This year, the Congress of the Society of Gastroenterology, the largest of the regular forums of the community of gastroenterologists, took place. The Society of Gastroenterology has existed for over 100 years and is the third in the world in terms of creation. Its congresses are held every two years, each time in a different university city, and attract the attention of doctors of various specialties - gastroenterologists, surgeons, endoscopists, family doctors, pediatricians, as well as specialists involved in theoretical, fundamental problems of physiology and pathology of the digestive system.
The development of new world methods of treating gastritis
The main goal of the congress was the continuous training of doctors and raising their professional level - the reports were of a lecture nature and introduced doctors to the current level of knowledge about the diagnosis and treatment of digestive diseases, national, European and world instructions for actions necessary when the patient has an antrum (stomach). The congress was attended by over 1,500 specialists. Among others, a group of endoscopists from Russia attended the congress.
Helicobacter pylori ( Helicobacter pylori ) - a common cause of gastritis
Since the vast majority of the adult population is infected with Helicobacter pylori (therefore, it has at least morphological signs of chronic gastritis), in many Western countries the diagnosis of chronic gastritis of the antrum is not considered clinical. This is a morphological concept, and in the case of clinical signs of pathology, they are considered as functional (non-ulcer) dyspepsia. The favorite localization of Helicobacter pylori, as you know, is the antrum (stomach), so chronic Helicobacter pylori gastritis usually begins with damage to the antrum.
Considering that there are no main and parietal cells in the antrum of the gastric mucosa , it is clear that gastritis is not accompanied by hypoacidity. On the contrary, Helicobacter pylori is able to stimulate G-cells, increase gastrin production, and cause the antrum polyp of the stomach. It is for this reason that antral gastritis is often combined with a duodenal ulcer.
However, the long-term persistence of Helicobacter pylori in the antrum leads to atrophic changes in this area, and helicobacteria gradually move in the proximal direction, which causes an ulcer of the antrum. This leads to a gradual atrophy of the epithelium of the body of the stomach, which is manifested, in particular, by a decrease in the number of main and parietal cells, and, consequently, in gastric secretion.
Given the above pathogenetic aspects, it is clear why the generally accepted classification of chronic gastritis is Sydney-Houston, 1996. The main form of chronic gastritis is considered to be atrophic (antral) gastritis, when the antrum (stomach) is affected and there is no secretory insufficiency.
Chronic pancreatitis
Chronic pancreatitis is a chronic inflammation, damage to the pancreatic tissue with destruction of its parenchyma, fibrosis and, in its later stages, destruction of the endocrine parenchyma. The frequency of chronic pancreatitis when the antrum (stomach) is affected is 6–9%. Chronic pancreatitis becomes such if the pathological process lasts more than 6 months.
Classification: pancreatitis of alcoholic etiology, chronic recurrent pancreatitis, infectious, hereditary, idiopathic, autoimmune.
Etiology: alcoholism; violation of the diet (fatty, fried foods); periodic hypotension with cold sweat, fainting; paresis of the intestine; compression syndrome of adjacent organs: jaundice, duodenostasis, splenomegaly.
Diagnosis: general blood test: leukocytosis, ESR acceleration, eosinophilia.
New directions in the treatment of chronic gastritis
Among the successful directions in the treatment of chronic atrophic gastritis , replacement therapy should be mentioned, however, it is difficult to carry out today due to the lack of drugs to correct the inadequate production of pepsin and hydrochloric acid by the stomach cells (one of the drugs of this direction, Acidin-Pepsin, recently rarely find in pharmacies). One of the components of the treatment of chronic gastritis with low acidity is enzyme preparations, which to some extent compensate for digestive disorders. They are effective in erosion of the antrum. These include Panzinorm. For the treatment of such patients, drugs are used that normalize the motor function of the stomach. To improve the cytoprotective properties of the epithelium of the stomach, individual patients are prescribed Sucralfate (Venter) and bismuth preparations. In case of dysbiotic changes, eubiotics or probiotics are added.
Gastric Drop Treatment
A promising treatment for patients in gastroenterological departments today is the use of antioxidants, in particular preparations of vitamins A, E, C. However, today it is recommended that patients not decoctions or tinctures, but ready-made herbal preparations prepared from mixtures of medicinal herbs. Among them, the preparation "gastric drops" deserves attention. There are several varieties of it (choleretic, cardiac, sedative, etc.). One of these varieties in the form of gastric drops is intended for the treatment of patients with chronic gastritis with secretory insufficiency and erosion of the antrum. The preparation "gastric drops" consists of 4 plant components. 2 components ( yellow gentian roots and centaury grass) are bitterness, 2 more (chamomile flowers and common caraway seeds) have an antispasmodic effect.
Where is the antrum (stomach) treated?
The gastroenterological department performs medical diagnostic, advisory and organizational and methodological work on the provision of specialized in-patient care for patients with a gastroenterological profile. It provides emergency assistance to patients with gastroenterological diseases.
He carries out a set of rehabilitation measures aimed at the social and labor adaptation of gastroenterological patients. Introduces into clinical practice new achievements in the provision of medical care for diseases of the digestive system and analyzes the effectiveness of their implementation.
Prepares and conducts scientific and practical conferences, seminars aimed at introducing the results of scientific research into the practice of the gastroenterological service. Organization of work by the department is determined by the regulation on the gastroenterological department.
Planned hospitalization in the department is carried out in the direction of gastroenterological rooms, district physicians, general practitioners of family medicine of the city.
Patients with chronic diseases of the digestive system are sent to the department. Hospitalization according to emergency indications is carried out in the direction of emergency medical teams, a doctor on duty.