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- chronic inflammation of the gastric mucosa (diffuse or focal), accompanied by a violation of the physiological regeneration of the epithelium, its atrophy, functional insufficiency of the stomach, upset secretory, motor and often incretory functions of the stomach
The main clinical manifestations of chronic gastritis
Locally, the appearance of pain (dull, without irradiation), severity and pressure b of the epigastric region, arising after eating, belching, regurgitation, nausea, occasionally heartburn, an unpleasant aftertaste in the mouth; rumbling and transfusion in the abdomen, flatulence, stool disorders (unstable stool, diarrhea); weakness, irritability, sweating. An objective examination shows weight loss, pallor of the skin, signs of hypovitaminosis (seizures in the corners of the mouth, bleeding gums, brittle nails, hair loss); white tongue overlay, bloating, moderate pain in the epigastric region (for chronic gastritis type A) and local pain in the pyloroduodenal zone (for chronic gastritis type B).
The main clinical manifestations of chronic gastroduodenitis
Ulcer-like pains (early and late, nocturnal and hungry) in the upper abdomen, accompanied by heartburn, belching, weight loss, constipation, irritability, insomnia. Palpation of the abdomen - pain in the pit of stomach and pyloroduodenal zone, sometimes a positive symptom of Mendel. Primary chronic gastroduodenitis is considered as the initial stage of peptic ulcer.
Classification of chronic gastritis
According to the localization of morphological changes and their depth
1) chronic gastritis type B, existing in two forms - antral and diffuse;
2) chronic gastritis type A;
3) mixed, atrophic pangastritis A + B. Depending on the state of the acid-producing function of the stomach:
1) chronic gastritis with increased and preserved (normal) secretion;
2) chronic gastritis with secretory insufficiency (moderate and severe, including achlorhydria).
Disease phases: exacerbation; remission.
Refined classification of gastritis (gastroduodenitis) chronic
S. Savchenko, A.M. Nogaller, 1966)
1. According to the clinical and functional basis: a) with preserved secretion; b) with secretory insufficiency.
2. On an etiological basis: a) alimentary; b) alcoholic; c) infectious; d) toxic (exogenous and endogenous).
3: By the nature of the course: recurrent or monotonous course.
4. According to the phases of the disease: a) remission; b) exacerbation.
5. By severity: a) mild; b) moderate; c) severe form.
6. According to morphological characteristics: a) superficial; b) interstitial; c) atrophic; d) atrophic with the phenomena of structural rearrangement of the glands; e) erosive; e) polypous.
1) Gastric dyspepsia; 2) intestinal dyspepsia; 3) asthenoneurotic syndrome; 4) dumping syndrome (sometimes); 5) hypopolivitaminosis syndrome; 6) pain on palpation in the epigastric region (with chronic gastritis type A) and in the pyloroduodenal zone (with chronic gastritis type B); 7) signs of a violation of the secretory, acid-forming, pepsin-forming and enzyme-forming functions of the stomach; 8) radiological signs of gastritis; 9) endoscopic symptoms (superficial, atrophic, granular polypous, erosive); 10) morphological criteria (superficial, interstitial, atrophic, atrophic with the phenomena of "restructuring" according to the pyloric or intestinal type, atrophic-hyperplastic - mixed, polypous).
1. Chronic gastritis, type B, antral form with increased secretion of the stomach, exacerbation phase.
2. Chronic gastritis, type A, with moderate secretory insufficiency, phase of remission.
3. Chronic atrophic pangastritis A + B (mixed) with severe secretory insufficiency, acute phase.
4. Chronic hypertrophic (polyadenomatous) gastritis with secretory insufficiency, exacerbation phase.
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