The wall of the stomach consists of 4 layers: the internal mucosa, submucosa, muscle layer and the external serous membrane. The mucous membrane (CO) is normally folded, in it there are recesses - pits, flat sections (fields) and folds.
The mucosal epithelium is highly prismatic (columnar) cells that line the entire stomach and all its folds in one layer. The cells of this epithelium secrete a special mucus, it forms a layer up to 1-1.5 mm thick. In the production of enzymes and hydrochloric acid, temporary channels are formed in this layer. Mucus protects the wall from digestion by the juice of the stomach and various injuries. The epithelium is updated every 1-3 days.
What is proliferation?
Cell proliferation is a normal process that the body needs to update. In other words, this is the physiological reproduction of cells with a result in the form of an increase in tissue volume. This process is controlled by hormones. Proliferation occurs in any organ and tissue. It controls the state of immunity, leads to the destruction of tissue defects, regenerates them and restores the former functioning of organs. Due to proliferation, connective tissue grows, new vessels form, burns are scarred, damage is eliminated with the replacement of tissues with new cells or connective tissue. This applies to blood cells, epithelium and mucous membranes, cartilage, myocardial walls, etc. The most active process occurs in the gastric mucosa.
But proliferation under certain conditions can become pathological, i.e., excessive. For example, with an increased concentration of somatropin, it leads to an increase in organs and limbs. If the differentiation of cells is disrupted during proliferation , this becomes the beginning of oncology with the appearance of atypical growths. Such uncontrolled active (abnormal) cell division is called hyperproliferation or hyperplasia. This can also be explained by the predominance of proliferation over the differentiation of mucosal cells. Then the number of narrowly differentiated cells decreases and the epithelium begins to lose its "legitimate properties" due to immature cells. The proliferation of integumentary epithelium can and often is accompanied by processes of intestinal metaplasia of the stomach.
Hyperplasia
Proliferation of integumentary epithelium of the stomach is one of the subspecies of mucosal proliferation. The name is given because as a result of tissue proliferation, corkscrew-shaped pits form. This proliferation means hyperplasia of the cells that produce mucus (goblet cells), which plays a protective role. The integumentary epithelium undergoes a mutation, the content of mucin in the cells increases, pushing the nucleus to the base of the cell, pathological cells begin to replace healthy ones. The pits in the mucosa are formed, which in shape resemble a corkscrew pin. The process is a harbinger of oncology.
Most often, proliferation of integumentary-fossa epithelium occurs with hyperplastic gastritis, peptic ulcer , ulcer-like cancer. According to the clinic and morphology, they are identical, therefore, a biopsy is required. Cytological examination can reveal pronounced proliferation of integumentary-fossal epithelium of the stomach. In fact, this is a precancerous condition, and such patients should be registered with an oncologist and undergo a systematic examination.
Development reasons
The main reason is chronic or prolonged damage and irritation of the mucosa, which causes the appearance of wounds and ulcers. In addition to the above pathologies, the cause may be:
- hereditary predisposition;
- hormonal disorders;
- the presence of Helicobacter pylori - its waste products pollute the entire body, which inhibits the immune system, destroys the mucous membrane and causes proliferation of the integumentary-fossa epithelium; this bacterium leads to inflammation of the gastric mucosa and the development of gastritis in 90% of cases;
- eating disorders, in which there are many additives E, preservatives, alcohol;
- taking NSAIDs;
- stress
- changes in the work of the duodenum 12 (it provokes an excess of gastrin, which irritates the gastric mucosa; casting bile with reflux) and the pancreas.
Classification
Several types of gastric hyperplasia have been identified. They vary in appearance and affected areas. The main ones include the following:
- antrum;
- focal;
- foveolar;
- glandular;
- polypoid;
- lymphatic follicular;
- proliferation of integumentary-fossa epithelium of the stomach;
- lymphoid.
Species briefly
The following types of pathology:
- Foveolar hyperplasia of the stomach. In this case, the folds and gastric fossa are deformed, they are elongated and curved. The most frequent and non-hazardous type. It develops when taking NSAIDs.
- Antral - tissues grow at the junction of the gastric mucosa in the duodenum. The reason is malnutrition. These changes look like multiple small growths.
- Lymphofollicular - the mucosa thickens and grows due to the accumulation of lymphocytes forming follicles. Possible malignancy. With lymphoid hyperplasia , the antrum of the stomach is more often affected, when the number of lymphocytes in the lymph nodes increases. With an increase in lymphocytes, the mucosa thickens and hyperplasts. Moreover, the increase in lymph nodes in this case is not inflammatory. The causes are peptic ulcer and infectious digestion lesions.
- The glandular is the rarest form, with it there is a proliferation of glandular cells and the formation of round and oval polyps. Occurs when the stomach is stretched.
- Polypous - the appearance of multiple polyps in any part of the stomach. The reason is unknown.
- Focal - "wart" - the appearance of additional tissue in one or more places. The process is observed in the initial stages of hyperplasia and is benign.
That is, it can be said that proliferation of integumentary-fossa epithelial cells is a proliferative growth of mucus-producing cells.
Degrees of proliferation
Today, hyperplasia is divided into 3 stages:
- The first degree - the production of mucus is reduced, hyperchromatosis is noted. The process is initial, it is reversible with proper treatment.
- The second degree is moderate proliferation of integumentary-fossa epithelium. The process is already more obvious, cell division is accelerating and increasing, the number of Paneth cells and goblet cells is decreasing. The process can still be stopped by timely and modern treatment.
- The third degree is pronounced proliferation of cells of the integumentary-fossal epithelium of the stomach. Large areas proliferate, mucus does not stand out, there is no protection, the process becomes precancerous.
Symptoms and signs
For a long time, a person does not know about the existence of a pathology in himself, he does not have any ailment, therefore, early diagnosis is so late. Then, as the process progresses, first after eating there is severe pain in the upper abdomen, nausea, loss of appetite, sour belching, hiccups.
In the advanced stages, vomiting, general weakness, bloating, flatulence are observed. The pain can be cramping in nature - at first they are stitching or burning, then they become aching. Stool is broken, prone to diarrhea. Signs of intoxication appear - pallor, headache, dizziness, temperature, a feeling of tight muscles. Symptoms are nonspecific, so they often go unnoticed. Early diagnosis is of paramount importance: it is necessary to timely identify and prescribe an effective treatment for the proliferation of integumentary epithelium of the stomach. It is dangerous, but in the first stages of the therapy is malleable.
Diagnostic measures
The main diagnostic method is gastroscopy. With such an examination, a biopsy with subsequent histology is possible. The gastric mucosa is thoroughly examined and the specialist can see all the changes in it immediately.
During the examination, the doctor can see neoplasms, an abnormality of tissues and membranes.
X-ray with barium will reveal polyps, their shape and size of the legs. When establishing the etiology, an analysis is carried out for the presence of Helicobacter pylori. This is a urea breath test and a blood test for antibodies.
If the diagnosis is "pronounced proliferation of integumentary epithelium hp" with a certain number of crosses, then this indicates the presence of Helicobacter pylori in the mucosa. A significant role can be played by a biopsy, it is carried out with gastroscopy. The study makes it possible to establish the fact of the presence of the disease and its subspecies. I must say that the combination of proliferation of integumentary-fossa epithelium and Helicobacter is not such a rare occurrence.
Treatment principles
The treatment of the disease is multicomponent, aims to improve gastric motility and normalize the production of hydrochloric acid.
The treatment of proliferation of integumentary and fossa epithelium, i.e., hyperplastic gastritis, depends on the etiology, subspecies of proliferation, hypo- or hyperacidity, the severity of the clinic, and concomitant diseases. Self-medication is strictly prohibited.
How to treat proliferation of integumentary epithelium of the stomach? For therapy, groups of the following drugs are prescribed:
- Antispasmodics - No-Shpa, Papaverin, Spazgan, Drotaverin. Relieve spasm and pain.
- Antibiotics - Amoxicillin, Tetracycline, Clarithromycin, etc.
- Antimicrobial agent "Metronidazole" and bismuth preparations. Helicobacter bacteria are used for eradication (excretion) in case of its presence.
- Enzyme preparations - "Festal", "Creon", "Mezim", "Panzinorm" and others. They are used to improve digestion.
- Antacids - "Rennie", "Almagel", "Maalox" and others. They remove heartburn, pain, protect the mucous membrane.
- Amino acids - "Methionine", "BCAA" and others. Necessary to make up for protein deficiency.
- Multivitamins - B vitamins, vit. C and R.
- In case of hypoacid conditions, gastric juice preparations are prescribed - Pepsin, hydrochloric acid.
- To reduce increased secretion - proton pump inhibitors. They are rarely prescribed, they are effective in the initial stages. In recent years, conservative therapy has been using hyperbaric oxygenation.
Alternative methods of treatment
As for alternative methods of treatment, they can help in the initial stages. Herbal medicine is used only in consultation with the attending physician, is symptomatic. Apply decoctions of herbs with an anti-inflammatory effect.
Chamomile is considered very useful - tea from it has an antispasmodic and anti-inflammatory effect. Ginger possesses antibacterial properties. Tea with mint, infusion of parsley or Ivan tea will relieve nausea and heartburn.
When is surgery needed?
Surgical treatment of hypertrophic gastritis is carried out with the ineffectiveness of conservative therapy. Indications for the operation are as follows:
- gastric bleeding;
- polyps of the stomach;
- the presence or suspicion of malignancy of the process;
- severe course of pathology.
Endoscopic removal of polyps (polypectomy), resection of the stomach (complete or partial) is performed. Polyps are formed with all types of hyperplasia, and can be hereditary. The latter are often malignant
Polyps larger than 1 cm are endoscopically removed. Small formations are not removed if there is no suspicion of malignancy, but their development is monitored - they are examined every six months.
Special diet
Food should be balanced. It should be taken in small portions (fractionally), preferably at the same time, every 3 hours.
It is advisable to completely abandon alcohol and any products that irritate the mucous membranes: pickles, smoked meats, marinades, canned foods, pickled foods, fast foods, soda and convenience foods. Salt must be minimized, canned food and red meat fall under the ban. All food should only be boiled, all fried is prohibited.
Recommended table number 2. This food system is prescribed for bowel diseases and gastritis. Its purpose is to stop the development of inflammation and normalize the secretory apparatus of the stomach.
The prognosis of envy on the subtype of hyperplasia and its intensity, timeliness and modern diagnostic.
Preventive actions
There is no specific prophylaxis of gastric hyperplasia, but no one has canceled the general recommendations for improvement. Food should be with a sufficient content of vitamins and minerals, smoking and alcohol should be abandoned, negative emotions and stresses should be avoided. Try to choose foods with the least amount of preservatives and carcinogens. Make a habit of drinking a glass of water before each meal, so that at least 2 liters of pure water enter the body per day. Do not abuse anti-inflammatory drugs, even if they help you. An active lifestyle will also help get rid of many diseases. Do not forget to visit a gastroenterologist every six months. If you really do not like the EFGDS method, you can just go through an ultrasound scan.
Proliferation of integumentary-fossa epithelium is a dangerous pathology, which in advanced cases provokes oncological diseases. Important early diagnosis to stop lesions in the initial stages.