Inflammatory changes in the stomach are observed in most people. In some cases, a person does not even know about the presence of the disease. The high frequency of gastritis is associated with the nature of the diet. Indeed, factors such as the use of spicy, fatty and fried foods lead to irritation of the gastric mucosa . In addition, one of the reasons for the development of gastritis is stress. Since the stomach is innervated by the vagus nerve. Often gastritis develops in people who smoke a lot and drink alcohol. Symptoms of this pathology are similar to the manifestations of many diseases. Therefore, the diagnosis of gastritis is very important. Firstly, 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
The inflammatory process of the gastric mucosa is called gastritis. The disease can have an acute and chronic course. In the first 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 periods of recovery (remission), so periodic and 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 a chronic course.
- Fibrinous inflammation. It can develop due to damage to the stomach by chemicals (burns with acids, alkalis).
- Phlegmonous gastritis. It occurs with abdominal injuries, the spread of infection.
Chronic inflammation is superficial, erosive, hyperplastic, autoimmune, atrophic, etc. Such forms of gastritis must be diagnosed as early as possible, since stomach ulcers, GERD, and cancer often occur on their background.
What are the methods for diagnosing gastritis?
With timely detection of the disease and treatment, it is possible to achieve complete recovery or prolonged remission. Diagnosis of gastritis of the stomach includes several stages. The first of these is the collection of complaints and medical history. The doctor specifies what symptoms the patient has (duration, localization, nature of the pain) when they occur (how much time passes 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 stage of diagnosis is an objective examination. Attention is paid to the digestive system. It is important to assess the condition of the tongue, palpation of the abdomen. Gastritis is characterized by unpleasant sensations 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 methods of research. The first include OAC, 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 bacteria are the causative agents of inflammation, then neutrophiliasis takes place in the KLA. With viral inflammation, an increase in the number of lymphocytes. In some cases, an analysis of the gastric contents is performed. Laboratory diagnosis of gastritis includes the study of biopsy samples (pieces of tissue taken during the performance of FEGDS). This method is carried out only with suspected hyperplastic processes in the stomach. These include cytological and histological examination. A urease test is also performed for some patients. It allows you to detect the presence of helicobacteria. 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. FGDS 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 a gastroscopy, a biopsy of “suspicious” tissue is performed. In some countries, a similar study is included in screening programs. This allows you to prevent several pathologies at once. Among them are gastritis, gastric ulcer and duodenal ulcer, benign tumors and cancer.
X-ray diagnosis is not very informative in inflammatory processes. Nevertheless, it is necessary for an accurate diagnosis. An X-ray of the stomach is carried out with a 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 these pathologies can have similar symptoms with inflammation of the stomach.
How to diagnose gastritis in children?
The 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 young children who cannot explain what exactly bothers them. Most often, acute gastritis occurs against the background of poisoning (foodborne toxicosis). 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 contributes to the consumption of 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 step is the differential diagnosis of gastritis. After all, the correctness of treatment and the further prognosis depend on it. It is worth noting that in acute gastritis, clinical manifestations are more pronounced, in contrast to chronic pathology. Typical 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.
The chronic inflammatory process is not as pronounced as acute. Symptoms of gastritis can resemble an exacerbation of other gastrointestinal pathologies. Among them are chronic cholecystitis, pancreatitis, hepatitis, gastric ulcer and duodenum. Also, gastritis is differentiated with helminthic invasions. To distinguish inflammation of the stomach from other diseases, it is necessary to carry out FEGDS.
Diagnostic features for atrophic gastritis
Atrophic gastritis is more dangerous compared to other forms of the disease. This is because 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 attrition of symptoms. Sometimes belching, nausea, discomfort in the stomach can be observed.
Diagnosis of atrophic gastritis is based on an endoscopic picture. Thinning of the walls of the stomach, destructive processes, signs of inflammation - swelling, hyperemia of the tissue are characteristic. In this case, a biopsy of the affected areas is necessary. A histological examination reveals depletion of the cellular composition, a decrease in the size of the elements, and functional insufficiency.
The difference between acute gastritis and infectious pathologies
It should be remembered that some food poisoning occurs with gastric dyspepsia syndrome, 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 the rapid development of symptoms of intoxication (nausea, fever, headache, general weakness). Often gastritis is combined with enteritis and colitis. That is, in addition to lesions of 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 distinguish gastritis from appendicitis?
Acute gastritis must be differentiated from appendicitis. Indeed, at the beginning of the disease, these pathologies have the same manifestations. With appendicitis, epigastric pain, low-grade fever, 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 according to the clinical picture, therefore appendicitis must be excluded in the first place. For this purpose, a UAC and a general urine test 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 manifestations of acute gastritis. Therefore, the elderly should first do an ECG. In addition, it is necessary to find out whether the patient had pain in the heart, increased blood pressure, tachycardia.
Treatment of acute gastritis
Diagnosis of gastritis is important for therapeutic measures. Depending on the form of the disease, there may be differences in drug therapy. In acute gastritis, the main treatment method is diet (table No. 1). Etiological therapy is also important. For this purpose, antibiotics are prescribed (Azithromycin, Metronidazole). With an increase in acidity, the use of medicines "Omez", "Pantoprazole" is necessary. Enveloping agents are also prescribed . These include drugs "Almagel", "De-nol."