Depending on the etiology and related features of the pathogenesis and clinic of the disease, there are alimentary, texico- infectious and secondary ( para-infectious ) forms of acute gastritis (gastroenteritis). The first two forms are more often observed in the summer, which is facilitated by the lability of the digestive processes under conditions of overheating, a greater possibility of overeating unripe fruits and berries, as well as the comparative ease of spoilage and infection of food products. Acute gastritis occurs more easily in children weakened, as well as in children with hypersensitivity to certain food ingredients.
Clinic of acute gastritis, gastroenteritis
Alimentary form of acute gastritis
The alimentary form of acute gastritis begins suddenly in the midst of full health, 4-8 hours after a violation of the diet. Abundant, sometimes repeated vomiting with the remnants of food in the vomit is usually preceded by a period of discomfort when the child complains of malaise, chills, nausea, headache, a feeling of fullness of the stomach and spilled pain in the abdomen. When examined, pale skin and lethargy of the child are noteworthy. . The tongue is coated with a coating, a sweet smell of fermentation from the mouth appears, with repeated vomiting – the smell of acetone. The abdomen is slightly swollen, on palpation it is sensitive in the epigastric region, sometimes the body temperature rises to 38 – 39 ° С. In mild cases, the child’s condition after vomiting quickly improves, and in the next 1 to 2 days, he recovers.
Occasionally, preschool children may develop severe general intoxication, resembling a picture of toxic dyspepsia. Vomiting is repeated even after drinking water, diarrhea intensifies, oliguria occurs . In the urine, protein, gzone , cylinders are determined . Against the background of severe dehydration and impaired salt metabolism, signs of irritation of the meninges, convulsions, symptoms of damage to the cardiovascular system – dull heart sounds, frequent and low heart rate, and a tendency to lower blood pressure can occur.
Toxic infectious form
The toxic-infectious form of the disease usually proceeds as gastroenteritis or gastroenterocolitis , signs of a predominant lesion of the stomach are detected less often. In the first case, food infection, leading to the development of the disease, is caused by microbes from the Salmonella group, sometimes Escherichia coli, in the second – more often by staphylococci. Features of the course of the disease depend on the age and reactivity of the child’s body, the massiveness of the infection, and also the virulence of the flora.
The duration of the incubation period ranges from several hours (staphylococcal infection) to a day or more (salmonellosis). The clinical picture of the disease is very similar to that described in the alimentary form of acute gastritis, however, intoxication and dehydration are more pronounced, more persistent vomiting and diarrhea, the nervous and cardiovascular systems are more often involved in the pathological process, the level and prolonged period of increase in body temperature are higher. In severe cases, the process recovery is delayed up to 7-10 days, and if untimely or improper treatment can be fatal.
Secondary acute gastritis
Secondary acute gastritis, complicating severe infectious and somatic diseases (scarlet fever, measles, viral respiratory diseases, dysentery, rheumatism, glomerulonephritis , etc.), develops due to the high sensitivity of the gastric mucosa to trophic disorders and pathological metabolic products circulating in the blood. Intravital diagnosis of gastritis is difficult, as the nausea, vomiting, abdominal pain and other symptoms that are observed in this case are often interpreted as a manifestation of the underlying disease. Meanwhile, the probability of developing gastritis is evidenced not only by morphological studies. It has long been known that the diet has a beneficial effect in these diseases, not only taking into account metabolic disorders associated with toxicosis, but also sparing the mucous membrane of the stomach and intestines. Strict adherence to such a diet and the subsequent gradual expansion of the diet in combination with stimulating vitamin and enzyme therapy can prevent the development of functional disorders of the alimentary canal, anorexia, and reduced food tolerance in convalescents .