Stomach is an organ in the shape of the letter J and in which the swallowed food is temporarily stored, broken down into small pieces and digested. is passed into the small intestine in portions. The inner surface of the stomach is covered with a layer called the mucosa, which consists of cell lines that roughly form 3 separate layers. There are different types of cells in the gastric mucosa. These cells secrete hydrochloric acid, digestive enzymes (pepsin) and various hormones.
WHAT IS GASTRIT?
Gastritis is a kind of inflammation (inflammation) of the gastric mucosa. This means that white blood cells accumulate in the mucosa after stimulation by various factors. Gastritis can be acute or chronic.
WHAT ARE THE CAUSES OF GASTRITIS?
Helicobacter pylori (HP) :
It is the most common cause of chronic gastritis. HP is a spiral-shaped bacterium that settles in the stomach when taken orally, causing an inflammation we call gastritis. It lives under the mucus layer that covers the gastric mucosa, protecting it from stomach acid and other factors. HP makes the gastric mucosa sensitive to acid and other aggressive factors by weakening the mucus layer with both the toxins it secretes and some substances that appear after the body’s immune response against the bacteria (the body’s immune system responds to the bacteria). Since it is usually taken in childhood in developing countries, it causes a life-long chronic inflammation in the gastric mucosa if not treated. It has been shown that approximately 80% of our society is infected with this bacterium, especially in the elderly population. Although HP infection is accepted as one of the leading factors in ulcer formation, the absence of ulcers in all people infected with this bacterium and the detection of HP negative ulcers at an increasing rate in recent years suggest that other factors besides HP are effective in ulcer formation.
Today, diseases that are accepted to be caused by HP infection are seen in the figure. HP has been accepted among the 1st degree carcinogenic factors by the World Health Organization (WHO). The presence of bacteria in the stomach can be demonstrated by tests such as endoscopic biopsy, urea-breath testing, and searching for antibodies and antigens in blood and stool. In patients who are found to have HP in the stomach, some special drug regimens are used to clear the bacteria from the stomach. The effectiveness of this treatment is around 80-85%.
Aspirin and antirheumatic drugs:
Such drugs cause gastritis by increasing the sensitivity of the mucosa to acid and other aggressive factors by weakening the protective mechanisms in the gastric mucosa. The gastritis that occurs can be passed without any symptoms, or it can progress in a chronic form with the formation of complications such as ulcers / bleeding.
Autoimmune gastritis:
The body’s immune system (immune system) may in some cases become active against its own tissues and organs by mistake, and these tissues and organs can form damaging substances and cells (Autoimmunity and autoimmune diseases). Hypothyroidism (Hashimoto’s thyroiditis), Sjögren’s syndrome, rheumatoid arthritis, lupus, type I diabetes can be counted among this group of diseases. Some cells in the gastric mucosa may also be among the targets of the immune system, and this causes chronic gastritis and a disease characterized by the loss of acid-secreting cells in the gastric mucosa. In these patients, besides the decrease in stomach acid, anemia due to iron and vitamin B12 deficiency in the body is also seen, and this is called autoimmune gastritis and pernicious anemia. In this type of stomach, the probability of developing stomach cancer in the later stages of life is increased compared to normal people.
Alcohol :
Alcohol and other chemicals can cause damage to the gastric mucosa. When used in normal doses and not drunk on an empty stomach, alcohol is not expected to cause a significant gastritis in the gastric mucosa.
Hypertrophic gastritis:
Gastritis that occurs after the mucosal folds covering the inner surface of the stomach due to inflammation and enlargement due to inflammation is called hypertrophic gastritis. One type of this type of gastritis is known as Menetrier’s disease. As a result of excessive protein loss from the gastric mucosa, the protein level in the blood decreases and edema occurs.
WHAT SYMPTOMS DO GASTRIT CREATE?
Symptoms of gastritis vary depending on whether it is acute or chronic. In acute gastritis, symptoms such as pain, gas, burping, burning, heartburn, nausea and vomiting are seen in the upper abdomen, while in chronic gastritis the pain is less pronounced and dyspeptic symptoms such as bloating and fullness after meals, early satiety, nausea, belching, loss of appetite and bad taste in the mouth are observed. complaints are more common. When pain becomes evident in chronic gastritis, it is thought that ulcers or other diseases may have developed on the basis of gastritis. Occult or overt bleeding may occur in acute gastritis after the use of aspirin and antirheumatic drugs.
HOW IS GASTRIT DIAGNOSED?
After taking a detailed history from the patient and a careful body examination, when gastritis is suspected, your doctor can arrange a treatment to alleviate your complaints. However, for the definitive diagnosis of gastritis, endoscopy (gastroscopy) must be performed to see the mucosa and a tissue sample must be taken for pathological examination (biopsy). Endoscopy is not required in every patient who presents with complaints suggestive of gastritis. Especially in patients under the age of 40, if there is no other reason to require endoscopy, the presence of HP infection can be investigated by tests using blood or stool samples.
WHAT ARE THE COMPLICATIONS OF GASTRITIS?
In the background of chronic gastritis caused by HP, serious complications such as stomach and duodenal ulcers, lymphoma and stomach cancer may develop, although not frequently. Lymphoma caused by HP gastritis is called MALT lymphoma (MALT = Mucosa associated lymphoid tissue) in the early period and full recovery can be achieved by clearing the bacteria in the early period of the disease. Gastritis caused by aspirin and antirheumatic drugs can sometimes be accompanied by severe bleeding.
HOW IS GASTRIT TREATED?
Gastritis is treated according to the cause. Most of the time, reducing stomach acid provides relief from complaints. In cases with positive HP, 1 or two-week treatment courses containing at least two antibiotics are applied to clear the bacteria. In patients using aspirin and antirheumatic drugs, it would be appropriate to discontinue these drugs and / or review their use. In more specific types of gastritis and in cases with complications, treatment methods are applied for the cause and complications.
