"All have gastritis": What to do if your stomach hurts
It’s hard to find someone who’s not diagnosed with gastritis at least once - many designate this word any anxiety in the stomach. In fact, real gastritis - inflammation of the stomach wall - is not so common, and it can only be diagnosed by examining a piece of tissue under a microscope.
If such a tissue sample is not taken, then it is impossible to unequivocally talk about inflammation, even when the inner surface of the stomach was examined using gastroscopy and saw redness or erosion (superficial ulcers). Therefore, doctors use two different concepts: "gastritis" (actually inflammation) and "gastropathy" (a condition where the wall of the stomach is damaged, but there is no inflammation).
We understand how to distinguish one condition from another and recover, together with doctors: Candidate of Medical Sciences, Gastroenterologist, General Director of the Evidence-Based Clinic Rassvet, author of the book “The Gut with Comfort” Alexey Paramonov and Candidate of Medical Sciences, Gastroenterologist of the GMS Clinic Medical Center Alexey Golovenko .
Why does the stomach become inflamed
The stomach contains an aggressive environment: the gastric juice is hydrochloric acid and enzymes. At the same time, the body itself does not digest: the acid does not have access to the stomach lining protected by a layer of mucus. Aggressive effects of gastric juice are only those areas where this layer is destroyed.
Painkillers (nonsteroidal anti-inflammatory drugs) and alcohol are the enemies of the protective layer. Their effect over time changes the property of mucus. As a result, the acid begins to affect the stomach - and gastropathy develops, and ulcers may occur later on. But the link between spicy food, smoked products, fibrous products and damage to the gastric mucosa is not proven by scientists.
In addition to external influences, internal factors can affect the state of the stomach - for example, there is an autoimmune gastritis. Acute inflammation can develop due to a viral infection and, as a rule, passes quickly without requiring treatment.
Do I need to be afraid of Helicobacter pylori
The bacterium Helicobacter pylori (Helicobacter) is able to cleave mucus, exposing the wall of the stomach. Her “goal” is to get to the latter and provoke persistent inflammation or an ulcer, and then cause a precancerous condition — metaplasia. Interestingly, most people have Helicobacter (for example, in Russia - 80% of the population) - and this has been going on for more than fifty thousand years.
To the question "why has humanity still not died out from stomach cancer?" The answer is simple: most carriers of the infection do not develop inflammation. This is due to the fact that the immune system and Helicobacter reach "armed neutrality": bacteria interact with the human immunity and defeat only occasionally. However, the risk still remains - and to facilitate microorganisms access to the stomach is easy if you often drink painkillers or abuse alcohol.
Only a few years ago it was believed that it was necessary to identify and destroy Helicobacter only in individual cases. Today, it is shown to almost all adult patients: experts believe that the bacterium is the main provoker of gastric cancer. According to the recommendations of the Kyoto global agreement on Helicobacter pylori-associated gastritis, it is necessary to be examined and treated from the age of twelve. European consensus recommendations are slightly different: everyone who lives in high-risk countries for stomach cancer (particularly in Russia and Japan), patients who have poor heredity, gastritis, peptic ulcer, any "stomach" complaints, iron deficiency should get rid of Helicobacter. , vitamin B12 deficiency, as well as those who take painkillers and anticoagulants.
Alexey Paramonov notes that the damage caused by Helicobacter is different for different people, but the risk of developing a malignant tumor of the stomach is increased in each carrier. According to the doctor, it is especially important to eliminate the bacterium for those who have to take anti-acid drugs for a long time (omeprazole, lansoprazole, esomeprazole). These drugs contribute to the development of atrophy of the gastric mucosa - and this is the first step to cancer, if the microbes are not destroyed. But there is good news: timely methods of dealing with these bacteria allow the mucosa to fully recover.
What is easy to confuse gastritis
According to gastroenterologist Alexei Golovenko, most of the symptoms that many people associate with gastritis are not related to inflammation, or to a stomach ulcer, or to a dangerous bacterium. The feeling of heaviness in the abdomen after eating, distended "under the spoon", nausea or severe weakness after fatty foods most often speak of functional dyspepsia - that is, a violation of the digestive process. First of all, we are talking about a violation of motility (physical activity) of the digestive organs, which can be caused, for example, by stress. To improve the condition, it is usually enough to drink prokinetics (for example, domperidone or itopride) - drugs that stimulate the motility of the gastrointestinal tract. Psychotherapy and antidepressants can also give a positive result, but they should be prescribed by a doctor.
Alexey Paramonov emphasizes that it is not safe to use classical painkillers for any discomfort in the stomach: most of them themselves can lead to an ulcer. First aid for acute stomach pain is antacids that neutralize gastric acid. Another effective option - the so-called proton pump inhibitors, they also reduce the acidity. But you still need to visit the doctor: it is important to understand the cause of the ailments and undergo treatment. For example, pregnant women often complain of so-called reflux disease or heartburn of pregnant women, when acid from the stomach enters the esophagus. And if during gastritis or dyspepsia it is not necessary to observe a special diet (the use of Soviet “tables” is not scientifically proven), then in this case the diet will have to be changed. Such a diet will not be hard and certainly will not prevent the development of the fetus.
If the pain in the upper abdomen, heartburn, belching, nausea appeared for the first time and you are less than forty-five years old, there is no point in doing a gastroscopy: dyspepsia treatment can be prescribed without looking into the stomach. According to the recommendations of the American College of Gastroenterology, gastroscopy is relevant when there is a chance to detect an ulcer, metaplasia or a tumor. Symptoms of such conditions: discomfort when swallowing, iron deficiency anemia, frequent vomiting, unintentional weight loss by more than 5% in six months. Otherwise, it is sufficient to perform a respiratory test for Helicobacter and eliminate the bacteria, if they are found. Only if after this state of health has not improved, you need to undergo gastroscopy with biopsy - the latter is required to confirm gastritis and allows you to assess the risk of developing stomach cancer in the future.
If you are over forty-five years old, or someone from close relatives has had stomach cancer, then the doctor will prescribe a gastroscopy at the first "stomach" complaints. This examination can detect not only gastritis, but also, for example, inflammation of the esophagus (esophagitis) or an ulcer. An unpleasant procedure has no alternative yet, but in order not to suffer, “swallowing the gut” can already be examined under anesthesia. There is progress in the treatment of peptic ulcer. Alexey Paramonov says that twenty years ago it was possible to cope with it by removing part of the stomach. Now surgeons recommend surgery only in an emergency, for example, if complications have already arisen - and in other cases, the affected areas of the stomach are simply cauterized with a laser or radio waves.
What to do to prevent illness
In fact, to deal with Helicobacter pylori, to refuse to take painkillers frequently, not to abuse alcohol and not to take too long intervals between meals is the best prevention of gastritis. And in order to prevent functional dyspepsia (after all, it is she who most often causes stomach discomfort), Alexey Golovenko advises not to forget about training: regular physical activity reduces unpleasant symptoms. It is also helpful to learn how to relive stress more easily — meditation can help.
Why folk remedies and dietary supplements will not help
Self-medication of gastritis or gastric ulcers with dietary supplements, as well as a decoction of plantain, sea buckthorn oil, badger fat, and other “finds” of traditional medicine, even if they once helped your grandmother, is useless and may even worsen the condition. Trying the "magic pill", you participate in the lottery: such funds have not been tested in clinical studies, which means you can only guess what the result will be.
Alexei Paramonov cites a case that occurred with his patient: a man discovered three stomach ulcers, but instead of treatment, he went to hunt a badger - he remembered that badger fat saves from illness. As a result, fat for breakfast, lunch and dinner provoked severe bleeding from ulcers - it was possible to save the patient at the last moment. And after the extermination of Helicobacter and the course of drugs that lower acidity, the man managed to fully recover in less than a month.
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