CHRONIC GASTRITIS AND

PEPTIC ULCER DISEASE

RAHMA LABATJO
 gastritis

 Gastritis - a focal or diffuse inflammation of the gastric

mucosa in response to its damage with disorders of the
secretory, motor, and sometimes inkretory functions.
types of gastritis
 acute;
 chronic;
 Etiologic factors
Exogenous:

 Alimentary disorders

 Smoking

 Alcohol

 Neuropsychiatric stress

 Occupational hazard

 The uncontrolled use of drugs

Etiologic factors

Endogenous:
 Chronic infection
 Diseases of the nervous and endocrine
systems
 Cardiovascular and respiratory systems
 Renal failure
Laboratory studies:
■ complete blood count (deviation possible more prolonged chronic
disease with symptoms of atrophic gastritis, iron deficiency or B12
deficiency anemia);

■ urinalysis;

■ fecal occult blood worms and eggs;

■ cytology of byoptites (during the first endoscopy, the dynamics - if

necessary, after the end of treatment);

■ histological examination of biopsy samples (if necessary – in dynamics);

■ tests for Helicobaster pylory detection (fast urease test, breath test,
smear-mark);

■ total protein and protein fractions of blood serum;

■ determination of glucose in blood and urine.

 Drug treatment of autoimmune gastritis
(type A)
1. Drugs that stimulate the secretory function of the stomach
(Lymontar, Pentagastrin, Calcium Gluconate).
2. Replacement therapy (gastric juice pepsydyl, pepsin,
pepsin-atsydyn, Abomin, Panzinorm, Hydrochloric Acid).
3. In the presence of pain and frustration Dyspepcyc -
Cerukal, Eglonil, Nospanum, Halidor.
4. Anti-inflammatory therapy (plantain leaves, Plantahlyutsyd,
Venter).
5. Enzymes (Solizym, Oraz, Festal, Mezim forte).
6. Mineral water ("Mirgorodskaya", "Slov'yanivska" - in the
form of heat for 15-20 minutes before meals, in small sips
to 1/2-1 cup 2-3 times a day).
ulcer
 Peptic ulcer disease - a chronic disease with cyclic flow and a
tendency to progression, which is characterized by the
formation of a defect in the lining of the stomach or
duodenum due to the reduction of its security properties or
increasing aggressiveness of gastric juice.
Classification of peptic ulcer

1. Localization ulcer:
-ulcer
-duodenal ulcer (bulbar, postbulbar)
-combined gastric and duodenal ulcers;
-hastroyeyunal ulcer (ulcer anastamoses).

2. Etiology:
-HP - positive ulcer;
-HP - negative ulcer.

3. Phase ulcerative process:

-active (acute, fresh);
-scarring;
-stage of scar;
-prolonged absence of scarring.
 4. Accompanying morphological changes:
-localization and activity of gastritis and duodenitis;
-the presence and severity of mucosal atrophy
-the presence of intestinal metaplasia;
-erosions, polyps;
-availability gastroezofagal or duodenogastric reflux.

5. Complications:
-bleeding
-perforation
-penetration
-stenosis
-malignization
 Variants of the course:
 Light - periods of heightened at least once in 1-2 years, clinical
manifestations expressed mild, easily treatable;
 Moderate - aggravation 1-2 times a year, expressed clinical
manifestations, in the pathological process involved other organs of
digestion;
 Severe - aggravation 3-4 times a year, pronounced clinical signs,
which are difficult to treat, there are complications.
 Major syndromes of gastric
ulcer
 Pain - is caused by irritation of the ulcer surface
aggressive content of gastric inflammation in ulcer
area, regional spasm of smooth muscle,
peryhastryt, peryduodenit.
 Syndrome gastric dyspepsia, resulting heartburn,
belching, nausea, vomiting.
 Syndrome of intestinal dyspepsia, which is a sign
of constipation, crampy pain in the gut.
 Increased irritability, emotional lability, sleep
disorders.
Laboratory diagnosis
 Complete blood count (to exclude bleeding);
 Biochemical analysis of blood (in the presence of anemia -
to investigate the level of Fe + in blood and Ferum-binding
ability of serum)
 Blood (duodenum ulcers - most often in patients of group I,
gastric ulcer - 3-A blood group)
 Fecal occult blood;
 Cytological examination of bioptites (at least 5 fragments
from different parts of the stomach and duodenum;
 Histological examination of the bioptites to exclude atypical
cells in the center;
 Determination of microbial type of H. pylori (urease test,
cytology, histology)
Medication
1. Anticholinergic drugs (anticholinergics):
selective (Atropine, Methacin, Platifillin)
selective (Hastrotsypin, Pirenzepin)
2. Antacids (Almagel, Fosfalyugel, Maalox, Haviskon, Helyusyl
varnish, etc..)
3. H2-histamine receptors (Cimetidine, Ranitidine, Famotidine,
Roksatydyn);
4. Proton pump blockers (Omeprozol, Lanzoprazol, Pantoprazole,
esomeprazole);
5. Means, which form a protective film (Sucralfate,
De-nol, Smectite);
6. Helicobacter drugs: antibiotics (Amoxicillin,
Flemoksyn-Solutab, Clarithromycin, Tetracycline,
Metronidazole, De-nol);
7. Means that normalize gastric motor activity
(Reglan, Eglonil, Motilium);
8. Reparant (Hastrofarm, Solcoseryl, Pentoxyl);
9. Means sedation (Amitriptyline, Rhaponticum,
Chinese Magnolia, Dalargin).