Gastric is one organ that is integrated to the digestion of food. Where the organ is closely interconnected with other digestive organs in the process of digestion. Gastric digestive enzymes and produces some of which are hydrochloric acid (HCl) acidic and functioning kill germs. This acid is very corrosive, however, the stomach wall is protected by a lot of mucosal bicarbonate that protects the stomach from hydrochloric acid.
Gastritis definition
Disease Gastritis is an inflammation of the stomach caused by several conditions are complex and interrelated. Conditions that cause gastritis is Helicobacter pylori infection, physical trauma, stress, irregular eating patterns, etc. Gastritis is not a single disease, but several different conditions that all have inflammation of the stomach lining.
Because gastritis is one of the many digestive diseases with symptoms that are similar to each other, causing the disease is easily mistaken for other diseases such as :
1. Gastroenteritis.
Gastroenteritis is also referred to as the stomach flu ,which typically occurs as a result of a viral infection of the intestine. Symptoms include diarrhea, abdominal cramps and nausea or vomiting, as well as the inability of the stomach to digest. Symptoms of gastroenteritis often disappear within one or two days, while for gastritis can occur continuously.
2. Heartburn.
The pain that feels like burning behind the breastbone usually occurs after eating. This occurs because the stomach acid up and into the esophagus (the tube that connects the throat and stomach). Heartburn may also cause a sour taste in the mouth and feel the sensation of partially digested food as back-to-mouth.
3. Stomach ulcers.
If the pain and heartburn occurs continuously and severe, then it was likely caused due to ulcers in the stomach. Stomach (peptic) ulcer or gastric ulcers are open sores that occur in the stomach. The most common symptom is pain that becomes more severe when the evenings or the stomach is empty. Gastritis and stomach ulcers have some of the same causes, notably Helicobacter pylori (H. pylori). The disease can result in gastritis and vice versa.
4. Nonulcer dyspepsia.
Is a functional disorder that is not related to a particular disease. The exact cause of this condition is unknown, but stress and eating too much fried foods, spicy or fatty foods could be expected to result in this situation. The symptoms are pain in the upper abdomen, bloating and nausea.
Classification of Gastritis
Broadly speaking, the division grastritis divided into 2 parts :
1. Acute Grastritis.
Acute Grastritis is an acute inflammation of the stomach, usually limited to muklosa. And broadly acute grastritis can be divided into 2 parts :
a. Acute exogenous grastritis , due to chemicals, by thermal, mechanical irritation is a bacterial causal factors that usually occurs in acute exogenous grastritis.
b. Grastritis acute endogenous.
Grastritis acute endogenous, occurs due to abnormalities in the body is the cause of acute endogenous grastritis. One grastritis acute clinical manifestations can be severe form of the disease is grastritis erosive or hemorrhagic grastritis. The clinical symptoms that often cause erosive grastritits is widespread trauma, renal failure, oprasi large, widespread burns, head trauma, and septicemia. While other factors are derived from drugs, such as aspirin, non-steroidal and anti-inflammatory.
Factors that cause erosive grastritis is :
• Ischaemia in gastric mucosa.
• Pepsin factors.
• Bile reflux.
• Pancreatic juice.
2. Chronic gastritis.
Gastric may experience chronic inflammation of the particular type that causes gastritis of specific types called gastritis kronisa. The occurrence of inflammatory cell infiltration that occurs in the lamina propria, epithelial area or in both areas consist mainly of lymphocytes and plasma cells called chronic gastritis. Infection of the bacteria Helicobacter pylori which is also the cause of gastritis that is also included in the group of chronic gastritis. Increased activity of chronic gastritis is characterized by the presence of neutrophil granulocytes in the area.
Classification is often used is :
1. If the chronic inflammatory cell infiltration limited to the superficial lamina propria mucosa, and edema separating the mucous glands, while the cells remain intact gland called chronic superficial gastritis.
2. Changes in gastric mucosal glands histopatogik into the small intestine mucous glands containing goblet cells are metaplasia intestinalis. Such changes can occur in almost all segments of the stomach, but it can also be just the spots on some parts of the hull.
3. If the chronic inflammatory cells spread deeper accompanied by distortion and destruction of the glandular cells are more noticeable called chronic atrophic gastritis.
4. At the time of the glands structure disappeared and separated from each other significantly with tissue cells that bind, while the infiltration of inflammatory cells also decreased, gastric atrophy is considered the end stage of chronic gastritis. And the mucosa becomes very thin, so it can explain why the blood vessels becoming visible at the time of endoscopy.
Meanwhile, according to its anatomic distribution, chronic gastritis can be divided into :
• Chronic gastritis type A, where the histopathologic changes occur in the body and gastric cardia. This type is often associated with autoimmune process and continues with pernicious anemia.
• Antrim chronic gastritis type B, This type is the most common type, which is often associated with infectious germs Helycobacter pylori (H. pylori).
• Maag multifocal or type AB whose distribution throughout gastric (stomach). Along with the elderly, the spread has increased.
Comparative anatomy
A . Normal gastric anatomy
Gaster is located in the upper abdomen, extending from the lower surface of the left arcus costalis until an umbilical region epigastrica. Most gastric located below the bottom costae. Roughly gastric J-shaped and has two holes, and ostium cardiacum pyloricum [ 2 Curvatura, curvatura major and minor and two walls, anterior paries and posterior Paries ].
In general, the stomach is divided into 3 parts :
1. Cardia / glands found in the heart of the heart the mouth regia. It simply secrete mucus.
2. Fundus / gastric located almost in the entire corpus, which this gland has three main types of cells:
a. Zigmogenik cell / cell chief, secreting pepsinogen.
This pepsinogen is converted to pepsin under acidic conditions. These glands secrete gastric lipase, and renin less important.
b. Parietal cells, secrete hydrochloric acid and intrinsic factor. Intrinsic factor is required for absorption of vitamin B12 in the small intestine.
c. Mucous neck cells are found in the neck of all the gastric glands. These cells secrete mucus barrier thickness of 1 mm and protects the stomach lining against damage by HCL or autodigestion.
3. Pylorus lies in pyloric antrum regia. These glands secrete gastrin and mucus, a peptide hormone that is influential in the process of gastric secretion.
The gastric coating consists of four layers :
1. Outside the peritoneal lining or serosa layers that are part of the visceral peritoneum. Two visceral peritoneum layer fused to the lesser curvature of the stomach and duodenum , extends towards the liver to form the lesser omentum. Peritoneum folds out of the organ one toward another organ called a ligament. In the greater curvature of the peritoneum, omentum continues down to form Mayus.
2. Muscular layer consisting of three layers :
• longitudinal fibers, which are not contiguous with the muscle in the esophagus.
• circular fibers thickest and is located in the pyloric sphincter muscle and form and is under the first layer.
• Oblique fibers which are mainly found in the gastric fundus and runs from cardiac orifice, and turned down through the lesser curvature (small arch).
3. Submucosal layer consisting of areolar tissue containing blood vessels and lymphatics. Mucous layer that is located on the inside, thick, and consist of many wrinkles or rugue, which is lost when it expands organ for containing food.
4. Mucous membranes coated cylindrical epithelium and contains many lymph channels. All cells that secrete mucus secretions. Mucosal surface is crossed by tiny channels of the glands of the stomach. All of this runs from the stomach gland tubule branching channel and the holes covered by cylindrical epithelium. Epithelium is continuous with the mucosal surface of the stomach. From the glandular epithelium discharging fickle and vary in some areas of the stomach.
B. Anatomy of the stomach affected Gastritis.
In Gastritis, mucous membranes become edematous (edema) and hyperemic ( mixing of fluids and blood ) as well as on a superficial erosion, where a discharge containing little gastric acid but many mucosal. Superficial ulcers also occur and it can cause bleeding.
Causes And Symptoms Gastritis
A. Causes of Gastritis
The cause of this disease can be divided into two kinds of substances due to external and internal. External substances are substances from outside the body which can cause corrosive or gastric irritation. While the internal substance is spending excessive stomach acid and irregular. As for the other symptoms that can occur is because of the prolonged stress that can lead to the production of stomach acid as well as for their autoimmune disorders.
The conditions of the causes include :
1. Causes external substances that cause irritation and infection
• Helicobacter Pylori bacterial infection, viruses (including herpes simplex) fungi and parasites.
Most of the causes gastritis is caused by infection with the bacteria Helicobacter pylori living in the inner mucosal layer lining the stomach wall. Until now can not understand how such bacteria can be transmitted, but it is expected that transmission occurs via the oral (mouth) or as a result of consuming food or water contaminated by these bacteria. Helicobacter pylori infection is now recognized as a major cause of peptic ulcer and a major cause of gastritis.
• The use of pain medication continuously.
Analgesic anti-inflammatory drugs (NSAIDs) such as antalgin, mefenamic acid, aspirin, ibuprofen and naproxen can cause inflammation of the stomach by reducing prostaglandin duty.
• Excessive alcohol use.
Alcohol can irritate and erode the mucosa of the stomach wall and make the wall of the stomach more susceptible to stomach acid even if under normal conditions.
• Cocaine use.
Cocaine can damage the stomach and cause bleeding and gastritis.
• Poisoned.
2. Causes of internal substances (their growing cause excessive stomach acid) :
• Frequently eating acidic foods, including spicy pepper.
• Irregular eating habits.
• The psychological condition of mental stress and frustration.
3. Autoimmune disorders.
Where the immune system attacking normal cells of the stomach the which causes damage to the stomach wall.
All of these causes can cause damage to the lining of the stomach resilience. If the situation is allowed to continuously without food intake, there will be an increase in stomach acid. and will increase cholinergic stimulation which will further increase gastric motility. Increased gastric motility can cause erosion of the stomach, if left unchecked, it can cause stomach ulcers.
B. The symptoms of gastritis
Gastritis pain symptoms or have some marks even sometimes vague symptoms depending on the severity of gastritis. Symptoms of mild gastritis pain is usually just a temporary bloating and frequent belching symptoms of severe gastritis pain or chronic gastritis such as stinging, burning in the pit of the stomach area.
Gastritis pain symptoms in the form of :
1. Stinging or burning pain in the upper abdomen that may be better or worse when eating.
2. Frequent Vomiting.
3. Loss of appetite.
4. Bloated.
5. Feels full in the upper abdomen after eating.
6. And weight loss.
Risk Factor Gastritis
The risk factors are some conditions that cause a person susceptible to disease gastritis. If a person has been exposed to the disease gastritis then some of these risk factors should be removed so that the disease does not get worse gastritis.
Gastritis disease risk factors :
1. Helicobacter pylori infection.
2. Stay somewhere crowded and rundown, the condition can increase the risk of infection by Helicobacter pylori.
3. Acquired immunodeficiency syndrome (AIDS)
4. An addict alcoholic beverages & a Smoker.
5. Old age factor.
6. Genetic factors or genetic disorder.
Gastritis Diagnose
Diagnosis gastritis based :
- Physical examination.
Physical examination gastritis tenderness in the area of heartburn.
- Laboratory examination.
Laboratory tests of the examination of endoscopy to see the condition of the stomach and if necessary take stomach samples (biopsy) for detecting Helicobacter Pylori.
- Anamnesis (frequently asked questions).
By history in the form of information and gastritis patient complaints such as heartburn that are like cutting or burning, nausea, bloating, and poor appetite.
Diagnosing Gastritis with laboratory tests
Gastritis is diagnosed through one or more medical tests :
1. Endoscopy of the upper gastrointestinal tract.
Doctors encourage slowly an endoscope, a thin tube containing a tiny camera, through the patient's mouth ( sometimes through the nose ) and down into the stomach of patients to look at the lining of the abdomen / stomach. The doctor will check for inflammation and may remove a small sample of tissue for examination. The procedure to remove a tissue sample called a biopsy.
2. With Blood Tests.
The doctor may check the number of red blood cells to see if the patient has anemia, which means that the patient does not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
3. With stool tests (feses test).
This test checks for the presence of blood in the stool of the patient, or a sign of bleeding. Stool test may also be used to detect the presence of Helicobacter pylori in the gastrointestinal tract.
4. Upper Gastrointestinal (GI) Test.
This test is performed with the patient swallow barium, then the liquid material contrast makes the digestive tract visible with X-rays. Then the images of the X-ray imaging can be used to see if there is a change in the lining of the stomach, such as indications of erosions or ulcers.
Healing Gastritis
A. Treatment of gastritis
Treat gastritis should involve setting a healthy lifestyle, diet and stress management in patients with gastritis.
The goal of treatment gastritis is :
a. Neutralize stomach acid.
b. Reduce expenditure stomach acid.
c. Reduce symptoms due to stomach irritation.
d. Improve the condition of the stomach wall is damaged by stomach irritation.
e. Increase blood flow to the stomach.
The treatment involves such things as :
• Healthy lifestyles.
Healthy lifestyle for the treatment of gastritis by regulating sleep patterns and exercise. Avoid sleeping stay up late at night and try to wake up early. Exercise regularly at least 3 times a week really helps the healing process gastritis. Regular exercise will increase blood flow to the stomach so as to accelerate healing of wounds in the stomach. Combination medicine doctors and exercise can accelerate the healing of gastritis pain. Sports longest adapted to endurance is best jogging or running tailored to ability.
• Diet in patients with gastritis is to eat a little bit, not full nor hungry.
Avoid eating foods that stimulate gastric acid expenses like eating acidic foods, sauces and spicy. Gastritis patients should not delay the time to eat, but if you do not have time to eat, then eat a snack or cake to neutralize stomach acid. if there is no snack or cake then drink a lot to help neutralize stomach acid.
B . Drugs used for Gastritis
Gastritis drug that is often used by doctors is :
1. Antacids.
Antacids containing calcium carbonate and magnesium hydroxide. There is a tablet and liquid form. Antacids are used to neutralize stomach acid and can relieve pain due to stomach acid quickly.
2. H2 antagonists such as ranitidine, cimetidine, nizatidine, and famotidine which serves to reduce the amount of stomach acid produced.
3. Proton pump inhibitors.
Proton pump inhibitors reduce acid by closing the work of pumps of cells in the stomach produces gastric origin. Which includes categories this class of drugs is omeprazole, lansoprazole, rabeprazole and esomeprazole. This class of drugs also block the action of Helicobacter pylori.
4. Cytoprotective agents.
This class of drugs helps to protect the tissues that line the stomach and small intestine. That falls into this type of drug is sucraflate and misoprostol.
Traditional medicine for gastritis
Traditional medicine for gastritis that is often used is ginger. Herbal ginger is great to improve digestive health include gastritis and gallbladder disease.
Treatment depends on the cause gastritis
Healing in acute gastritis.
Acute gastritis caused by consumption of alcohol and excessive coffee , NSAID drugs and smoking habits can also be cured by stopping the consumption of these materials.
Acute gastritis due to the use of aspirin, and the best prevention is to misoprosto. But you should be careful in the treatment of covering ; prevention against any highy-risk patients , treatment of the underlying disease, and stopping the drug can be authorized.
Prevention can be done by giving antacids. a minority of patients need invasive action is taken to stop life-threatening bleeding , for example with endoscopic sclerotherapy, left gastric artery embolization, or gastrectomy. Giving antacids and sucralfate H2 still recommended despite their therapeutic effect is still in doubt.
Healing in Chronic Gastritis
In chronic gastritis caused by infection with the bacteria Helicobacter pylori can be treated with eradication therapy. Eradication can restore the picture back to normal histopathology. Eradication therapy consists of two kinds of antibiotic and one kind of inhibitor of gastric acid production, ie PPI (proton pump inhibitor). In autoimmune chronic gastritis, aimed at the treatment of pernicious anemia resulting. To improve the state of anemia, may use vitamin B-12 parenteral.
The various combinations of drugs to the bacteria Helicobacter pylori eradication is :
1. Quadriple therapy.
The combination of PPI, CBS (4 x 120 mg/day) with two kinds of anti Biotica selected from amoxicillin, clarithromycin, Tetracycline or Metonodasol.
2. Triple drugs (Given 1-2 weeks).
Bismuth triple therapy : Colloidal bismuth subnitrat (CBS) 4 x 120 mg / day + Select 2 out of 3: metronidazole 4 x 500 mg / day, Amoxicillin 4 x 500 mg / day, and tetracyclines 4 x 500 mg / day.
3.“Proton Pump Inhibitor (PPI) based” triple therapy :
Omeprasol 2 x 20 mg / day or Lansoprasol 2 x 30 mg / day or Lansoprasol 2 x 40 mg / day + 2 antibiotics of : Klaritromosin 2 x 250-500 mg / day, Amoxicillin 2 x 1000 mg / day or metronidazole 2 x 400-500 mg / day.
Gastritis treatment
Caring for Gastritis.
Treatment usually involves taking drugs to reduce stomach acid, and thus it helps relieve symptoms and promote healing. Stomach acid irritates the inflamed tissue in the stomach. Avoiding foods, beverages, or medications may also be recommended.
If the patient gastritis is caused by an infection, that problem maybe also be treated. Talk with your doctor before stopping any medicine or starting any gastritis treatment that can be done alone.
Hopefully with a lengthy explanation is helpful for all of us.
Read also :
- Endometriosis Causes, Symptoms and Treatment.
- Anemia & Women.
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