Dysplasia of the stomach is a chronic pathology in which the flat epithelium of the gastric mucosa begins to proliferate, its cells mutate. Then they replace healthy cells, this is 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 incorrect development. The diagnosis of dysplasia is not made without indicating the part of the body, tissue or organ where it is found. The flat epithelium of CO (mucous membrane) changes its structure so noticeably that it completely ceases to produce secretions, thereby 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 a dysfunction that leads to cell death.
Change mechanism
The epithelium changes its histological structure and tinctorial properties (staining ability). The squamous epithelium begins to transform and is replaced by atypical cells.
The secretion during gastric epithelial dysplasia decreases - the 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 an almost transitory stage between hyperplastic processes and cancer. This is the basis of its danger. The probability of malignancy is 75%.
The process always progresses, and initially focal dysplasia of the stomach begins to actively capture new areas, the process becomes generalized. The stomach is affected not only in breadth, but also inland. Moreover, dysplasia, starting with glandular cells, passes into the upper layers of the liver, mammary glands, genitals, etc. Then dysplasia develops in these zones.
Development reasons
According to a variety of studies, it has been proven that the development of gastric dysplasia is directly dependent on diet and ecology.
Provocative factors are combined in 2 large groups: external and internal.
External reasons:
- the main offenders are smoking and alcohol;
- further comes the insufficient intake of minerals and vitamins from food;
- malnutrition with a predominance of all carcinogenic foods and simple carbohydrates;
- passion for salt and red meat;
- spicy, sour, smoked, canned;
- junk food in the form of semi-finished products, fast food, chips, mayonnaise, etc .;
- irrational food intake - snacks on the go, overeating, a dry man, plentiful 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 digestive tract.
The leading place belongs to smoking, it causes a mutation not only of the cells of the stomach, but also of 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 damage factors also include long-term use of medications - oral contraceptives, hormones, non-steroidal anti-inflammatory, cardiac glycosides, cytostatics, aspirin, etc.
Internal reasons:
- poor absorption of beneficial trace elements due to chronic diseases of the stomach;
- their lack of diet;
- a decrease in immunity and the attack of the body due to this by viruses and bacteria;
- hereditary predisposition to gastrointestinal diseases, so babies from such families immediately fall into the risk group;
- genetic mutations of cells;
- immunodeficiency states;
- endocrinopathies - diabetes, pancreatitis, hypothyroidism, thyreotoxicosis;
- increased production of hydrochloric acid by the stomach;
- gastrointestinal dysbiosis;
- infectious lesions - helicobacteriosis, dysentery, salmonella, E. coli.
Important! The main damaging factor is an unbalanced diet and an unhealthy lifestyle.
The 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 (CO), atypia of the cells and disturbances in their differentiation.
By the nature of changes in the secretion of production, dysplasia of the gastric mucosa is hyper- and hyposecretory.
With hypersecretory dysplasia in the glandular epithelium, the number of granules grows, these degraded 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:
- I 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 an intestinal one.
- II degree - the process continues to grow, cells begin to divide more often and faster. Against this background, the number of Paneth and goblet cells decreases. Goblet cells belong to the stomach, they produce mucus, Paneta - cells of the small intestine. Thus, division also increases in the cells of the small intestine. Clinical symptoms become more pronounced.
- III degree of gastric dysplasia - the proliferation process is generalized, now the secret is not produced at all. Atrophic gastritis develops - a precancerous condition. Maybe 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 polyps of the stomach. The risk of rebirth is 75%.
Hyposecretory dysplasia is the opposite process, but no less insidious. The granules in the cells become smaller, too. Revealed moderate dysplasia of the stomach, and even more pronounced - these are markers of high risk of oncology.
Of the types of cancer, moderately and highly differentiated adenocarcinomas often develop.
Intestinal metaplasia of the stomach
Intestinal dysplasia of the stomach, or metaplasia, is a transformation at the cellular level of the gastric glandular epithelium into the intestinal. The production of hydrochloric acid by the parietal cells is completely stopped.
There are 2 types of such intestinal pathology of the stomach. If the mutated cells of the stomach are replaced by cells of the small intestine, this is dangerous, but can be treated. If colon cells come in 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 is tubular adenoma of the stomach. When microscoping, it has clear contours, raspberry color and a constant ability to grow. Its complications are obstruction of the digestive tract.
Tubular adenoma of the stomach and dysplasia are very closely related, since they affect mucosal lesions. They combine 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 no symptoms for a long time either. If there is an admixture of blood in the stool, an examination of the patient can diagnose an adenoma. 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, therefore, the best way is to examine patients from risk groups and with provoking factors. The patient may sometimes notice discomfort in the stomach, heaviness after eating, and increased fatigue.
With dysplasia of the 2nd degree, signs of discomfort become more pronounced:
- Epigastric pains become more frequent, and then constant; they may not be related to food.
- Heaviness in the stomach is now constantly present.
- Nausea - occurs especially quickly when absorbing poor-quality food.
- Heartburn - indicates the onset of gastroesophageal reflux disease (GERD).
- Belching with air or stomach contents with an acidic tinge. The abdomen can become full of gas.
3rd degree dysplasia:
- The secretion of the stomach is sharply reduced. Pain, a feeling of fullness in the abdomen and discomfort are intensified and permanent.
- Losing weight.
- Symptoms of constant weakness and fatigue.
- Anemia and folic acid deficiency.
- The skin becomes dry, inelastic, although dryness alone does not indicate dysplasia.
- Dyspeptic disorders - diarrhea, followed by constipation.
- Complications may occur in the form of bleeding from the stomach or intestines. They are manifested by vomiting and black stools.
Any of these signs requires urgent medical attention.
Diagnostic measures
For diagnosis, apply:
- Ultrasound
- Helicobacteria tests.
- The study of pH metering, gastric juice.
- Endoscopic examination.
- Biopsy of the affected area of the stomach - performed during endoscopy, the procedure is painless.
- Stool and urine tests.
Additional research methods include fluoroscopy, biochemical blood tests.
Therapeutic measures
The treatment of gastric dysplasia will be positive only if it is complex. The mood of the patient should be for long-term treatment. All therapy includes:
- medications;
- diet
- sometimes radical methods of treatment.
Important! Alternative methods for dysplasia are ineffective and harmful, because they lose valuable time.
Radical methods - endoscopic resection or cryodestruction, also performed endoscopically.
Resection is carried out in extreme cases, special preparation of the patient is not required. With it, the affected part of the stomach is removed, and it is a complete operation.
Dysplasia is not treated for 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 products, 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 does not leave complications after itself. Stage 3 borders oncology and requires urgent treatment by an oncologist.
Conservative treatment includes 3 main links of drugs:
- antibiotics
- IPP - proton pump inhibitors;
- bismuth preparations.
Metabolics, symptomatic agents can also be used.
Links of treatment
Proton pump inhibitors reduce the production of hydrochloric acid in the parietal cells of the stomach - Zulbeks, Rabelok, Pariet, Ontime, Lanzap, Omez, Omeprazole, Emanera and others. Children under 12 years old they are not appointed.
When Helicobacter pylori is detected, the task of treatment becomes its complete destruction.
Antibiotics are aimed at destroying the bacteria Helicobacter pylori - these 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 Ulkavis, Gastronorm, Vikalin, Vikair, etc. These drugs can not be taken for more than 8 weeks.
The treatment is symptomatic: for pain, antispasmodics can be recommended, for vomiting - “Tserukal”, for heartburn - “Maalox”, “Rennie”, “Almagel”, etc.
Important! Antibiotics for gastric dysplasia give an effect in patients under 18 years of age, they do not act on the formed mucosa.
Proper nutrition in the treatment of the disease
Any treatment always begins with a correction of nutrition and daily routine. In the diet they limit carbohydrates, fats, focus on protein. Nutrition correction is important from the start.
At any stage of the disease, there must be a sufficient amount of fluid entering the body.
It is especially good to use fresh juices (preferably not in store). Onions, garlic and radish, for which Chinese scientists so advocate, can be prevention only in the absence of hyperacid gastritis and ulcerative lesions. Citrus fruits are contraindicated for the same purpose. Salt intake should be minimal.
Useful low-fat cottage cheese and kefir. The ratio of BZHU should be correct: most should be occupied by proteins, the smaller - by fats and carbohydrates.
Heat treatment - the complete exclusion of frying, cooked only for steam, stewing and cooking is possible. Frequency of meals - 5-6 times in small portions. Slimming starvation and extreme diets are excluded. After a meal, it is advisable to take a little walk to stimulate the digestive process.
An indicator of the correct diet is an improvement in metabolism and weight gain. The main criterion for choosing a product should be its usefulness for the stomach. You should often use foods that increase immunity.
Prevention
It is necessary to lead a healthy lifestyle, maintain a balanced diet. Fiber, fresh vegetables and fruits, greens should be introduced into the diet.
Scheduled examinations by a doctor every six months are necessary, especially for children.
It is necessary to refuse smoking and alcohol. Moderate exercise is not out of place.
It is necessary to strengthen immunity - its lactobacilli - Linex, Acipol, omega-3 acids, antioxidants - vitamin C and selenium support it well.
Women ask a lot of questions. Judging by the reviews, many did not suspect at all not only about the presence of a problem, but also about the existence of such a pathology. But the unanimity of the reviews is that the treatment is always long-term, it is advisable to start it as soon as possible.