Prompt treatment is essential

The question is especially acute of late. Let’s look at chronic gastritis and its manifestations. Chronic gastritis is one of the most widespread digestive illnesses. It is morphological: only able to be diagnosed through pathohistological examination of the mucous membrane of the stomach (i.e. after endoscopic examination with biopsy).
By Tatiana Zhukova, gastroenterologist, doctor of higher category, D.M. Ph.D.

‘Much has been spoken of chronic gastritis lately
but different doctors single out different symptoms
and some fail to attach importance to this disease.
In your expert opinion, what is chronic gastritis?’


N. Kozhemyakina, Brest

The question is especially acute of late. Let’s look at chronic gastritis and its manifestations. Chronic gastritis is one of the most widespread digestive illnesses. It is morphological: only able to be diagnosed through pathohistological examination of the mucous membrane of the stomach (i.e. after endoscopic examination with biopsy). It is the chronic inflammation of the stomach’s mucous membrane, characterised by:

  • Abnormality of physiological regeneration;

  • Reduction of quantity of glandular cells;

  • Eventual atrophy of glandular epithelium;

  • Development of intestinal metaplasia and, later, dysplasia.

The sequence of development of pathological processes in the mucous membrane of the stomach — under the influence of adverse factors (in particular, helicobacter infection) is presented by the following stages (P. Correa, 1992г.):

In diagnosing gastrointestinal diseases, endoscopic examination is vital, including morphological examination of the mucous membrane of the stomach. Results of endoscopic and morphological research form the basis of modern classifications used by doctors.

Gastritis illnesses associated with HP-infection and atrophic gastritis dominate (the latter tends to be linked to auto-immune deficiency and is often manifested alongside В12-deficit anaemia). Other gastritis illnesses are associated with alcohol and medicines, as well as granulomatous, eosinophilic and other forms of gastritis.

Clinical manifestation of chronic gastritis

Clinical presentation of chronic gastritis in the exacerbation phase is characterised by a number of symptoms — of local and general character. Among local symptoms, the most important is dyspepsia, characterised by dull pain or unpleasant sensations in the pit of the stomach, discomfort, feeling full or bloated, and sometimes nauseous. Pain increases following a meal, and when standing, but remains dull rather than sharp. The condition can be aggravated by spicy, fried or smoked food, or by eating heavy meals. Symptoms may ease after consuming milk, porridge, or thick soup.

Patients with chronic gastritis have a tendency to constipation and bloating (having lots of gas), and may see changes in the appearance of their stool or, even, suffer from diarrhoea. Other parts of the digestive system — such as the duodenum or pancreas — may become affected. Chronic gastritis does not affect the general condition of the majority of patients but, quite often, they have asthenovegetative syndrome. This is characterised by weakness, irritability, chilliness, increased perspiration in the extremities, and cardiovascular abnormalities — including pains around the heart, arrhythmia, and arterial hypertension.

Usually, the skin remains looking healthy, but lesions may occur where helicobacter infection is present: manifested by an allergic rash. Where the stomach’s mucous membrane is being destroyed, the patient may suffer from hypoferric anaemia — pale skin and mucous membranes, poor circulation, a mild fever, or systolic heart murmurs. Stomach cramps bring muscle tension and tenderness.

Chronic gastritis associated with helicobacter infection can present the symptoms of ulcer-like dyspepsia, with marked pains in the pit of the stomach, as well as ‘hunger pangs’ and night pains. These symptoms are caused by raised gastric secretion and motor-evacuation abnormalities, which appear because of helicobacter infection.

Autoimmune, chemical, radiation and other forms of gastritis are rare among younger people, so should be verified by evidence of specific endoscopic and morphological changes.

There is no doubt that chronic gastritis is a serious disease and should not be ignored. If you are concerned that you are presenting symptoms, consult a doctor immediately. They should prescribe examination straight away, in order to make an exact diagnosis. Correct treatment will depend on this.

Stay healthy!

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