Hospital therapy. Etiology, pathogenesis, clinical picture of chronic gastritis (the most important)

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Hospital therapy. Etiology, pathogenesis, clinical picture of chronic gastritis (the most important)

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39. Etiology, pathogenesis, clinical picture of chronic gastritis

Chronic gastritis is a disease that is clinically characterized by gastric dyspepsia, and morphologically - by inflammatory and degenerative changes in the gastric mucosa, impaired cell renewal processes, and an increase in the number of plasma cells and lymphocytes in the mucous membrane's own membrane.

Etiology and pathogenesis. At the present stage of development of gastroenterology, it has been established that the appearance of chronic gastritis is promoted by the microbial expansion of Helicobacter pylori (HP), which causes antral gastritis in 95% of cases and pangastritis in 56% of cases.

The etiological factors of chronic gastritis can be attributed with a high degree of certainty to risk factors (irregular unbalanced diet, smoking, alcohol intake, hypersecretion of hydrochloric acid and pepsin). The leading role in the development of the disease also belongs to autoimmune mechanisms, accompanied by the accumulation of antibodies to the parietal cells of the gastric mucosa, aggravated heredity, as well as the use of drugs that have a damaging effect on the gastric mucosa.

Classification. In 1990, at the IX International Congress of Gastroenterologists in Australia, a new systematization of chronic gastritis was adopted, called the Sydney system.

Histological bases of classification.

1. Etiology: chronic gastritis associated with HP, autoimmune, idiopathic, acute drug-induced gastritis.

2. Topography: antral, fundal, pangastritis.

3. Morphology: acute, chronic, special forms.

Endoscopic basis of classification:

1) gastritis of the antrum of the stomach;

2) gastritis of the body of the stomach;

3) pangastritis;

4) changes in the gastric mucosa: edema, erythema, mucosal vulnerability, exudate, flat erosions, elevated erosions, fold hyperplasia, fold atrophy, visibility of the vascular pattern, supramucosal hemorrhages.

clinical picture. Chronic gastritis is one of the most common diseases in the clinic of internal diseases. Its frequency among the inhabitants of the globe ranges from 28 to 75%.

Chronic gastritis is more often manifested by symptoms of gastric dyspepsia and pain in the epigastric region. Rarely, it is asymptomatic.

An equally important place in the clinical picture of chronic gastritis is dyspeptic syndrome: nausea, belching (sour, bitter, rotten), heartburn, constipation or diarrhea, unstable stools. With isolated antral gastritis, complaints of heartburn and constipation, arising from the hypersecretion of hydrochloric acid and pepsin, become paramount.

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