Symptoms of reduced gastric acidity and treatment of hypoacid gastritis
Gastric juice has a pronounced acid reaction, which is determined by its high content of hydrochloric acid( HCl).It is produced by parietal cells of the fundal glands.Such a chemically active medium provides disinfection of food and beverages, destroying a significant part of dangerous microorganisms.In addition, it promotes denaturation of protein compounds, which is extremely important for the normal digestion of food.
For the normal course of the digestive process, a number of enzymes are involved directly, the main one being pepsin.It is synthesized and operates exclusively in an acidic environment.Table of contents: Reasons for reduced acidity Laboratory indicators of reduced acidity Clinical symptoms of hypoacid gastritis Treatment at reduced acidity
The gland responsible for producing HCl is located in the zones of the body and bottom of the stomach.The neutralization of the acid, necessary for the normal progression and assimilation of food in the intestine, proceeds in the antral part of the organ.
- fasting acidity - 1,5-2,0;
- the upper limit of the norm is 0.86;
- antral department of the stomach - 1,3-7,4.
Secretion of gastric juice reflexively increases with eating.The normal pH after eating is between 1.5 and 2.5 units.
Clinical symptoms of hypoacid gastritis
With hyperacid gastritis against a background of inflammation, enhanced production of HCl begins.As dyspepsia progresses, some of the secretory cells die, and at a certain stage, acidity can return to normal.With further development of the pathology, the functional activity of the damaged base glands continues to decrease, and acid production falls to a minimum.In such cases, they speak of a hypoacid gastritis. The most severe form of the disease is atrophic anacid gastritis, in which the digestive capacity of gastric juice is close to zero.
Laboratory indicators of reduced acidity
Diagnostic tests of patients with pathologies of the digestive system determine basal and stimulated acidity.The first indicator reflects the reaction of gastric juice on an empty stomach, and the second - after taking so-called."Trial breakfast."Stimulated acidity is normally higher, i.e., the pH is less.
Clinical sign of reduced acidity is considered to be pH 2.1-6.0 when determining the basal rate and 2.1-3.0 after stimulation.
Note: If basal pH & gt;6.0, and after a trial breakfast the indicator does not exceed 5.0 - this is an anacid gastritis.
Varieties of pH-metry:
- express method.
A short-term intragastric pH-metry is performed using an acidoastrometer, which is a probe equipped with sensitive sensors .The procedure takes several hours.The diurnal makes it possible to assess changes in acid production, including at night, when the secretion is activated.Endoscopic pH-metry is carried out in parallel with endoscopic examination of the walls of the stomach( fibrogastroscopy);The indicators correspond to the stimulated level.With the express method, the probe is inserted for only 15-20 minutes.
The aspiration method involves taking the contents of the stomach and duodenum through the fractional probe.The result of the study can only be regarded as very approximate, because during the sampling process the contents of the various departments are mixed.
Clinical symptoms of hypoacid gastritis
With reduced acidity, the decontaminating capacity of gastric juice decreases.This promotes the growth of microorganisms, which in turn increases the severity of the inflammatory reaction.The splitting of nutrients against the background of dyspepsia proceeds slowly, so rotting and fermentation begins.
Characteristic symptoms of prolonged course of hypoacid gastritis:
- burp with the smell of rotting organic matter;
- burp with the smell of hydrogen sulfide( "rotten egg");
- metallic taste in the mouth;
- sensation of heaviness and bursting in the epigastrium( after eating);
- dull pain in the stomach( immediately or 20-30 minutes after eating);
- intestinal disorders( constipation or diarrhea);
- bloating due to increased gas formation;
- rumbling in the abdomen;
- acne( acne);
- dilated capillaries in cheek and nose.
In the case of digestive disorders, other organs and systems of the patient inevitably suffer.Vitamin and mineral deficiency develops, manifested in particular by the separation of nails, as well as fragility and dryness of hair.During the laboratory examination of the patient's blood, a reduced level of hemoglobin is determined, ie, anemia( anemia) takes place.In addition, hypoproteinemia( protein deficiency) is detected, as the digestion of proteins is significantly reduced, and their assimilation slows down.In the analysis of the stool, undigested food remains often found.
With strongly reduced acidity, patients quickly lose weight.They have low blood pressure values. Patients complain of general poor health, lethargy, fatigue and reduced mental and physical performance.They try to lead an inactive way of life, since with normal loads the body copes worse.
Lack of acid provokes impairment of intestinal motility, resulting in chronic constipation of .Increased gas formation is due to excessively active fermentation processes.Incomplete processing and assimilation of proteins leads to an increase in the concentration of toxic products of their decay.A common poisoning of the body develops, against which nonspecific immunity decreases.Patients with hypoacid gastritis are more susceptible to viral and bacterial infections, and more often suffer from fungal lesions - mycoses of different localization.
Note: on the background of gastritis of autoimmune genesis often develops B12-deficiency anemia( malignant anemia or Adisson-Birmer disease).As an indirect symptom of reduced acidity, iron deficiency anemia is also considered.
Hypoacid gastritis is a chronic disease characterized by exacerbations and fading( temporary relief of the condition). The severity of symptoms during the period of remission is reduced, and against the background of exacerbation - is amplified( new clinical signs may also be added).Pathology is curable, but to achieve a lasting therapeutic effect, long-term course treatment and strict adherence to the prescribed diet are required.
Note: according to medical statistics, hypoacid form of the disease accounts for up to 25% of all diagnosed cases of chronic gastritis.This type of pathology is more often detected in the elderly.
Treatment with reduced acidity
Complex treatment of stomach diseases is in the competence of a specialist gastroenterologist. If you have the first, even mild symptoms, it is strongly recommended that you seek medical help.Early diagnosis of gastritis facilitates and accelerates cure, and also helps prevent the development of serious complications.A dietitian will help you to create the optimal menu suitable for each patient.
Important: hypo- and anacid gastritis in some cases leads to the development of oncology - stomach cancer.
Complex therapy includes the administration of medications and compliance with the diet.During the treatment, the patient's condition is regularly monitored.It is necessary for monitoring the dynamics of the process, and is of particular importance in connection with the high level of oncological tension against the background of hypoacid gastritis.
If the disease is not accompanied by the appearance of erosive lesions of the mucous membrane of the body, substitution therapy is recommended.
The patient is shown the following drugs:
- Acedin-pepsin( enzymes);
- solution of HCl;
- gastric juice.
If a gastritis is found in the stomach, the bacterium Helicobacter pylori, then antibacterial therapy is prescribed, prescribing antibiotics and preparations of De-Nol and Trichopol( Metronidazole).
To stimulate the secretion of hydrochloric acid, phytopreparations-bitterness are prescribed on the basis of extracts of ayr marsh, peppermint and wormwood.
Diet with reduced acidity
Patients suffering from hypoacid gastritis often have an irresistible urge to eat something acidic or a product that increases the secretion of gastric juice.
Important: temporarily relieve the condition of the patient with reduced secretory activity of the stomach, bitterness, in particular - plantain juice.
The products, at the consumption of which the production of the secretion of the stomach increases particularly actively:
- rye bread;
- spices and spices;
Patients need to make a number of serious adjustments to their diet.From the menu it is important to exclude products that cause fermentation. These are:
- milk and milk products;
- fresh bakery products( especially - from wheat flour of the highest grade);
- dried fruits.
It is necessary to limit the consumption of animal protein, especially sausages, various smoked foods and canned food.
In any form of chronic inflammation of the gastric mucosa, too hot or cold dishes, as well as coarse food, are contraindicated.
It is especially important to adhere to a strict diet during the period of exacerbations.
Elena Sovinskaya, medical reviewer, nutritionist