diagnosis of "dysplasia" is not made without specifying the part of the body, tissue or organ where it is found. The squamous epithelium of the CO (mucous membrane) changes its structure so noticeably that it completely ceases to produce a secret, thus violating the general secretion of the stomach. The life span of the epithelial cells themselves with dysplasia of the epithelium of the stomach is reduced.
Important! It is the dysfunction that leads to cell death.
Mechanism for change
The epithelium changes its histological structure and tinctorial properties (ability to stain). Flatthe epithelium begins to transform and be replaced by atypical cells.
Secretion in dysplasia of the epithelium of the stomach decreases - parietal and main cells responsible for the production of gastric juice begin to work weakly and are pushed to the periphery. They quickly begin to die.
Dysplasia is practically a transitional stage between hyperplastic processes and cancer. This is the basis of its danger. The probability of malignancy is 75%.
The process is always progressing, and initially focal gastric dysplasia begins to actively capture new areas, the process becomes generalized. The stomach is affected not only in breadth, but also in depth. Moreover, dysplasia, starting from glandular cells, passes into the upper layers of the liver, mammary glands, genital organs, etc. Then dysplasia develops in these areas.
Reason for development
According to a variety of studies, it has been proven that the development of gastric dysplasia directly depends on diet and ecology.
Factors-provocateurs are combined into 2 large groups: external and internal.
External causes:
- the biggest offenders are smoking and alcohol;
- followed by insufficient intake of minerals and vitamins from food;
- malnutrition with a predominance of all carcinogenic foods and simple carbohydrates;
- passion for s alt and red meat;
- spicy, sour, smoked, canned;
- junk food in the form of convenience foods, fast food, chips, mayonnaise, etc.;
- irrational eating - snacking on the go, overeating, dry food, a hearty meal once a day in the evening.
Fact! The most harmful product is vinegar - a direct provocateur of dysplasia. This is especially true of the gastrointestinal tract.
The leading place belongs to smoking, it causes a mutation not only in the cells of the stomach, but also in other internal organs in 99% of cases, i.e., in other words, dysplasia is a disease of smokers.
The systematic use of alcohol causes a violation of the morphology and structure of cells at the gene level. This also includes bad ecology, work in hazardous industries, exposure to radiation, poisoning with chemicals, alkalis and acids.
External factors of damage also include long-term use of medications - oral contraceptives, hormones, non-steroidal anti-inflammatory drugs, cardiac glycosides, cytostatics, aspirin, etc.
Internal causes:
- poor absorption of useful trace elements due to chronic stomach diseases;
- their lack in diet;
- decreased immunity and body attacks as a result of viruses and bacteria;
- hereditary predisposition to diseases of the gastrointestinal tract, so babies from such families immediately fall into the risk group;
- genetic cell mutations;
- immunodeficiency states;
- endocrinopathy – diabetes, pancreatitis, hypothyroidism, thyretoxicosis;
- increased production of hydrochloric acid by the stomach;
- dysbacteriosis of the gastrointestinal tract;
- infectious lesions - helicobacteriosis, dysentery, salmonella, intestinalwand.
Important! The main damaging factor is an unbalanced diet and an unhe althy lifestyle.
Degrees of severity of dysplasia
Any dysplastic process in any organ always has 3 main degrees, or they can be called features: disorganization of the structure of the mucous membrane (SO), cell atypia and impaired differentiation.
Dysplasia of the gastric mucosa can be hyper- and hyposecretory by the nature of changes in secretion production.
With hypersecretory dysplasia in the glandular epithelium, the number of granules increases, these destructured cells are located separately at first.
Hypersecretion according to the degree of manifestation can be mild, moderate or severe.
In pathology, there are three stages or stages of development:
- І degree of gastric dysplasia - hyperchromatosis appears (chromatin increases in the nucleus, and the nucleus becomes sharply colored). The core itself also increases and pushes the plasma to the periphery, the production of the mucosa decreases. Such an epithelium begins to metaplase, being replaced by the intestinal one.
- II degree - the process continues to grow, cells begin to divide even more often and faster. Against this background, the number of Paneth cells and goblet cells decreases. Goblet cells belong to the stomach, they produce mucus, Paneth cells belong to the small intestine. Thus, the division increases in the cells of the small intestine. Clinical symptoms become more pronounced.
- III degree of gastric dysplasia - the process of proliferationgeneralized, the secret is now not produced at all. Atrophic gastritis develops - a precancerous condition. There may be a picture of peptic ulcer. The onset of dysplasia is treated successfully with conservative methods. She is always reversible. 3rd stage - can be combined with atrophic gastritis and gastric polyps. The risk of rebirth is 75%.
Hyposecretory dysplasia is the opposite process, but no less insidious. The granules in the cells become smaller, the secret too. Identified moderate gastric dysplasia, and even more pronounced, are markers of a high risk of oncology.
From the types of cancer, moderately and well-differentiated adenocarcinomas often develop.
Intestinal metaplasia of the stomach
Intestinal dysplasia of the stomach, or metaplasia, is the transformation at the cellular level of the gastric glandular epithelium into the intestinal one. The production of hydrochloric acid by parietal cells stops completely.
There are 2 types of such intestinal pathology of the stomach. If mutated stomach cells are replaced by cells in the small intestine, this is dangerous, but treatable. If colon cells take their place, then there is a greater risk of cancer, treatment is possible, but it is impossible to predict the result.
Tubular adenoma of the stomach
Adenoma of the stomach, or polyps, are benign neoplasms. Despite this, they always require urgent treatment.
There are 3 varieties, the most common and combined with dysplasia tubular adenoma of the stomach. She under microscopyhas clear contours, crimson color and a constant ability to grow. Her complications are obstruction of the digestive tract.
Tubular adenoma of the stomach and dysplasia are very closely related, as they affect the mucosal lesions. They pair often.
Most often, adenoma can develop at the 2-3rd stage of gastric dysplasia. The work of the stomach with adenoma is not disturbed. There are also no symptoms for a long time. If an admixture of blood appears in the stool, an adenoma can be diagnosed during examination of the patient. With its intensive growth, the patient develops heaviness after eating, appetite decreases and nausea appears.
Clinical picture
The initial stages or degrees of gastric dysplasia usually do not have symptoms, this is the difficulty of early diagnosis, so the best way out is to examine patients at risk and with provoking factors. The patient may sometimes notice discomfort in the stomach, heaviness after eating, increased fatigue.
With grade 2 dysplasia, signs of discomfort become more pronounced:
- Pain in the epigastrium becomes more frequent, and then permanent; they may or may not be related to food.
- Heaviness in the stomach is now constantly present.
- Nausea - especially quickly occurs when eating poor quality food.
- Heartburn - indicates the addition of gastroesophageal reflux disease (GERD).
- Belching air or stomach contents with a sour taste. The stomach may swell with gas.
3rd grade dysplasia:
- The secretion of the stomach sharplyreduced. Pain, abdominal distension and discomfort are intensified and persistent.
- Slimming.
- Symptoms of constant weakness and fatigue.
- Anemia and folic acid deficiency.
- The skin becomes dry, inelastic, although dryness itself does not indicate dysplasia.
- Dyspeptic disorders - diarrhea, followed by constipation.
- Complications may appear in the form of bleeding from the stomach or intestines. They present with vomiting and black stools.
Any of these signs require immediate medical attention.
Diagnostic measures
For diagnostic use:
- Ultrasound.
- Helicobacter pylori tests.
- Research of pH-metry, gastric juice.
- Endoscopic examination.
- Biopsy of the affected area of the stomach - performed during endoscopy, the procedure is painless.
- Fecal and urine tests.
Additional research methods include fluoroscopy, biochemical blood tests.
Therapeutic interventions
Treatment of gastric dysplasia will be positive only if it is complex. The patient's attitude should be for long-term treatment. All therapy includes:
- drugs;
- diet;
- sometimes radical treatments.
Important! Alternative methods for dysplasia are ineffective and harmful, because precious time is wasted on them.
Radical methods - endoscopic resection or cryodestruction, also performed endoscopically.
Resection is performed in extreme cases, no special preparation of the patient is required. It removes the affected part of the stomach and is a complete operation.
Dysplasia is not treated within a month, patience is required for several years. Help in therapy can be a review of your diet. It is also a rejection of bad habits, the exclusion of carcinogenic foods, it is advisable not to eat red meat, canned food, exclude soy, etc.
Drug therapy
Treatment of gastric dysplasia is most successful in the focal form of the lesion. This form leaves no complications behind. Stage 3 borders on oncology and requires urgent treatment by an oncologist.
Conservative treatment includes 3 main links of drugs:
- antibiotics;
- PPIs - proton pump inhibitors;
- bismuth preparations.
Metabolics, symptomatic agents can also be used.
Healing Links
Proton pump inhibitors reduce the production of hydrochloric acid in the parietal cells of the stomach - Zulbex, Rabelok, Pariet, Ontime, Lanzap, Omez, Omeprazole, Emanera, etc. Children under 12 are not prescribed.
When Helicobacter pylori is detected, the task of treatment becomes its complete destruction.
Antibiotics aim to killHelicobacter pylori bacteria are Amoxiclav, Clarithromycin, Azithromycin. Appointments are made only by a doctor. Self-medication is excluded.
Bismuth preparations protect the gastric mucosa, are considered gastroprotectors. The most famous is De-Nol, followed by Ulcavis, Gastronorm, Vikalin, Vikair, etc. These drugs should not be taken for longer than 8 weeks.
Treatment is symptomatic: for pain, antispasmodics can be recommended, for vomiting - Cerucal, for heartburn - Maalox, Rennie, Almagel, etc.
Important! Antibiotics for gastric dysplasia give an effect in patients under 18 years of age, they do not affect the formed mucosa.
Proper nutrition in the treatment of disease
Any treatment always begins with the correction of nutrition and daily routine. In the diet, they limit carbohydrates, fats, and focus on protein. Nutrition correction is important from the very beginning.
At any stage of the disease, there should be a sufficient amount of fluid entering the body.
It is especially good to use fresh fresh juices (preferably not store-bought). Onion, garlic and radish, for which Chinese scientists advocate so much, can be preventive only in the absence of hyperacid gastritis and ulcerative lesions. For the same purpose, citrus fruits are contraindicated. S alt intake should be kept to a minimum.
Low-fat cottage cheese and kefir are useful. The ratio of BJU should be correct: most should be occupied by proteins, less by fats and carbohydrates.
Heat treatment –complete exclusion of frying, steaming only, stewing and boiling is possible. The frequency of meals is 5-6 times in small portions. Starvation for weight loss and extreme diets are excluded. After eating, it is advisable to take a short walk to stimulate the digestion process.
Indicating the correctness of the diet is an improvement in metabolism and weight gain. The main criterion for choosing a product should be its usefulness for the stomach. Eat immune-boosting foods more often.
Prevention
It is necessary to lead a he althy lifestyle, keep a balanced diet. Fiber, fresh vegetables and fruits, greens should be introduced into the diet.
Required scheduled check-ups with a doctor every six months, especially for children.
You should stop smoking and drinking. Moderate physical activity will be useful.
It is necessary to strengthen the immune system - lactobacilli support it well - "Linex", "Acipol", Omega-3 acids, antioxidants - vitamin C and selenium.
Women ask a lot of questions. Judging by the reviews, many did not even suspect not only that they had a problem, but in general about the existence of such a pathology. But the unanimity of the reviews is that the treatment is always long-term, it is desirable to start it as early as possible.
