Differential diagnosis of chronic gastritis

In contrast to chronic gastritis, with functional secretory-motor disorders of the stomach, pain and dyspeptic symptoms are less associated with food intake, are less stable and quickly disappear after correction of the diet and successful treatment of the underlying disease (rheumatism, tuberculosis intoxication, etc.).

Treatment and prevention of chronic gastritis

The variety of etiology and pathogenetic features of various forms of chronic gastritis determines the diversity of measures to prevent the disease and its exacerbations. The main one is to ensure the diet and diet according to the age of the child. In this case, it is necessary to monitor the thorough chewing of food, its moderate temperature, limit or exclude the use of hot seasonings and canned food. It is also necessary to ensure timely detection and treatment of somatic diseases, neuro-endocrine disorders, focal infectious processes, ascariasis, which contribute to the development of chronic gastritis after functional secretory-motor disorders of the stomach. In this light, clinical examination of children with the risk of developing chronic gastritis or undergoing its exacerbation is of great importance. It is necessary to remember the role of a hereditary predisposition to diseases of the stomach, in particular to chronic gastritis.
The basis of the complex of therapeutic measures for chronic gastritis is diet therapy, built taking into account the clinical, functional (primarily secretory) features and phase of the disease. Regardless of the form of gastritis, the diet includes 5 – 6 feedings per day in reduced portions. With hyposecretion, this is explained by the desire to reduce the residence time of food masses in the stomach, as well as maximize the use of the reduced digesting ability of gastric juice.
With hypersecretion and increased acidity, an increase in food intake helps to some extent prevent the adverse effects of gastric juice on the wall of an empty stomach in conditions of an impaired mucous protective barrier.
In the initial period of exacerbation, mashed non-meaty soups, jelly, white crackers, butter, tea are prescribed . Being chemically and mechanically gentle, this diet almost does not irritate the mucous membrane of the patient’s stomach. A few days later, boiled ground lean meat, fish, eggs, vegetable and fruit purees are introduced into the diet. Such nutrition can be immediately prescribed to patients who are poorly tolerated by food restriction, malnourished children.
As the condition of patients improves, the diet is expanded. For gastritis with secretory insufficiency, diet number 2 is prescribed for several months, including products that stimulate secretion quite strongly – meat and fish decoctions, soaked chopped herring, caviar, etc. In the future, cutlets, fried meat, low-fat sausages are introduced into the diet casseroles. The diet should be full in composition and energy value, fortified, which contributes to reparative processes in the gastric mucosa. Fatty meats and fish, fresh bread, foods containing a large amount of crude fiber, spicy and canned foods, and cold drinks are still not recommended. With increased acidity, a fairly complete, but sparing and less sokogonny diet No. 1 with a subsequent expansion of the diet is prescribed for the same period .
Clinical experience convinces of the advisability of starting treatment of chronic gastritis in a hospital. This allows you to immediately change the usual stereotype in the conditions of which the disease arose, it is better to examine the child and establish the optimal therapeutic and dietary regimen. A prerequisite for successful treatment in the hospital and at home is a calm benevolent environment, a rational regime with the correct alternation of classes and rest, a long stay in the air, enough time for night and day sleep.
In gastritis with secretory insufficiency, a 2% solution of diluted hydrochloric acid should be prescribed in a dessert or tablespoon 4 times a day, natural gastric juice or tablets of beta-acid or acidin- pepsin in an age-related dosage. A plantaglucid has a good therapeutic effect , a freshly prepared solution of which (1/2 – 1 teaspoon of granules in 1/4 cup of warm water) the child takes 3 times a day 20 minutes before meals for 3 to 4 weeks. In gastritis with high acidity and the corresponding symptoms, alkali (drinking soda, magnesium oxide), vicalin , which, like other antacids, should be taken 30 to 40 minutes after a meal, washed down with 1/3 cup of warm water. Almagel is also effective – 1 teaspoon 20 minutes before meals 3 times a day, gastropharma . Favorably affect the tone and motility of the stomach, contribute to the removal of pain quateron , no-spa, platifillin , drugs of the belladonna group. Ascorbic acid, nicotinic acid, pyridoxine and cyanocobalamin are also shown . Patients with reduced appetite and significant emaciation should undergo a course of treatment with non-hormonal and hormonal anabolic drugs – potassium orotate , nerobol . Treatment for gastritis that occurs as a complication of a disease should be carried out in combination with intensive care of the underlying disease. Sanatorium treatment of chronic gastritis in children is carried out in Essentuki, Zheleznovodsk, Truskavets and other resorts.

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