Dr. Ertan Beyatlı

The Gastritis Contradiction and its vicious cycle

(Update: ) - Digestive System Diseases

This disease has become so common. It is now used as a complaint rather than a disease. Physician: what is your complaint? Patient: Sir, I have gastritis! Let's see what are the true and false information about this disease?

What is gastritis?

Gastritis, inflammation of the stomach means. It consists of two words. Gastrique means stomach. -thrust attachment means inflammation. In latin Gastritis It is written in the form.

what is gastritis?

What are the causes?

Gastritis can occur in the following situations:

  • Acid Gastritis: a type of gastritis due to an increase in stomach acid (also called stress or sadness gastritis)
  • Irritants induced gastritis: alcohol, chronic vomiting, hot drinks, medications such as: pain relievers, aspirin, anti-inflammatory, Ursactive
  • Helicobacter pylori (H. pylori): A bacterium that lives on the mucous membrane of the stomach; Without treatment, these bacteria can lead to ulcers and, in some people, even stomach cancer.
  • Bile Reflux (Bile gastritis): It is a condition in which bile fluid passes from the small intestine to the stomach.
  • Infection: infections caused by bacteria and viruses.
  • Radiation therapy (radiation gastritis, radiotherapy) It may be caused by some situations such as.

In cases of untreated gastritis, excessive removal from the body blood loss ve gastric cancer There is an increase in risk.

What are the Symptoms of Gastritis?

The following symptoms can be seen:

  • Ache. Stomache ache, stomach pain, cramping, headache
  • Stomach problems. Indigestion, rancidity, loss of appetite, bloating, nauseavomiting
  • General Problems. Weakness, flushing
Erosive linear #gastrit seen at #endoscopy http://ertanbeyatli.com/nedir-bu-gastrit

How is the diagnosis made?

Gastritis symptoms can also be seen in other malignant stomach diseases. For example, stomach cancer complaints are sometimes exactly the same. Therefore, attention should be paid to this situation when diagnosed.

For a definitive and accurate diagnosis of gastritis Endoscopy is essential. (see How is an endoscopy done?)

With endoscopy, a definitive diagnosis is made and a piece is taken when necessary. (biopsy for pathological examination).

In some patients who have been followed for months with complaints of stomach discomfort and indigestion and who are given various gastric protective drugs, early stomach cancer findings can be found in endoscopy.

Complaint → diagnosis → treatment → recovery

People rush to pharmacies for the slightest stomach complaint and buy plenty of stomach medicines. Medicines randomly, disorderly and unconsciously is used, but there is no improvement. The same troubles are always the same stories are repeated and a vicious circle occurs.

How many types of Gastritis are there?

The stomach is anatomically divided into five regions: cardia, fundus, corpus, antrum, and pylorus. (pylorus) is called.

Anatomical parts of the stomach
Anatomical parts of the stomach
Anatomy of the stomach

There are two main forms of gastritis acute ve chronic.

  • Akut Gastritis - sudden and short-term spasm.
  • Chronic Gastritis - Long term (autoimmune, H. pylori, chemical gastritis)

Classification according to the severity of gastritis is as follows:

  • Erosive Gastritis (erythematous gastritis, erythematous gastropathy): It is the condition of the stomach lining. Can cause ulcers if left untreated
  • Non-Erosive Gastritis: Non-corrosive type.

Other Types of Gastritis: Iatrogenic type, Autoimmune type, Granulomatous type, Lymphocytic type (T lymphocyte), Collagen type, Eosinophilic type

What is Antral Gastritis

It is the most common type of gastritis in endoscopy. As the name suggests, inflammation is the lower part of the stomach. antrum is limited to. Stomach acid and food are collected in this area before passing to the small intestine and waited (average 4-8 hours).

How is gastritis treated?

Treatment is based on the cause of the gastritis. The general name of the drugs used in the treatment is stomach protective drugs. In resistant cases, the presence of bacteria should be investigated - Helicobacter pylori

What is pangastrit?

Pangastrit the name of the disease "Pan”And”GastritisIt consists of the words. The word pan means broad or comprehensive in Latin. Pangastritis means inflammation of most or all of the stomach.

"Pangastritis" chart seen on endoscopy. Ertan BEYATLI, MD
"Pangastritis" chart seen on endoscopy. Ertan BEYATLI, MD

Therefore, the word Pangastritis refers to the condition of gastritis that covers at least 75% of the gastric mucosa. Erythematous pangastritis is the most common type seen.

There has been a significant increase in the number of pangastritis cases worldwide since 2000. Especially in 2018-1019, this increase was noticeable.

Among the most important reasons for this increase H.pylori bacteria against antibiotics resistance development, endoscopy more specific identification of diagnoses and a growing number of food additives. It is thought that there will be a gradual increase in pangastrit cases in 2020.

What is Bile Gastritis?

It occurs as a result of the passage of bile from the small intestine to the stomach. Bile fluid irritates the stomach lining, causing it to become inflamed. For more detailed information on this topic: Alkaline Reflux Gastritis

What is Helicobacter Pylori?

In the last 30 years, this bacterium appears as the cause of many digestive diseases. Helicobacter Pylori (H.pylori) was discovered in 1980 by nobel laureates Warren and Marshal.

Dr. Barry J. Marshal and Dr. J. Robin Warren found Helicobacter pylori bacteria

H.pylori is spiral-shaped bacteria that live in the stomach. Its most important feature is that it can hydrolyze urea and produce urease and ammonia. Ammonia causes gastrin release by affecting stomach cells (antral G cell) with negative feedback loop method.

Helicobacter Pylori (H. Pilori)
Helicobacter Pylori (H. Pilori)

This situation causes an increase in stomach acid. (hypergastrinemia and gastric acid hypersecretion). Many tests have been described to detect the presence of the organism, thanks to its urease (ability to hydrolyze urea). For example, 13C and 14C breath test (breath test) and CLO Rapid Urease test kit (Campylobacter-Like Organism). In addition, H.pylori can be detected by Giemsa and Ethin Starey Silver Stain methods.

For the diagnosis and follow-up of bacteria, breath (blowing test) or stool antigen test is performed. However, a biopsy taken by endoscopy is essential for a definitive diagnosis.

What is the CLO Test?

Used in the diagnosis of Helicobacter pylori (H.Pylori). It is a rapid and diagnostic urase test and is an abbreviation of (Campylobacter-Like Organism Test) in Latin (i.e. Campylobacter-like organism test).

The main idea of ​​the test is that it catalyzes the conversion of urease enzyme, secreted by H. pylori, from urea to ammonia and carbon dioxide (CO2). The time to be positive for the CLO test is related to the H.pylori density of the gastric mucosa and does not provide any information about the degree of inflammation!

Thanks to the enzymatic effect of Helicobacter Pylori, the degradation and damage in the inner layer of the stomach (mucus, mucosa) and the inflammation response of the epithelium cause many diseases related to this organism.

H.pylori antigen in stool

The presence of bacteria can be easily detected by stomach biopsy in patients undergoing endoscopy. In patients who do not undergo endoscopy, the presence of bacteria can be detected with a breath or stool test.

When H.pylori is investigated, the patient should not use drugs or antibiotics that reduce stomach acid because such drugs ensure that the bacteria do not appear in the tests. Showing antibody developed against this bacterium in blood or saliva tests does not indicate the presence of the bacteria.

The antibody shown with these tests indicates that the patient has encountered bacteria in any period of his life, it is not an indicator of the viability of the bacteria. Therefore, these tests should not be used in practice. It can be done by examining the bacteria, breath test or stool examination without endoscopy. The breath test is more sensitive than the stool examination.

Diseases caused by H. Pylori

  1. Gastritis
  2. Duodenitis
  3. Peptic Ulcer
  4. Esophagitis
  5. Colitis
  6. Stomach cancer (stomach CA)
  7. chronic dyspepsia
  8. Nausea

How is H. Pylori treated?

In the treatment, more than one antibiotic and medication that reduces stomach acid is used. Triple or quadruple drug courses are used in the treatment. Duration of treatment is 7-14 days.

Medication given may cause side effects. Among these, taste changes in the mouth, stomach pain, headache, heartburn, nausea, vomiting, diarrhea, skin rash. These complaints are seen in 60% of patients. However, these complaints pass 1-2 days after using the drugs. Therefore, it is strongly recommended not to disrupt the medication. (see. In what situations does Antibiotic Resistance develop?)

Does H. Pylori repeat?

The probability of bacteria recurrence is 5-10%. Random use of antibiotics increases this risk. If the bacteria cannot be treated with a combination of antibiotics, the same combination should not be used for repeat treatment. A different treatment protocol should be applied. In case of failure, the treatment to be used in the second attempt will be more intense.

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