What are the common symptoms of gastritis. How is gastritis diagnosed and treated. What causes inflammation of the stomach lining. Can gastritis lead to serious complications if left untreated.

Understanding Gastritis: An Overview of Stomach Lining Inflammation

Gastritis is a condition characterized by inflammation, irritation, or erosion of the stomach lining. This common digestive disorder can occur suddenly (acute gastritis) or develop gradually over time (chronic gastritis). While gastritis is often not serious and can be effectively treated, it’s essential to understand its causes, symptoms, and potential complications to ensure proper management and prevent long-term health issues.

Recognizing the Symptoms of Gastritis

The symptoms of gastritis can vary widely among individuals, and in some cases, people may not experience any noticeable signs. However, when symptoms do occur, they may include:

• Indigestion or discomfort in the upper abdomen
• Gnawing or burning stomach pain
• Nausea and vomiting
• Feeling full after eating small amounts of food
• Loss of appetite
• Bloating

In cases of erosive gastritis, where the stomach lining has been worn away and exposed to stomach acid, additional symptoms may include:

• Severe abdominal pain
• Bleeding in the stomach
• Development of stomach ulcers

Acute vs. Chronic Gastritis: Understanding the Difference

Acute gastritis occurs suddenly and may cause severe symptoms that last for a short period. Chronic gastritis, on the other hand, develops gradually and can persist for months or even years if left untreated. Is there a difference in the management of acute and chronic gastritis? While the underlying principles of treatment are similar, chronic gastritis may require more long-term management strategies and lifestyle modifications to prevent recurrence.

Common Causes of Gastritis: What Triggers Stomach Lining Inflammation?

Gastritis can be caused by various factors that irritate or damage the stomach lining. Some of the most common causes include:

1. Helicobacter pylori (H. pylori) infection: This bacteria can live in the mucous lining of the stomach and is a leading cause of gastritis worldwide.
2. Excessive alcohol consumption: Regular or heavy alcohol use can irritate and erode the stomach lining.
3. Nonsteroidal anti-inflammatory drugs (NSAIDs): Frequent use of medications such as aspirin, ibuprofen, and naproxen can lead to gastritis.
4. Stress: Severe stress can increase stomach acid production and potentially lead to gastritis.
5. Autoimmune disorders: In some cases, the immune system may mistakenly attack the stomach lining, causing autoimmune gastritis.
6. Bile reflux: A backflow of bile from the bile tract into the stomach can irritate the stomach lining.
7. Bacterial or viral infections: Certain infections can cause gastritis as a secondary effect.

Are certain individuals more susceptible to developing gastritis? People with weakened immune systems, older adults, and those who regularly use NSAIDs or consume excessive amounts of alcohol may be at higher risk for developing gastritis.

Diagnosing Gastritis: Medical Tests and Procedures

To diagnose gastritis, healthcare providers may employ various diagnostic tools and procedures. These may include:

• Physical examination and medical history review
• Upper endoscopy: A thin tube with a camera is inserted through the mouth to examine the stomach lining
• Blood tests: To check for anemia, H. pylori infection, or other markers of inflammation
• Stool tests: To detect the presence of blood in the stool or H. pylori bacteria
• Breath tests: To identify H. pylori infection
• Barium swallow: An X-ray examination of the upper digestive tract

How accurate are these diagnostic methods in identifying gastritis? While each test has its strengths and limitations, a combination of these diagnostic tools, along with a thorough evaluation of symptoms and medical history, can provide a reliable diagnosis in most cases.

Effective Treatment Options for Gastritis

The treatment of gastritis typically involves a combination of medication, dietary changes, and lifestyle modifications. The specific approach may vary depending on the underlying cause and severity of the condition. Common treatment options include:

Medications

• Antacids: To neutralize stomach acid and provide quick relief from symptoms
• Proton pump inhibitors (PPIs): To reduce stomach acid production
• H2 blockers: To decrease acid production in the stomach
• Antibiotics: To eradicate H. pylori infection, if present
• Cytoprotective agents: To protect the stomach lining from acid and promote healing

Dietary and Lifestyle Changes

• Avoiding trigger foods: Spicy, acidic, or fatty foods may worsen symptoms
• Eating smaller, more frequent meals
• Limiting or avoiding alcohol consumption
• Quitting smoking
• Managing stress through relaxation techniques or counseling
• Avoiding NSAIDs or using them under medical supervision

How long does it typically take for gastritis to improve with proper treatment? Many people experience significant improvement within a few weeks of starting treatment. However, the duration of treatment may vary depending on the underlying cause and individual response to therapy.

Potential Complications of Untreated Gastritis

While gastritis often resolves with appropriate treatment, leaving it untreated can lead to various complications, including:

• Stomach ulcers: Prolonged inflammation can cause open sores in the stomach lining
• Gastrointestinal bleeding: Severe gastritis may result in bleeding within the digestive tract
• Anemia: Chronic blood loss from gastritis can lead to iron-deficiency anemia
• Increased risk of stomach cancer: Long-term, untreated H. pylori infection and chronic gastritis may increase the risk of developing stomach cancer
• Pernicious anemia: A specific type of autoimmune gastritis can interfere with vitamin B12 absorption, leading to this form of anemia

Can gastritis lead to long-term digestive issues if left untreated? Chronic, untreated gastritis can potentially cause persistent digestive problems and increase the risk of developing more serious conditions such as peptic ulcers or gastric cancer.

Preventing Gastritis: Lifestyle Strategies for Stomach Health

While not all cases of gastritis can be prevented, certain lifestyle choices and habits can help reduce the risk of developing this condition:

• Practicing good hygiene to reduce the risk of H. pylori infection
• Moderating alcohol consumption
• Using NSAIDs responsibly and under medical guidance
• Managing stress through healthy coping mechanisms
• Eating a balanced diet rich in fruits, vegetables, and whole grains
• Avoiding tobacco products
• Maintaining a healthy weight

Are there specific dietary recommendations for preventing gastritis? While individual triggers may vary, a diet low in acidic and spicy foods, and rich in fiber and antioxidants, may help support stomach health and reduce the risk of gastritis.

When to Seek Medical Attention for Gastritis Symptoms

While mild cases of gastritis may resolve on their own or with over-the-counter treatments, it’s important to recognize when professional medical care is necessary. Consider seeking medical attention if you experience:

• Severe or persistent abdominal pain
• Vomiting blood or passing black, tarry stools
• Symptoms that persist for more than a week despite self-care measures
• Difficulty swallowing or painful swallowing
• Unintended weight loss
• Symptoms that interfere with daily activities or quality of life

How urgently should one seek medical care for suspected gastritis? While gastritis is often not a medical emergency, severe symptoms or signs of complications (such as gastrointestinal bleeding) warrant immediate medical attention.

Understanding gastritis, its causes, symptoms, and treatment options is crucial for maintaining digestive health and preventing potential complications. By recognizing the signs of gastritis and seeking appropriate medical care when necessary, individuals can effectively manage this common condition and protect their long-term stomach health. Remember that while gastritis can be uncomfortable and concerning, with proper diagnosis and treatment, most people experience significant improvement and can return to their normal daily activities.

Symptoms, Causes, Treatments, and More

Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).

What Causes Gastritis?

Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs. It may also be caused by any of the following:

• Helicobacter pylori (H. pylori): A bacteria that lives in the mucous lining of the stomach; without treatment, the infection can lead to ulcers, and in some people, stomach cancer.
• Bile reflux: A backflow of bile into the stomach from the bile tract (that connects to the liver and gallbladder)
• Infections caused by bacteria and viruses

If gastritis is left untreated, it can lead to a severe loss of blood and may increase the risk of developing stomach cancer.

What Are the Symptoms of Gastritis?

Symptoms of gastritis vary among individuals, and in many people there are no symptoms. However, the most common symptoms include:

How Is Gastritis Diagnosed?

To diagnose gastritis, your doctor will review your personal and family medical history, perform a thorough physical evaluation, and may recommend any of the following tests:

• Upper endoscopy. An endoscope, a thin tube containing a tiny camera, is inserted through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may perform a biopsy, a procedure in which a tiny sample of tissue is removed and then sent to a laboratory for analysis.
• Blood tests. The doctor may perform various blood tests, such as checking your red blood cell count to determine whether you have anemia, which means that you do not have enough red blood cells. They can also screen for H. pylori infection and pernicious anemia with blood tests.
• Fecal occult blood test (stool test). This test checks for the presence of blood in your stool, a possible sign of gastritis.

What Is the Treatment for Gastritis?

Treatment for gastritis usually involves:

• Taking antacids and other drugs (such as proton pump inhibitors or H-2 blockers) to reduce stomach acid
• Avoiding hot and spicy foods
• For gastritis caused by H. pylori infection, your doctor will prescribe a regimen of several antibiotics plus an acid blocking drug (used for heartburn)
• If the gastritis is caused by pernicious anemia, B12 vitamin shots will be given.
• Eliminating irritating foods from your diet such as lactose from dairy or gluten from wheat

Once the underlying problem disappears, the gastritis usually does, too.

You should talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.

What Is the Prognosis for Gastritis?

Most people with gastritis improve quickly once treatment has begun.

Gastritis – NHS

Gastritis occurs when the lining of the stomach becomes inflamed after it’s been damaged. It’s a common condition with a wide range of causes.

For most people, gastritis is not serious and improves quickly if treated. But if not, it can last for years.

Symptoms of gastritis

Many people with gastritis caused by a bacterial infection do not have any symptoms.

In other cases, gastritis can cause:

• indigestion
• gnawing or burning stomach pain
• feeling and being sick
• feeling full after eating

If the stomach lining has been worn away (erosive gastritis) and exposed to stomach acid, symptoms may include pain, bleeding or a stomach ulcer.

The symptoms of gastritis may come on suddenly and severely (acute gastritis) or last a long time (chronic gastritis).

When to see a GP

If you have indigestion and stomach pain, you can try treating this yourself with changes to your diet and lifestyle, or with medicines you can get from a pharmacy, such as antacids.

See a GP if:

• you have indigestion symptoms lasting a week or longer, or it’s causing you severe pain or discomfort
• you think it’s brought on by medicine you have been prescribed
• you’re vomiting blood or have blood in your poo (your poo may appear black)

Stomach ache and abdominal pain are not always a sign of gastritis.

The pain could be caused by a wide range of other things, from trapped wind to irritable bowel syndrome (IBS).

Diagnosing gastritis

A GP may recommend 1 or more of the following tests:

• a stool test – to check for infection or bleeding from the stomach
• a breath test for Helicobacter pylori (H. pylori) infection – this involves drinking a glass of clear, tasteless liquid that contains radioactive carbon and blowing into a bag
• an endoscopy – a flexible tube (endoscope) is passed down your throat and into your oesophagus and stomach to look for signs of inflammation
• a barium swallow – you’re given some barium solution, which shows up clearly on X-rays as it passes through your digestive system

Possible causes of gastritis

Gastritis is usually caused by 1 of the following:

• an H. pylori bacterial infection
• excessive use of cocaine or alcohol
• smoking
• regularly taking aspirin, ibuprofen or other painkillers classed as non-steroidal anti-inflammatory drugs (NSAIDs)
• a stressful event – such as a bad injury or critical illness, or major surgery
• less commonly, an autoimmune reaction – when the immune system mistakenly attacks the body’s own cells and tissues (in this case, the stomach lining)

H. pylori gastritis

Many people become infected with H. pylori bacteria and do not realise it. These stomach infections are common and do not usually cause symptoms.

But an H. pylori infection can sometimes cause recurring bouts of indigestion, as the bacteria can cause inflammation of the stomach lining.

This sort of gastritis is more common in older age groups and is usually the cause of chronic (persistent) non-erosive cases.

An H. pylori stomach infection is usually lifelong, unless it’s treated with eradication therapy.

Treating gastritis

Treatment aims to reduce the amount of acid in the stomach to relieve symptoms, allowing the stomach lining to heal and to tackle any underlying cause.

You may be able to treat gastritis yourself, depending on the cause.

Easing symptoms

• antacids – these over-the-counter medicines neutralise the acid in your stomach, which can provide rapid pain relief
• histamine 2 (h3) blockers – these medicines decrease acid production and are available to buy from your pharmacist and on prescription
• proton pump inhibitors (PPIs), such as omeprazole – these medicines decrease acid production even more effectively than h3 blockers

Some low-dose PPIs can be bought from your pharmacist without a prescription.

You’ll need a prescription from a GP for stronger doses.

Treating H. pylori infection

If an H. pylori infection is the cause of your gastritis, you’ll need to take a course of antibiotics alongside a proton pump inhibitor.

Things you can do to ease gastritis

If you think the cause of your gastritis is repeated use of NSAID painkillers, try switching to a different painkiller that’s not in the NSAID class, such as paracetamol.

You may want to talk to a GP about this.

Also consider:

Possible complications of gastritis

Gastritis that lasts for a long time can increase your risk of developing:

• a stomach ulcer
• polyps (small growths) in your stomach
• tumours in your stomach, which may or may not be cancerous

Gastritis or gastroenteritis?

• Gastroenteritis is inflammation (irritation) of the stomach and bowel, caused by an infection.
• Gastritis is inflammation of the stomach lining specifically, and not always caused by infection.

Page last reviewed: 20 May 2019
Next review due: 20 May 2022

Helicobacter Pylori | Cedars-Sinai

Not what you’re looking for?

What is Helicobacter pylori (H.
pylori)?

Helicobacter pylori (H. pylori) is a type of bacteria that infects your stomach. It can damage the tissue in your stomach and the first part of your small intestine (the duodenum). This can cause pain and inflammation . In some cases, it can also cause painful sores called peptic ulcers in your upper digestive tract.

H. pylori is common. Many people have it. Most people who have it won’t get ulcers or show any symptoms. But it is a main cause of ulcers.

H. pylori attacks the lining that protects your stomach. The bacteria makes an enzyme called urease. This enzyme makes your stomach acids less acidic. This weakens your stomach’s lining. Your stomach cells then have greater risk of being hurt by acid and pepsin, strong digestive fluids. That can lead to sores or ulcers in your stomach or duodenum.

The H. pylori bacteria can also stick to stomach cells. Your stomach can’t protect itself very well. The area gets red and swollen (inflamed).

H. pylori can also get the stomach to make more acid. Health experts don’t fully understand how.

H pylori can also cause stomach cancer.

What causes H. pylori
infection?

Health experts don’t know for sure how H. pylori infection is spread. They believe the germs can be passed from person to person by mouth, such as by kissing.

It may also be passed by having contact with vomit or stool. This may happen if you:

• Eat food that was not cleaned or cooked in a safe way
• Drink water that is infected with the bacteria

Who is at risk for H. pylori infection?

You may be at greater risk for H. pylori infection because of:

• Your age.
  Over half the people in the U.S. with the bacteria are over age 50.
• Your race or
  ethnicity. Almost half of all African Americans have the bacteria. Out of the
  people who come to the U.S. from developing countries, at least 50% of Latinos and
  50% of people from Eastern Europe have H. pylori.

Most people first get the bacteria when they are children, but adults can get it too.

What are the symptoms of H. pylori?

Most
people have the bacteria for years without knowing it because they don’t have any
symptoms. Experts don’t know why.

You
may have redness and swelling (inflammation) in your stomach lining. This is called
gastritis.  

You
may get sores or peptic ulcers in your stomach or the first part of your small intestine
(duodenum). Ulcer symptoms may include belly or abdominal pain, which can:

• Be a
  dull pain that doesn’t go away
• Happen
  2 to 3 hours after you eat
• Come and
  go for several days or weeks
• Happen
  in the middle of the night when your stomach is empty
• Go away
  when you eat or take medicines that reduce your stomach acid level (antacids)
• May cause anemia because of bleeding

Other symptoms of an ulcer may include:

• Weight
  loss
• Not
  feeling hungry
• Swelling or bloating
• Burping
• Having
  an upset stomach or nausea
• Vomiting

The
symptoms of ulcers may look like other health problems. Always see your healthcare
provider to be sure.

How is H. pylori diagnosed?

Your
healthcare provider will look at your past health and give you a physical exam. You may
also need to have tests, including:

• Blood
  tests. These check for infection-fighting cells (antibodies) that mean you
  have the bacteria.
• Stool
  culture. This looks for any abnormal bacteria in your digestive tract that
  may cause diarrhea and other problems. A small stool sample is collected and sent to
  a lab. In 2 or 3 days, the test will show if you have any abnormal bacteria.
• Stool antigen test. This takes a stool sample to
  check for the H pylori bacteria.
• Breath
  tests. These can check if there is any carbon after you swallow a urea pill
  that has carbon molecules. If carbon is found that means that H. pylori has made the
  enzyme urease. This enzyme makes your stomach acids less acidic. It weakens your
  stomach’s mucous lining.
• Upper
  endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at
  the lining of your food pipe (esophagus), stomach, and duodenum (the first part of
  your small intestine). It uses a thin, lighted tube or endoscope. The tube has a
  camera at one end. The tube is put into your mouth and throat. Then it goes down into
  your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of
  these organs. A small tissue sample (biopsy) is taken if needed. The tissue sample
  can show if you have the enzyme urease. It can also check the bacteria that is
  there.

How is H. pylori treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on
how severe the condition is.

Your
healthcare provider may have you take medicine that kills bacteria (antibiotics).

Other medicines may include:

• H-2 blockers.
  These are used to reduce the amount of acid in your stomach by blocking the
  hormone histamine. Histamine helps to make acid.
• Proton pump
  inhibitors. These help to keep your stomach from making acid. They do this by
  stopping the stomach’s acid pump from working.
• Stomach-lining protectors.These medicines protect your stomach lining from
  acid and help kill bacteria.
• You may
  have to take multiple medicines at the same time to get rid of the H pylori.
  Sometimes the medicine plan can be complicated, but it is important to follow
  instructions to get rid of the bacteria.

What are possible complications of
H. pylori?

If
you are infected with the bacteria you can get a painful sore called a peptic ulcer.
These sores form in your upper digestive tract.

A
very bad ulcer can wear away your stomach lining. It can also cause problems such
as:

• Bleeding
  when a blood vessel is worn away
• A hole
  or perforation in your stomach wall
• Blockage
  when the ulcer is in a spot that blocks food from leaving your stomach

H. pylori can also lead to stomach
cancer.

What can I do to prevent H. pylori?

Health experts don’t know for sure how the bacteria passes from person to person. But having good health habits (hygiene) can help keep you safe. These habits include:

• Washing your hands with soap and water. It is very important to do this after using the bathroom and before eating.
• Making
  sure all food you eat has been cleaned and cooked safely.
• Making
  sure that your drinking water is safe and clean.

Living with H. pylori

Once you know for sure that you have
H. pylori, follow up with your healthcare provider. They will do some tests to make sure
the bacteria has been removed.

When should I call my healthcare provider?

Call your healthcare provider if your
symptoms get worse or you have new symptoms. Call right away if you have symptoms such
as bloody vomit, blood in your stools, or black, tarry-looking stools. Call your
healthcare provider if you are losing weight without trying.

Key points about H. pylori

• H. pylori is a type of bacteria that infects your stomach.
• It attacks your stomach and the first part of your small intestine (duodenum). This can cause redness and swelling (inflammation).
• Many people with the bacteria won’t have any symptoms.
• It can cause open sores called peptic ulcers in your upper digestive tract.
• It can cause stomach cancer.
• It may be passed or spread from person to person by mouth, such as by kissing. It may also be passed by direct contact with vomit or stool.
• Having good health habits (hygiene) can help protect you.

Next steps

Tips to help you get the most from a visit to your healthcare
provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember
  what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any
  new medicines, treatments, or tests. Also write down any new instructions your
  provider gives you.
• Know why a new medicine or treatment is prescribed, and how it
  will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results
  could mean.
• Know what to expect if you do not take the medicine or have the
  test or procedure.
• If you have a follow-up appointment, write down the date, time,
  and purpose for that visit.
• Know how you can contact your provider if you have questions.

Not what you’re looking for?

Indigestion, Symptoms, Causes, Treatment, Diagnosis

Overview

What is gastritis?

Your stomach has a protective lining of mucus called the mucosa. This lining protects your stomach from the strong stomach acid that digests food. When something damages or weakens this protective lining, the mucosa becomes inflamed, causing gastritis. A type of bacteria called Helicobacter pylori (H. pylori) is the most common bacterial cause of gastritis.

What’s the difference between gastritis and indigestion?

Gastritis symptoms can mimic indigestion symptoms. Indigestion is pain or discomfort in the stomach associated with difficulty in digesting food. It may be a feeling of burning between your lower ribs. You may hear indigestion referred to by its medical term, dyspepsia.

How common is gastritis?

Acute (sudden) gastritis affects about 8 out of every 1,000 people. Chronic, long-term gastritis is less common. It affects approximately 2 out of 10,000 people.

Who might get gastritis?

Your risk of developing gastritis goes up with age. Older adults have thinner stomach linings, decreased circulation and a slower metabolism of mucosal repair. Older adults are also more likely to be on medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) that can cause gastritis. About two-thirds of the world’s population is infected with H. pylori. Fortunately, it is less common in the United States. In the United States, H. pylori is found more often in older adults and lower socioeconomic groups.

What are the types of gastritis?

There are two main types of gastritis:

• Erosive (reactive): Erosive gastritis causes both inflammation and erosion (wearing away) of the stomach lining. This condition is also known as reactive gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or bacterial infections and stress from illnesses or injuries.
• Non-erosive: Inflammation of the stomach lining without erosion or compromising the stomach lining.

Symptoms and Causes

What causes gastritis?

Gastritis occurs when something damages or weakens the stomach lining (mucosa). Different things can trigger the problem, including:

• Alcohol abuse: Chronic alcohol use can irritate and erode the stomach lining.
• Autoimmune disease: In some people, the body’s immune system attacks healthy cells in the stomach lining.
• Bacterial infection: H. pylori bacteria are the main cause of chronic gastritis and peptic ulcer disease (stomach ulcers). The bacteria break down the stomach’s protective lining and cause inflammation.
• Bile reflux: The liver makes bile to help you digest fatty foods. “Reflux” means flowing back. Bile reflux occurs when bile flows back into the stomach instead of moving through the small intestine.
• Medications: Steady use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to manage chronic pain can irritate the stomach lining.
• Physical stress: A sudden, severe illness or injury can bring on gastritis. Often, gastritis develops even after a trauma that doesn’t involve the stomach. Severe burns and brain injuries are two common causes.

What are the symptoms of gastritis?

Many people with gastritis don’t have symptoms. People who do have symptoms often mistake them for indigestion. Other signs of gastritis include:

Is gastritis contagious?

Gastritis isn’t contagious, but the bacteria, H. pylori, can be contagious via the fecal-to-oral route. Good hand washing before handling of foods and proper sanitation (sewer and water systems) are the first line of defense against spread. Many people can develop gastritis after being infected with H. pylori bacteria.

Diagnosis and Tests

How is gastritis diagnosed?

Your healthcare provider will ask about your symptoms and history and perform a physical exam. Your provider may also order one or more of these tests:

• Breath test: During an H. pylori breath test, you swallow a capsule or liquid containing urea, a harmless radioactive material. You then exhale into a balloon-like bag. H. pylori bacteria change urea into carbon dioxide. If you have the bacteria, the breath test will show an increase in carbon dioxide.
• Blood test: A blood test checks for antibodies titers that fight H. pylori bacteria.
• Stool test: This test checks for H. pylori bacteria in your stool (poop).
• Upper endoscopy: Your doctor uses an endoscope (a long thin tube with an attached camera) to see your stomach. The doctor inserts the scope through your esophagus, which connects your mouth to your stomach. An upper endoscopy procedure allows your provider to examine the stomach lining. You may also have a tissue sample (biopsy) taken from your stomach lining to test for infection.
• Upper gastrointestinal (GI) exam: During an upper GI exam, you swallow a chalky substance called barium. The liquid coats your stomach lining, providing more detailed X-ray images.

Management and Treatment

How is gastritis treated?

Treatment for gastritis varies depending on the cause. Certain medications kill bacteria, while others alleviate indigestion-type symptoms. Your healthcare provider might recommend:

• Antibiotics: Antibiotics can treat the bacterial infection. You may need to take more than one type of antibiotic for couple of weeks.
• Antacids: Calcium carbonate medications reduce stomach acid exposure. They can help relieve inflammation. Antacids, such as Tums® and Rolaids®, also treat heartburn.
• Histamine (h3) blockers: Cimetidine (Tagamet®), ranitidine (Zantac®) and similar medications decrease the production of stomach acid.
• Proton pump inhibitors: These medications, such as omeprazole (Prilosec®) and esomeprazole (Nexium®), reduce the amount of acid your stomach produces. Proton pump inhibitors also treat stomach ulcers and gastroesophageal reflux disease (GERD).

What are the complications of gastritis?

If left untreated, gastritis can lead to serious problems, such as:

• Anemia: H. pylori can cause gastritis or stomach ulcers (sores in your stomach).that bleed, thereby lowering your red blood counts (called anemia).
• Pernicious anemia: Autoimmune gastritis can affect how your body absorbs vitamin B12. You’re at risk of pernicious anemia when you don’t get enough B12 to make healthy red blood cells.
• Peritonitis: Gastritis can worsen stomach ulcers. Ulcers that break through the stomach wall can spill stomach contents into the abdomen. This rupture can spread bacteria, causing a dangerous infection called bacterial transloction or peritonitis. It also can lead to a widespread inflammation called sepsis. Sepsis can be fatal.
• Stomach cancer: Gastritis caused by H. pylori and autoimmune disease can cause growths in the stomach lining. These growths increase your risk of stomach cancer.

Prevention

How can I prevent gastritis?

H. pylori is one of the top causes of gastritis, but most people don’t know they’re infected. The bacteria are easily transmitted. You can lower your risk of infection by practicing good hygiene, including hand-washing.

You also can take steps to minimize indigestion and heartburn. These conditions are linked to gastritis. Preventive measures include:

• Avoiding fatty, fried, spicy or acidic foods.
• Cutting back on caffeine.
• Eating smaller meals throughout the day.
• Managing stress.
• Not taking NSAIDs.
• Reducing alcohol consumption.
• Not lying down for 2 to 3 hours after a meal.

Outlook / Prognosis

What is the prognosis (outlook) for people with gastritis?

Most cases of gastritis improve quickly with treatment. For most people, medications relieve gastritis. Your healthcare provider will recommend the most appropriate treatment based on what’s causing gastritis. Antacids reduce stomach acid, while antibiotics clear up bacterial infections. You can also make changes like reducing your alcohol consumption and managing pain without NSAIDs.

Living With

When should I call the doctor?

You should call your healthcare provider if you experience:

• Blood in your stool (poop).
• Bloody vomit.
• Extreme weakness or fatigue that may indicate anemia.
• Uncontrolled GERD.
• Unexplained weight loss.
• Signs of gastritis recurring (coming back).

What questions should I ask my doctor?

If you have gastritis, you may want to ask your healthcare provider:

• Why did I get gastritis?
• Should I get tested for H. pylori?
• Should I get tested for anemia?
• Can I get gastritis again?
• What steps can I take to avoid getting gastritis again?
• Should I make any dietary changes?
• What medications or supplements should I avoid?
• Do I need to cut out alcohol?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Gastritis is a common but generally treatable condition. You may be surprised to learn that your indigestion is actually due to gastritis. Some people with gastritis don’t have any symptoms. Tests can help your healthcare provider determine the cause of gastritis. This allows you to receive the appropriate treatment.

Gastritis – Better Health Channel

Gastritis is inflammation (irritation) of the stomach lining. This may be caused by many factors including infection, alcohol, particular medications and some allergic and immune conditions. Gastritis can be either acute (with severe attacks lasting a day or two) or chronic (with long-term appetite loss or nausea). In many cases, gastritis has no symptoms (asymptomatic).

Some forms, including chronic atrophic gastritis, have been associated with an increased risk of stomach cancer. Treatment options include avoiding exposure to known irritants and taking medication to reduce the amount of gastric juices.

Symptoms of gastritis

In many cases, gastritis has no symptoms. Common symptoms can include:

• loss of appetite
• pain in the upper abdomen just under the ribs
• nausea or indigestion
• hiccups
• vomiting
• blood in the vomit
• blood in the bowel actions, if the stomach lining has ulcerated (this turns stools black and is called melaena)
• weight loss.

The stomach

The stomach is an organ of the digestive system, located in the abdomen just below the ribs. Swallowed food is mixed with gastric juices containing enzymes and hydrochloric acid. The lining of the stomach, called the epithelium, is layered with multiple folds. The epithelium is coated with mucus (gastric mucosa) secreted by special glands. Inflammation caused by gastritis occurs in this lining.

Causes of gastritis

Gastritis can be caused by many different factors, including:

• medication such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDS)
• infection with the Helicobacter pylori bacteria, the organism responsible for the majority of stomach and duodenal ulcers
• alcohol
• protracted vomiting
• overproduction of gastric juices, which is a stress response in some people
• the backflow of bile from the small intestine (duodenum)
• some allergic and immune conditions – for example, pernicious anaemia
• exposure to radiation.

Diagnosis of gastritis

Diagnosing gastritis involves a variety of tests, including:

• Endoscopy – a thin flexible tube is threaded down the oesophagus into the stomach. The endoscope is fitted with a small camera so the physician can look at the stomach lining. If the gastric mucosa is reddened, this may indicate gastritis. A biopsy is needed for confirmation.
• Biopsy – small tissue samples are taken during an endoscopy and tested in a laboratory. The pathologist will look for changes, including the presence of inflammatory cells and epithelium damage.

Treatment for gastritis

Treatment for gastritis may include:

• Identifying the cause – once the cause is identified, steps can be taken to avoid exposure. For example, if alcohol is triggering the inflammation, you can abstain or reduce the amount of alcohol you drink. Anti-inflammatory drugs taken to help manage other conditions may need to be stopped or replaced with an alternative.
• Medication – tablets are available to reduce the acid content in the gastric juices. You may need to take these medications for a few weeks or months, depending on your situation.
• Dietary modifications – such as limiting or avoiding alcohol and caffeine, which can irritate the stomach lining.
• No treatment – often gastritis is found by chance during an endoscopy. If Helicobacter pylori is not present, and there are no other features seen on biopsy, there is usually no need to treat the gastritis.

Helicobacter pylori infection

The Helicobacter pylori bacterium causes gastritis and is also responsible for most peptic ulcers. A peptic ulcer is a hole in the lining of the stomach, duodenum or oesophagus. Helicobacter pylori bacterium is thought to be a cause of indigestion and a contributing factor in the development of stomach cancer.

The germs live in the lining of the stomach and the chemicals they produce cause irritation and inflammation. Diagnosis includes a special breath test to check for gaseous by-products of the bacteria. Treatment includes a combination of different antibiotics, followed by breath tests to make sure the medication has worked.

Where to get help

• Your doctor
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Gastroenterologist

Things to remember

• Gastritis is inflammation (irritation) of the stomach lining.
• Common causes include infection, anti-inflammatory medication and alcohol.
• Treatment options include avoiding exposure to known irritants, and medication to reduce the amount of gastric juices.

Peritonitis: Symptoms, causes, and treatment

Peritonitis is a disorder of the peritoneum. This is the moist tissue around the inside of the stomach wall. The condition usually occurs following a bacterial infection.

It is a serious and urgent condition that requires immediate treatment. Symptoms include sudden, severe abdominal pain.

A rupture, also known as a perforation, often causes infection. One example is the rupture of the appendix during a case of appendicitis. Pus from the infection can move from the gut into the peritoneum.

Fast facts on peritonitis

• Peritonitis is an infection of the stomach lining.
• It can cause swelling and severe stomach pain. Peritonitis is considered a medical emergency.
• The condition can be diagnosed using CT scans, ultrasound scans, and blood tests.
• Peritonitis can be caused by injury or infection.
• It is treated with IV antibiotics or surgery, depending on the cause.

The symptoms of peritonitis are serious. They need urgent medical attention in a nearby emergency room or an ambulance callout.

People who develop peritonitis while already in hospital need urgent attention.

The main symptom is sudden, severe stomach pain that gets worse.

Some effects of peritonitis are related to serious effects in the body such as dehydration and shock. Other symptoms include:

• fever
• nausea and vomiting
• diarrhea
• loss of appetite
• fast heart rate
• inability to pass stool or gas, and difficulties passing urine

It is important to get medical help for these symptoms whether they relate to peritonitis or not.

Doctors will want to rule out peritonitis or treat other potentially life-threatening conditions.

Swollen abdomen

A swollen abdomen is also a symptom of peritonitis. When a rupture causes peritonitis, fluid fills the abdominal cavity and the bowel, resulting in loss of fluid from the rest of the body. This causes the worst dehydration effects of peritonitis.

When liver disease is the cause of peritonitis, a swollen abdomen can occur for a different reason. This usually occurs without the perforation seen in other types of peritonitis. This is known spontaneous bacterial peritonitis.

This form of peritonitis has different symptoms. Discomfort is the main symptom of spontaneous bacterial peritonitis due to the pressure of the increased fluid. For people with liver disease whose swollen abdomens become infected, the pain is mild to moderate, not severe.

Complications

Without prompt treatment, peritonitis can lead to more dangerous conditions such as sepsis and septic shock. As a result, the condition can quickly become life-threatening.

The abdominal cavity contains the main parts of the gut, such as the stomach and intestines. It also contains other organs such as the liver and kidneys.

The peritoneum lines the abdominal wall but also forms folds that go inward. By folding in, the peritoneum weaves between abdominal organs, providing a membrane that protects and stabilizes the organs in the abdomen.

The folds of the peritoneum also contain blood and nerve supplies. These vessels can be seen running through the membrane that secures the intestines.

Infections cause most cases of peritonitis. In rare cases, these are infections of the peritoneum itself, but infections from elsewhere in the body are a more common cause.

A rupture in the gut is often a source of infection. Ruptures can come from a burst appendix or a hole created by a severe stomach ulcer.

People on a type of kidney dialysis that involves exchanging peritoneal fluids can also become infected.

Other possible causes include:

• inflammation of the pancreas
• inflammation of the gut by conditions such as Crohn’s disease
• diverticulitis, or inflammation of pouches in the large bowel wall
• injuries that cause abdominal trauma, such as knife or gun wounds

Peritonitis can happen to people who have excess fluid in their abdomen because of long-standing disease, especially liver disease. This is one of the less common causes.

While uncommon, the peritoneum can also be affected by cancer.

People with suspected peritonitis should visit a doctor for diagnosis as soon as possible.

A doctor will question the individual about their symptoms to help them narrow down the exact type, timing, and location of symptoms.

Share on PinterestAn ultrasound scan may be carried out to identify any physical injuries to the peritoneum.

A person with peritonitis may not notice any symptoms but a doctor can detect the condition before symptoms become noticeable.

During peritoneal dialysis for kidney disease, for example, a patient will be at risk of infection through the abdominal wall. Doctors will monitor the appearance and may diagnose and treat peritonitis straight away if this fluid is cloudy.

For any case of suspected peritonitis, doctors check the signs by carrying out a physical examination of the abdomen.

Further investigations are made to check for infection. These tests might include:

• blood samples to confirm immune reaction
• blood samples to test for wider bacterial complications
• X-ray or ultrasound imaging to help to locate ruptures in the gut
• CT imaging that can provide a more detailed computer picture

Paracentesis

Another diagnostic procedure is paracentesis. This involves taking fluid from the abdomen to directly check for infection. A thin needle is inserted through the abdominal wall under local anesthetic.

The fluid is then tested for signs of inflammation and infection.

Excess fluid in the abdomen can fill the abdominal cavity between the organs. Doctors call this condition ascites, and the fluid is known as ascitic fluid.

The test includes sending off the fluid sample to analyze white blood cell counts and chemicals. The lab can also look for bacteria and other microbes under the microscope, or by using stains and cultures.

Not all cases of peritonitis require paracentesis.

Having fluid in the abdomen may be the reason for the hospital visit in the first place. This extra fluid is more common in people who have liver disease.

According to a paper by the American College of Gastroenterologists, spontaneous bacterial peritonitis is found in some 20 percent of people admitted to hospital with ascites because of liver cirrhosis.

Peritonitis is considered an emergency and treatment is normally carried out in-hospital.

Treatment options will include:

• Antibiotic medications: These can be applied directly to the blood using intravenous (IV) injection. The doctor will start by using general purpose antibiotics before waiting for the tests to identify the bacteria. If the more general antibiotic medications do not have the desired effect, a doctor may administer more specific drugs later.
• Surgery: Doctors will consider surgery in cases where the cause is, for example, a hole in the gut. An operation may also be needed to remove damaged peritoneal tissue.
• Wider support therapies: These therapies can range from intensive life support to dietary assistance.

Prevention

Peritonitis is not always preventable, and it can happen without warning. However, some cases can be preventable.

Good clinical hygiene is vital. This is especially true for people with kidney disease who have the peritoneal form of dialysis. Infections can be introduced into the abdomen this way, so hygiene preparations before dialysis can be central to the prevention of peritonitis.

Rapid treatment can help prevent some potential cases of peritonitis. If a gut perforation or rupture is the cause, quick action could prevent the condition from developing.

People should call for medical attention immediately after the onset of severe stomach pain.

Gastritis | Patient

What are the symptoms of gastritis?

Many people with gastritis don’t have any symptoms. However, gastritis can cause indigestion (dyspepsia). See the separate leaflet called Indigestion (Dyspepsia).

Gastritis may start suddenly (acute) or may develop slowly and last for a long period of time (chronic).

Pain in your upper tummy (abdomen) just below the breastbone (sternum) is the common symptom. It usually comes and goes. It may be eased if you take antacid tablets. Sometimes food makes the pain worse. The pain may also wake you from sleep.

Other symptoms which may occur include:

• Loss of appetite.
• Bloating.
• Retching.
• Feeling sick (nausea).
• Being sick (vomiting).
• You may feel particularly ‘full’ after a meal.

What else might it be?

Don’t assume that stomach pain is always a sign of gastritis – the pain could be caused by a wide range of other things, such as a non-ulcer dyspepsia, duodenal ulcer, stomach ulcer or irritable bowel syndrome. See the separate leaflet called Abdominal Pain.

See your GP if:

• You have bad pain in your tummy (abdomen) or feel unwell.
• You have pain or any other indigestion symptoms lasting for more than a week.
• The gastritis starts after taking any medicine (prescription or over-the-counter).
• You are bringing up (vomiting) blood or the colour of the vomit is like coffee.
• You have any blood in your stools (faeces). (Bleeding from your stomach may make your stools look black.)
• You have recently lost weight without deliberately trying to diet.

What are the treatments for gastritis?

If you have indigestion and stomach pain, you can try treating this yourself with changes to your diet and lifestyle as follows:

If you think the cause of your gastritis is repeated use of non-steroidal anti-inflammatory drugs (NSAIDs), try switching to a different painkiller that isn’t in the NSAID class, such as paracetamol. You may want to talk with your GP about this.

Acid-suppressing medication

See the separate leaflet called Indigestion Medication for more information.

If your gastritis is caused by Helicobacter pylori (H. pylori)

The tests may show that you have infection with H. pylori. See the separate leaflet called Helicobacter Pylori for more details about the treatment for H. pylori infection.

If your gastritis is caused by an anti-inflammatory medicine

If possible, you should stop the anti-inflammatory medicine. This allows the gastritis to heal. You will also normally be prescribed an acid-suppressing medicine for several weeks. This stops the stomach from making acid and allows the gastritis to heal. However, in many cases the anti-inflammatory medicine is needed to ease symptoms of joint inflammation (arthritis) or other painful conditions, or aspirin is needed to protect against blood clots. In these situations, one option is to take an acid-suppressing medicine each day indefinitely. This reduces the amount of acid made by the stomach and greatly reduces the chance of gastritis forming again.

What causes gastritis?

Your stomach normally produces acid to help with the digestion of food and to kill germs (bacteria). This acid is corrosive, so some cells on the inside lining of the stomach produce a natural mucous barrier. This protects the lining of the stomach and the first part of the small intestine (the duodenum). There is normally a balance between the amount of acid that you make and the mucous defence barrier. Gastritis may develop if there is an alteration in this balance, allowing the acid to damage the lining of the stomach.

Infection with

H. pylori gastritis

Infection with H. pylori is the cause in about 8 in 10 cases of stomach ulcer. Once you are infected, unless treated, the infection usually stays for the rest of your life. See the separate leaflet called Helicobacter Pylori for more information.

Anti-inflammatory medicines – including aspirin

Anti-inflammatory medicines are sometimes called NSAIDs. Many people take an anti-inflammatory medicine for joint inflammation (arthritis), muscular pains, etc. These medicines sometimes affect the mucous barrier of the stomach and allow acid to cause an ulcer. About 2 in 10 stomach ulcers are caused by anti-inflammatory medicines.

Other causes

A stressful event – such as a bad injury or critical illness, or major surgery. Exactly why stress and serious illness can lead to gastritis is not known. However, it may be related to decreased blood flow to the stomach.

Less commonly, gastritis can be caused by an autoimmune reaction – when the immune system mistakenly attacks the body’s own cells and tissues (in this case, the stomach lining). This may happen if you already have another autoimmune condition, such as Hashimoto’s thyroid disease or type 1 diabetes.

Other causes of gastritis include cocaine abuse or drinking too much alcohol. Occasionally viruses, parasites, fungi and bacteria other than H. pylori are the culprits.

What tests may be done?

Your GP can usually make a diagnosis of gastritis by taking a history of your symptoms and an examination of your tummy (abdomen). Mild gastritis does not usually need any tests.

If gastritis doesn’t get better quickly or causes severe pain then your GP will arrange tests. Your GP may arrange blood tests, including a test for anaemia, as gastritis occasionally causes some bleeding from your stomach lining.

Gastroscopy (endoscopy) is the test that can confirm gastritis. In this test a doctor looks inside your stomach by passing a thin, flexible telescope down your gullet (oesophagus). They can see any inflammation or if there is any other abnormality, such as a stomach ulcer.

Small samples (biopsies) are usually taken of the stomach lining during endoscopy. These are sent to the laboratory to be looked at under the microscope. This also checks for cancer (which is ruled out in most cases).

A test to detect the H. pylori germ (bacterium) may also be done. H. pylori can be detected in a sample of stools (faeces), or in a ‘breath test’, or from a blood test, or from a biopsy sample taken during an endoscopy. See the separate leaflet called Helicobacter Pylori for more details.

Having a barium swallow and X-ray is another way to look for changes (such as ulcers) in the stomach lining. It is not as accurate as an endoscopy.

What are the possible complications of gastritis?

Gastritis usually resolves without any complications. Occasionally gastritis may develop into a stomach ulcer.

Bleeding from the stomach lining may also occur. This may cause you to bring up (vomit) blood (haematemesis) and you may become anaemic.

90,000 What prophylaxis is performed to prevent inflammation of the mucous membranes? How is mucositis (mucositis) treated?

author: Maria Yiallouros, Dr. med. habil. Gesche Tallen, erstellt am: 2009/07/29,
editor: Maria Yiallouros, Permission to print: Prof. Dr. med. Dr. h.c. Günter Henze, Translator: Dr. Natalie Kharina-Welke, last modified: 2019/03/19

The mucous membranes of the gastrointestinal tract (oral cavity, pharynx, esophagus, stomach and intestines) react very sensitively to the work of cytostatics.Therefore, when children receive chemotherapy [chemotherapy], it is these mucous membranes that often become inflamed. If, for example, the mucous membranes in the oral cavity and in the pharynx become inflamed, then the child may have bubbles, ulcers and / or other painful places there, it becomes painful for children to swallow, dry mouth appears and their taste sensations change.

If the mucous membranes in the stomach and intestines become inflamed, then the child may vomit, he has problems with digestion and diarrhea.The process itself, when the mucous membranes in the body become inflamed, doctors also call mucositis.

Since bacteria always live on the mucous membranes, especially in the oral cavity and in the intestines, our own bacteria through the surface of the wound on the mucous membrane can enter the body and cause other serious infections / infectious complications. Damaged mucous membranes are also susceptible to various viral and fungal infections. In addition, the body’s immunity is greatly weakened and the danger of contracting an infection is even higher because of this.

Good to know: in order not to cause pain to inflamed mucous membranes, as well as as a prophylaxis against infections, it is imperative to regularly and very thoroughly rinse your mouth with disinfecting solutions. In order not to injure mucous membranes, a mandatory recommendation is not to use toothbrushes with hard bristles, do not eat hot food and foods with sharp edges. You also need to give up hot spices and strongly acidic foods and drinks, sometimes you have to give up fresh fruits and vegetables for a while, so as not to further irritate the mucous membrane.

If a child has severe mucositis, then he is treated with an antibiotic or antiviral drugs (depending on the specific situation). Since the pain when swallowing is often so severe and the child cannot eat normally, he has to enter food through a vein [vein] (in such cases, doctors use the term parenteral, that is, bypassing the gastrointestinal tract), sometimes it can last long enough.

If a child has diarrhea, then, depending on the specific results of the examination, you will first have to refuse to eat or limit yourself only to those foods that are most gentle for the intestines.In some situations, the diet has to be reinforced with additional treatment. The child can be given both antibiotics and transfusions [infusions] when dehydration and loss of salts in the body. But I must say that with diarrhea, antibiotic treatment is extremely rare, since these drugs themselves can cause diarrhea.

If the child is receiving radiation therapy [radiation therapy], then the situation with the appearance of mucositis is similar. But these complications are usually easier to treat after radiation therapy, although they last longer than after chemotherapy.

90,000 Useful articles on the website of the laboratory Litech

The discovery of Helicobacter pylori (H. pylori) and its defining role in the pathogenesis of chronic gastritis, peptic ulcer and stomach cancer, made by Australian scientists B. Marshall and I. Warren in 1983, was truly revolutionary. It made it possible to develop new, more effective etiopathogenetic principles of treatment and prevention of these diseases.

For the first time, the idea of ​​the infectious development of gastroduodenal pathology arose at the end of the twentieth century, when spiral-shaped bacteria were found in the stomach of animals.In 1893 G. Bizzozero identified coiled bacteria in the parietal cells of the stomach of dogs. In 1896, H. Salomon established that these bacteria can be transmitted from infected mice to cats and dogs.

The first descriptions of spiral bacteria in the human stomach belong to W. Krienitz (1906) and A. Luger (1917), who discovered them on ulcerated gastric carcinoma. In 1938 J.L. Doenges, examining autopsy material, finds “spirochetes” in 43% of cases in the stomachs of people. However, these studies, carried out on the sectional material, did not allow a qualitative assessment of the autopsy due to the autolysis of the gastric mucosa and the development of foreign microorganisms.Further research is carried out on the operating and biopsy materials. In 1940, S. Freedberg and L. Barron found “spirochetes” in 37% of cases in stomachs resected for peptic ulcer and carcinoma. In 1954 E.D. Palmer described helical bacteria and their localization on large gastrobiopsy material However, at the same time, unfortunately, he made an erroneous conclusion, believing that these microorganisms are contaminants, are non-pathogenic, colonizing only on the affected gastric mucosa, getting into it from the oral cavity.

A more detailed description of the bacteria in the human stomach was published in 1975 by H.W. Street “Ultrastructure of cells migrating through the epithelium of the stomach and their relation to bacteria”, who, examining the microflora of gastrobiopsy specimens of patients with gastric ulcer, found Pseudomonas aeruginosa in them in 80% of cases. In 1979 W. P. Fung with a group of researchers described spiral bacteria in biopsies of patients with chronic gastritis, again pointing out the signs of inflammation of the gastric mucosa in the areas of their colonization.

Since 1852, when urease was first discovered in the stomach of animals, works related to its study appear in the literature. They indicate the relationship between the urease activity of the gastric mucosa and peptic ulcer disease (O. Fitzgerald and P. Murhy, 1954), and also made an assumption about the bacterial nature of human stomach urease. But, unfortunately, at that moment the source of the enzyme was not found.

So, by the 1980s, enough knowledge had accumulated indicating the infectious nature of chronic gastritis, peptic ulcer and stomach cancer.

In the period from 1979 to 1981, the Australian pathologist R. Warren, studying biopsy material with morphological signs of active gastritis, describes spiral bacteria similar to Campylobacter jejuni, and calls them Campylobacter-like organisms (CLO). After that, gastroenterologist B. Marshall, comparing clinical data and morphological changes in the gastric mucosa (gastric mucosa), suggests that this microorganism may cause the development of active gastritis in humans.Subsequently, he will confirm his hypothesis by drinking a pure culture of this microorganism. In 1982, B.J. Marshall and J.R. Warren succeeded in cultivating bacteria on a standard campylobacter medium from a biopsy material taken from the pyloric part of the stomach of a person with active gastritis, which in their morphological and biochemical properties were similar to those of the Campylobacter genus. The isolated microorganism was named Campylobacter pyloridis (C. pylori). B.J. Marshall and J.R.Warren reported for the first time at the Second International Workshop on Campylobacteriosis Infection in Brussels and in the same 1983 published in the Lancet. In 1989, C.S. Goodwin and a group of scientists finally identified the bacterium, giving it the name Helicobacter pylori, and in 1998 its genome was completely deciphered.

Thus, in 1983 a new page was opened in the study of the etiopathogenetic mechanisms of the development of chronic inflammatory processes of the coolant and the correctness of the infectious theory of the development of gastritis and peptic ulcer was confirmed.Research around this problem has intensified in various fields of medicine – pathomorphology, gastroenterology, microbiology, immunology, genetics, epidemiology and pharmacology. In various countries, groups for the study of Helicobacter pylori have arisen, in particular, in 1987 – the European and in 1995 – the Russian group. International conferences are held annually that form research programs for the creation of modern technologies and industrial production of new diagnostic and pharmaceutical products.

The study of the pathogenic properties of H. pylori has led to a rethinking of views on the pathogenesis and principles of treatment of not only chronic gastritis and peptic ulcer disease, but also adenocarcinoma and extranodal B-cell MALT lymphoma. A direct dependence of the clinical manifestation and the frequency of recurrence of chronic gastritis, peptic ulcer disease and the progression of precancerous conditions on the degree of H. pylori contamination of the gastric mucosa was established. According to D. Forman (1996), up to 75% of gastric cancer cases in developed countries, and about 90% in developing countries are associated with H.pylori infection. In 1994, the International Agency for Research on Cancer (IARK) classified H. pylori infection as a first-order carcinogen.

In the domestic literature, the concept of “helicobacteriosis” is becoming more and more widespread – by analogy with other terms (for example, campylobacteriosis, escherichiosis) adopted in infectious pathology. Many foreign authors prefer to use the concept of “diseases associated with H. pylori”. These concepts are not entirely unambiguous, although they belong to the same area of ​​gastroduodenal pathology.

In 1993 N.V. Safonov and A.B. Zhebrun gave, in our opinion, the most complete definition of this group of diseases: “Helicobacteriosis” is a chronic infection caused by pathogenic microorganisms of the Helicobacter genus and characterized by the predominant localization of the pathogen in the mucous membrane of the stomach and duodenum.

The rapid accumulation of theoretical knowledge about Helicobacter pylori is accompanied, unfortunately, by a noticeable lag in their implementation in everyday medical practice.As a result, this gap often turns into errors in the diagnosis and choice of treatment tactics for H. pylori infection.

Treatment of Helicobacter pylori infection, symptoms, complications

Helicobacter Pilory is a bacterium that can live for a long time, sometimes throughout a person’s life, in the mucous membrane of the stomach and duodenum and cause its inflammation. Against the background of this inflammation, the “resistance” of the shell of the gastrointestinal tract to aggressive factors of the internal environment decreases.Spreading over time from the antrum to the body of the stomach, the infection leads to the development of pangastritis, which, as the disease progresses, can lead to mucosal atrophy, intestinal metaplasia and stomach cancer.

Main symptoms

The presence of Helicobacter pylori in the human body often does not manifest itself in the form of any symptoms until it develops gastritis or an ulcer of the stomach or duodenum.

Symptoms of active gastritis caused by Helicobacter Pilory infection

• hungry epigastric pain;
• increased appetite
• heartburn, sour belching;
• nausea, vomiting, relieving
• tendency to constipation.

The mechanism of development of diseases caused by the bacterium H.pilory

An important mechanism that protects H. pylori from the aggressive environment of gastric juice is the ability to produce enzymes (urease) and toxins that aggressively affect the mucous membrane. These enzymes help to reduce the acidity of gastric juice, as well as damage the protective mucous layer of the stomach, expose the surface mucosal cells (epithelial cells), making them vulnerable to hydrochloric acid and pepsin.Having colonized the gastric mucosa, H. pylori causes inflammation, ulcers, and atrophy. According to modern concepts, atrophy of the gastric mucosa is a decrease in the number of glands characteristic of the mucous membrane of this part of the stomach, and the appearance in the glands of cells that are not characteristic of this part of the stomach (metaplasia).

When to see a doctor

• discomfort and pain in the epigastrium, in the stomach;
• heaviness after after eating;

90,066 complaints of bad breath;

• recurrent caries;
• heartburn, sour belching;

90,066 stool disorders;

• nausea or vomiting.

Complications

Infection with Helicobacter pylori can cause acute and chronic diseases: acute neutrophilic gastritis, chronic active gastritis, atrophic gastritis, peptic ulcer, intestinal metaplasia of the gastric epithelium (replacement of stomach cells with intestinal cells), stomach cancer, stomach maltome, b-cell non-Hodgkin’s lymphoma of the stomach.

The harm that the bacterium Helicobacter pylori will inflict on the stomach depends not only on the state of the human immune system, but also on which particular strain of the bacterium was infected.Different strains of bacteria produce different types of toxins that damage the mucous membrane. Not all people are infected with this bacterium leads to the development of diseases of the stomach and duodenum, but if there are such diseases, the destruction of the bacteria will ensure a complete recovery in most cases.

90,000 treatment in Medline in Kemerovo

Gastritis is a widespread disease – acute or chronic inflammatory-dystrophic changes in the gastric mucosa.

This disease occurs in all age groups and segments of the population. In the acute form, it is more often diagnosed in patients over 60 years old, but children, adolescents, and young people can suffer from them.

• About 2 million people visit doctors annually for acute gastritis
• Chronic forms account for approximately 80% of all stomach diseases
• The increase in incidence increases with age
• In Russia, the prevalence is very high: the pathogen of Helicobacter is detected in 75-80% of the adult population.At the same time, Helicobacter pylori etiology of inflammatory diseases of the stomach is ascertained in 90% of cases
• The second most common cause of chronic inflammation of the gastric mucosa is the production of autoantibodies
• Autoimmune etiology is more typical for women, among men its prevalence is three times lower than
• Another form of pathology – hemorrhagic – is quite rare, mainly in males. It is believed that about 4% of all gastric bleeding is associated with hemorrhagic gastritis

Causes of gastritis

The factors behind the onset of acute and chronic gastritis are similar in many ways, but can be very diverse.

These include:

• infections
• chemical and medicinal agents
• Power failure and other damaging mechanisms

The acute form of the disease can be caused by various pathogens: H. pylori, streptococci, staphylococci, Escherichia coli, etc., which cause severe purulent inflammation of the stomach wall – phlegmonous gastritis.

Risk factors for the development of this form of the disease are alcohol abuse, AIDS, and respiratory tract infection.Severe phlegmonous inflammation can result in gastric gangrene. A viral infection can be the cause of acute inflammation of the gastric mucosa. Most often, viral acute gastritis occurs in patients with immunosuppression (while taking immunosuppressants, in cancer patients, in the presence of primary or secondary immunodeficiency). The virus can localize in a limited area of ​​the mucous membrane or cause pangastritis.

Rarely enough, the cause of the disease is tuberculosis, syphilis, fungal infection, parasites, Helicobacter heilmannii invasion.

Taking medications also leads to the development of inflammation of the gastric mucosa – catarrhal, erosive and hemorrhagic. The “culprits”, as a rule, are non-steroidal anti-inflammatory drugs, cardiac glycosides, antibiotics and sulfonamides, adrenal cortex hormones. Chemical factors also include alcohol abuse, cocaine use. The following can damage the gastric mucosa with a further inflammatory response: radiation, mechanical trauma (for example, installation of a probe, violation of the EGDS technique), food allergies, exposure to bacterial toxins, bile flow from the duodenum (further leads to the development of chronic type C gastritis).

Severe lesions of the stomach are formed against the background of pronounced ischemia of its wall, with a general stress effect on the body, when massive blood loss, multiple organ failure occurs, etc. Errors in nutrition also lead to acute inflammation. The systematic use of too fatty, spicy, extractive foods, very hot or cold food, carbonated drinks often contributes to the development of acute gastritis. Sometimes acute inflammation occurs even against the background of poor chewing of food, overeating, eating dry food, since all this causes mechanical injury to the gastric mucosa.

Symptoms of gastritis

Symptoms of gastritis have many options, depending on the etiology, type, clinical form of the disease.

Acute gastritis is characterized by a violent onset of the disease, often a very severe course. The patient is observed: phenomena of intoxication, fever, dyspeptic disorders, pain in the epigastric region, nausea and vomiting.

Often, acute gastritis complicates the course of other diseases.With the development of hemorrhagic gastritis, bloody vomiting, melena, belching and heartburn join the above symptoms. An acute process should be distinguished from a chronic exacerbation. Chronic gastritis has both local and general manifestations. Local symptoms include dyspeptic symptoms – heaviness in the epigastrium, heartburn, belching, nausea, unpleasant taste and odor from the mouth, unstable stool, rumbling in the abdomen.

For autoimmune gastritis, the presence of immune disorders, antibodies to the parietal cells of the stomach, pernicious anemia, achlorhydria is required.Common manifestations of chronic inflammatory diseases of the stomach include asthenia, dumping syndrome, burning sensation in the oral cavity, paresthesia, and an ulcer-like complex.

Hemorrhagic gastritis often leads to the development of severe anemia against the background of profuse bleeding, shock; complicated by phlegmon of the gastric wall, perforation, the formation of strictures.

The course of acute phlegmonous gastritis can be aggravated by perforation of the stomach wall, the formation of external and internal fistulas, and gastric strictures.Among the neoplastic complications of chronic gastritis, adenocarcinomas (with type A gastritis) and stomach cancer (with type B gastritis) dominate.

Diagnostics of the gastritis

Diagnosis of any type of gastritis necessarily includes consultations with doctors such as a gastroenterologist and an endoscopist. It is they who determine the required scope of the survey.

Here, patients will be able to undergo laboratory diagnostics, endoscopic, pathomorphological and instrumental research methods.

A thorough history is sometimes sufficient to diagnose acute gastritis.

Instrumental diagnosis of acute and chronic gastritis involves:

• EGDS and endoscopic biopsy
• X-ray of the stomach with contrast
• MSCT of abdominal organs
• Electrogastrography
• Intragastric pH-meter
• antroduodenal manometry (with suspicion of reflux gastritis)

Morphological examination of biopsies allows you to establish an accurate diagnosis and prescribe a reasonable treatment.

Gastritis treatment

First of all, all the efforts of the specialists of the gastroenterological department of the Medline clinic in Kemerovo are aimed at eliminating the causes that led to its occurrence from the very first stages of treatment of the inflammatory process in the gastric mucosa.

Note!

Diet – without adhering to certain rules of eating behavior, the medication effect will be much less effective.Diet therapy for acute gastritis can include a period of complete starvation for 1-2 days, as well as giving up bad habits – smoking, alcohol abuse, uncontrolled medication, etc.!

Drug treatment of acute gastritis includes the use of antacids and antisecretory agents, gastroprotectors. Depending on the etiology of the process, H. pylori eradication, specific antibacterial therapy (for tuberculosis, syphilis, fungal process), symptomatic treatment (antispasmodics, analgesics, antiemetics, infusion therapy) are carried out.Hemorrhagic gastritis requires the appointment of hemostatic therapy, transfusion of blood products (erythrocyte mass, fresh frozen plasma).

Treatment for chronic autoimmune gastritis begins with a short course of glucocorticoid hormones. With the effectiveness of the first course, the administration of hormones is repeated, if there is no effect, they are canceled.

At the stage of atrophic gastritis, natural gastric juice and drugs that improve gastrointestinal motility are prescribed.bSymptomatic therapy includes treatment of B12-deficiency anemia, replacement of exocrine pancreatic function. Anti-Helicobacter therapy is of great importance in the treatment of acute and chronic H. pylori-associated gastritis. Ignoring this direction of treatment leads to the formation of mucosal atrophy within 10-15 years.

Here, in the treatment of gastroenterologists, the standard anti-Helicobacter pylori regimen is used, which involves the appointment of the first line of drugs: proton pump inhibitors at a dose of 40 mg, two-component antibacterial therapy (combinations of clarithromycin, amoxicillin, furazolidone).In the case of diagnosing gastritis with a reduced secretory function, a bismuth drug (de-nol) is prescribed instead of PPIs. In case of ineffectiveness of the indicated course, the second four-component line is used: a bismuth drug, a proton pump inhibitor in a half dosage (20 mg), tetracycline and metronidazole. The course of treatment is 1-2 weeks. Treatment of chemical and drug gastritis is aimed at normalizing the secretion and motility of the stomach. For this, proton pump inhibitors are prescribed (since bile can damage the gastric mucosa only in the presence of hydrochloric acid), urodeoxycholic acid (inactivates bile acids), dopamine receptor blockers (prevent duodeno-gastric reflux), prokinetics.

Treat Helicobacter pylori infection in Moscow

Helicobacter pylori (Helicobacter pylori) are bacteria that live on the mucous membrane of the human stomach. These bacteria are capable of producing and releasing a large amount of enzymes and toxins that damage the cells of the mucous membrane, which can lead to the development of inflammatory and ulcerative diseases of the stomach and duodenum. At the same time, it is known that almost 60% of the world’s population is infected with Helicobacter.Consequently, not every infected person develops a peptic ulcer, however, among those who are sick, this infection is detected in the majority, which contributes to the development of peptic ulcer. It has now been proven that the presence of Helicobacter pylori infection in inflammatory diseases of the stomach and duodenum is an indication for the appointment of antibiotic therapy.

Causes of the disease

Helicobacter pylori lives only in the human stomach. Infection occurs through contact with an infected person.Transmission of infection can occur through kissing or using the same utensils, as well as through hygiene items. As a rule, all family members are infected with one strain of Helicobacter pylori, which proves the contact-household transmission route.

Symptoms of the disease

Helicobacter pylori infection can often be asymptomatic. Identification of Helicobacter pylori in the absence of inflammatory diseases of the stomach or intestines is not an indication for the appointment of antibiotic therapy.With the development of inflammatory diseases against the background of Helicobacter pylori infection (stomach or duodenal ulcer, erosive gastritis, gastroduodenitis), the clinical picture will correspond to the disease.

Doctors of this direction

Diagnostics

Diagnosis of Helicobacter pylori infection is possible using a number of methods that allow to identify the microorganism itself, signs of its vital activity or the body’s immunological response to infection (antibodies in the blood serum).As a rule, upon detection of an active inflammatory process in the stomach or duodenum, the patient is referred for examination to exclude Helicobacter pylori infection.

1. Detection of specific anti-Helicobacter antibodies of classes in the patient’s blood.
2. Helicobacter pylori breath test with registration of waste products (carbon dioxide, ammonia)
3. Detection of bacterial DNA by PCR in the analysis of feces, saliva, dental plaque.
4. Detection of microorganisms by microscopic examination of a biopsy specimen of the mucous membrane taken during FEGDS.

Of all the listed examination methods, for the initial diagnosis, it is recommended to conduct a breath test, as a painless, non-invasive and highly informative method.

How is Helicobacter pylori treated?

This infection is diagnosed and treated by a gastroenterologist. Before starting treatment, it is recommended to be tested for Helicobacter pylori. Detection of Helicobacter pylori infection in the absence of inflammatory diseases of the gastrointestinal tract is an indication for treatment.

For the treatment of Helicobacter pylori infection, several therapeutic regimens have been developed, including one, two or three antibacterial drugs, antisecretory agents and bismuth preparations.

Control over the eradication (destruction) of Helicobacter pylori is carried out 2-6 weeks after treatment with at least two diagnostic methods from the above.

You may also be interested in:

Gastroduodenitis

Gastroscopy

Risk of stomach cancer

Artist: Mamunts Tsovinar Alekseevna

Chief Physician President-Med g.Vidnoe

Higher Medical, Perm State Medical Institute, Faculty of General Medicine, specialty-general medicine

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CUSTOMER REVIEWS

natalia

For a long time I gathered with the spirit to carry out the gastroscopy procedure and, as it turned out, completely in vain. When you first communicate with a doctor, you immediately find yourself in an atmosphere of calm and benevolence.Vladimir Izrailevich did this rather unpleasant study very gently and painlessly. Many thanks to him. His hands are just golden. Now for a control gastroscopy after 6 … […]

Helicobacter pylori, determination of DNA in a biopsy of the gastric and / or duodenal mucosa (Helicobacter pylori, DNA, Bioptates of Gastric Mucosa and / or Duodenum, PCR)

Study material
biopsy / biopsies of the mucous membrane of the stomach and / or duodenum.

Method of determination
polymerase chain reaction (PCR) with real-time detection.

Determination of Helicobacter pylori DNA in a biopsy of the gastric and / or duodenal mucosa by the polymerase chain reaction (PCR) method with real-time detection.

Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that lives on the gastric mucosa, attaching to the villi of the epithelium.Human infection with H. pylori is widespread. According to epidemiologists, the presence of this bacterium in the stomach can be found in about half of the world’s population, and in some regions in 80-100% of the population. Infected carriers of Helicobacter pylori may not show symptoms of the disease. At the same time, there is a correlation between the presence of bacteria and confirmed functional states, gastrointestinal diseases of the stomach and duodenum, such as dyspepsia, chronic and atrophic gastritis, peptic ulcer disease, stomach cancer.The likelihood of developing such threatening conditions depends on the H. pylori strain and the factors of its virulence, the individual characteristics of the organism and the nature of reactions to the presence of H. pylori, the influence of living conditions, in particular, diet. This infection is successfully eliminated (eradication of H. pylori), but this does not exclude the possibility of re-infection in the future. The need for H. pylori eradication is decided individually. The doctor’s tactics largely depend on the clinical manifestations of the infection and, which is especially important, the presence of pathological changes in the mucous membrane of the stomach and duodenum.

Analytical parameters: sensitivity of H. pylori DNA determination – 100 copies per sample. The specificity is 100%.

Literature

• Baranskaya E.K., Ivashkin V.T., Sheptulin A.A. Pariet in the treatment of peptic ulcer disease, symptomatic gastroduodenal ulcers and functional dyspepsia. Ch. 4., p. 75. In the book. Prevention and treatment of chronic diseases of the upper gastrointestinal tract. Under. ed. acad. RAMS V.T.Ivashkina. 2nd edition. – M .: Ed. MEDpress-inform. 2013: 152. ISBN 978-5-98322-905-1
• Isakov V.A. Diagnosis and treatment of Helicobacter pylori infection: IV Maastricht Agreement. New guidelines for the diagnosis and treatment of H. pylori infection – Maastricht IV (Florence). Best Clinical Practice. Russian edition. 2012; 2: 4-23.
• Chung W.C., Jeon E.J., Oh J.H., Park J.M., Kim T.H., Cheung D.Y., Kim B.W., Kim S.S., Kim J.I. Dual-priming oligonucleotide-based multiplex PCR using tissue samples from the rapid urease test kit for the detection of Helicobacter pylori in bleeding peptic ulcers.Digestive and Liver Disease. 2016; 4. pii: S1590-8658 (16) 30394-2. doi: 10.1016 / j.dld.2016.04.012.
• Du L.J., Chen B.R., Kim J.J., Kim S., Shen J.H., Dai N. Helicobacter pylori eradication therapy for functional dyspepsia: Systematic review and meta-analysis. World Journal of Gastroenterology. 2016; 22 (12): 3486-3495. doi: 10.3748 / wjg.v22.i12.3486.
• Helicobacter pylori and gastric or duodenal ulcer. Prescrire International. 2016; 25 (167): 18-23.
• Schulz C., Schütte K., Malfertheiner P. Helicobacter pylori and Other Gastric Microbiota in Gastroduodenal Pathologies. Digestive Diseases. 2016; 34 (3): 210-216. doi: 10.1159 / 000443353.
• Seo J.H., Hong S.J., Kim J.H., Kim B.W., Jee S.R., Chung W.C., Shim K.N., Baik G.H., Kim S.S., Kim S.G., Kim J.I. Long-Term Recurrence Rates of Peptic Ulcers without Helicobacter pylori. Gut Liver. 2016; 4. doi: 10.5009 / gnl15262.

Prevalence of gastric erosive and ulcerative lesions and Helicobacter pylori infection in patients with ulcerative colitis | Ponkratova

1.Parente F., Molteni P., Bollani S., Maconi G., Vago L., Duca P., Rembacken B., Axon A., Bianchi Porro G. Prevalence of Helicobacfer pylori infection and related upper gastrointestinal lesions in patients with inflammalory bowel diseases. A cross-sectional study with matching. Scand J Gastroenterol. 1997; 32 (11): 1140-6.

2. Parlak E., Ulker A., ​​Dişibeyaz S., Alkim C., Dağli U. There is no significant increase in the incidence of Helicobacter pylori infection in patients with inflammatory bowel disease in Turkey.J Clin Gastroent. 2001; 33 (1): 87–8. DOI: 10.1097 / 00004836-200107000-00025

3. Horjus Talabur Horje C.S., Meijer J., Rovers L., van Lochem E.G., Groenen M.J., Wahab P.J. Prevalence of upper gastrointestinal lesions at primary diagnosis in adults with inflammatory bowel disease. Inflamm Bowel Dis. 2016; 22 (8): 1896–901. DOI: 10.1097 / MIB.0000000000000786

4.Gastroenterology. National leadership. Ed. V.T. Ivashkina, T.L. Lapina. M .: GEOTARMedia; 2008. S. 754. [Gastroenterology. National guide. Ed. V.T. Ivashkin, T.L. Lapina. Moscow: GEOTAR-Media Publishing Group; 2008. P. 754 (In Rus.)].

5. Hori K., Ikeuchi H., Nakano H., Uchino M., Tomita T., Ohda Y., Hida N., Matsumoto T., Fukuda Y., Miwa H. Gastroduodenitis associated with ulcerative colitis. World J Gastroenterol.2008; 43 (3): 193–201. DOI: 10.1007 / s00535-007-2143-8

6. Lin J., McKenna B.J., Appelman H.D. Morphologic findings in upper gastrointestinal biopsies of patients with ulcerative colitis: a controlled study. AM J Surg Path. 2010; 34 (11): 1672-7. DOI: 10.1097 / PAS.0b013e3181f3de93

7. Hisabe T., Matsui T., Viyaoka K., Ishihara H. et al.Diagnosis and clinical course of ulcerative gastroduodenal lesion associated with ulcerative colitis: possible relationships with pouchitis. Dig Endosc. 2010; 22 (4): 268–74. DOI: 10.1111 / j.1443-1661.2010.01006.x.

8. D’Inca R., Sturniolo G., Cassaro M., di Pace C., Longo G., Callegari I., Rugge M. Prevalence of upper gastrointestinal lesions and Helicobacter pylori infection in Crohn’s disease. Dig Dis Sci. 1998; 43 (5): 988–92.PMID: 9590412

9. Chiba M., Ono I., Wakamatsu H., Wada I., Suzuki K. Diffuse gastroduodenitis associated with ulcerative colitis: treatment by infliximab. Dig Endosc. 2013; 25 (6): 622-25. DOI: 10.1111 / j.1443-1661.2012.01398.x

10. Endo K., Kuroha M., Shiga H., Kakuta Y., Takahashi S., Kinouchi Y., Shimosegawa T. Two cases of diffuse duodenitis associated with ulcerative colitis.Case Rep Gastrointest Med. 2012: 1–4. DOI: 10.1155 / 2012/396521

11. Ikeuchi H., Hori K., Nishigami T., Nakano H., Uchino M., Nakamura M., Kaibe N. et al. Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis. World J Gastroenterol. 2006; 12 (36): 5913-5. PMID: 17007066

12. Ivashkin V.T., Maev I.V., Lapina T.L. and etc.Treatment of Helicobacter pylori infection: mainstream and innovations (Literature review and resolution of the Expert Council of the Russian Gastroenterological Association on May 19, 2017) Ros jurn gastroent hepatol coloproctol. 2017; 27 (4): 4 21. [Ivashkin V.T., Mayev I.V., Lapina T.L. et al. Treatment of Helicobacter pylori infection: mainstream and innovations (Review of the literature and Russian gastroenterological association Advisory council resolution, May 19, 2017). Ross z gastroenterol gepatol koloproktol. 2017; 27 (4): 4 21 (In Rus.)]. DOI: 10.22416 / 1382 4376 2017 27 4 4 21]

13. Sładek M., Jedynak-Wasowicz U., Wedrychowicz A., Kowalska-Duplaga K., Pieczarkowski S., Fyderek K. The low prevalence of Helicobacter pylori gastritis in newly diagnosed inflammatory bowel disease children and adolescent. Przegl Lek. 2007; 64 Suppl 3: 65-7.

14. Buzás G.M., Lotz G., Schneider F., Józan J. Changing prevalence of Helicobacter pylori infection in the 9th district of Budapest. A retrospective endoscopic study, 1997–2012. Orv Hetil. 2013; 154 (23): 900-7. DOI: 10.1556 / OH.2013.29630.

15. Garza-González E., Pérez-Pérez G.I., Mendoza-Ibarra S.I., Flores-Gutiérrez J.P., Bosques-Padilla F.J. Genetic risk factors for inflammatory bowel disease in a North-eastern Mexican population. Int J Immunogenet.2010; 37 (5): 355– 9. DOI: 10.1111 / j.1744-313X.2010.00932.x

16. Väre P.O., Heikius B., Silvennoinen J.A., Karttunen R., Niemelä S.E., Lehtola J.K., Karttunen T.J. Seroprevalence of Helicobacter pylori infection in inflammatory bowel disease: is Helicobacter pylori infection a protective factor? Scand J Gastroenterol. 2001; 36 (12): 1295-300. PMID: 11761020 DOI: 10.1080 / 0036 55201317097155

17.Mantzaris G.J., Archavlis E., Zografos C., Zavos K., Petraki K., Triadaphyllou G. Low prevalence of Helicobacter pylori in inflammatory bowel disease: association with sulfasalazine. Am J Gastroenterol. 1995; 90 (10): 1900. PMID: 7572928

18. Jin X., Chen Y., Chen S., Xiang Z. Association between Helicobacter Pylori infection and ulcerative colitis – a case control study from China. Int J Med Sci. 2013; 10 (11): 1479–84.PMID: 24046521 DOI: 10.7150 / ijms.6934

19. Lidar M., Langevitz P., Barzilai O., Ram M., PoratKatz BS, Bizzaro N., Tonutti E., Maieron R., Chowers Y., Bar-Meir S., Shoenfeld Y .. Infectious serologies and autoantibodies in inflammatory bowel disease: insinuations at a true pathogenic role. Ann N Y Acad Sci. 2009; 1173: 640-8. PMID: 19758210 DOI: 10.1111 / j.17496632.2009.04673.x

20.Song M.J., Park D.I., Hwang S.J., Kim E.R., Kim Y.H., Jang B.I., Lee S.H., Ji J.S., Shin S.J. The prevalence of Helicobacter pylori infection in Korean patients with inflammatory bowel disease, a multicenter study. Korean J Gastroenterol. 2009; 53 (6): 341-7. PMID: 19556840

21. Duggan A.E., Usmani I., Neal K.R., Logan R.F. Appendicectomy, childhood hygiene, Helicobacter pylori status, and risk of inflammatory bowel disease: a case control study.Gut. 1998; 43 (4): 494-8. DOI: 10.1136 / gut.43.4.494

22. Papamichael K., Konstantopoulos P., Mantzaris G.J. Helicobacter pylori infection and inflammatory bowel disease: Is there a link? World J Gastroenterol. 2014; 20 (21): 6374–85. Doi: 10.3748 / wjg.v20.i21.6374

23. Piodi L.P., Bardella M., Rocchia C., Cesana B.M., Baldassarri A., Quatrini M. Possible protective effect of 5-aminosalicylic acid on Helicobacter pylori infection in patients with inflammatory bowel disease. J Clin Gastroenterol. 2003; 36 (1): 22-5.

24. Wagtmans M.J., Witte A.M., Taylor D.R., Biemond I., Veenendaal R.A., Verspaget H.W., Lamers C.B., van Hogezand R.A. Low seroprevalence of Helicobacter pylori antibodies in historical sera of patients with Crohn’s disease. Scand J Gastroenterol.1997; 32 (7): 712-718. DOI: 10.3906 / sag-1305-39

25. Halme L., Rautelin H., Leidenius M., Kosunen T.U. Inverse correlation between Helicobacter pylori infection and inflammatory bowel disease. J Clin Pathol. 1996; 49 (1): 65-7. PMID: 8666689

26. Wu X., Ji H., Yang M., Wu L., Wang F. Helicobacter pylori infection and inflammatory bowel disease in Asians: A meta-analysis.World J Gastroenterol. 2015; 21 (15): 4750-6. Doi: 10.3748 / wjg.v21.i15.4750

27. Zhebrun A.B., Svarval A.V., Balabash O.A., Ferman R.S. Characteristics of the Helicobacter pylori population in patients with diseases of the gastrointestinal tract. Journal of Microbiology, Epidemiology and Imunobiology. 2013; 2: 90–6 [Zhebrun A. B., Svarval ’A. V., Balabash O. A., Ferman R. S. Helicobacter pylori population characteristic in patients with diseases of gastrointestinal tract.Zh Microbiol Epidemiol Immunobiol 2013; 2: 90-6 (In Rus.)].

28. German S.V., Zykova I.E., Modestova A.V., Ermakov N.V. Prevalence of H. pylori infection among the population of Moscow. Ros zhurn gastroent hepatol coloproctol. 2010; 20 (2): 25–30 [German S.V., Zykova I.E., Modestova A.V., Ermakov N.V. Prevalence of Helicobacter pylori infection in Moscow population. Ross z gastroenterol gepatol koloproktol 2010; 20 (2): 25-30 (In Rus.)].

29. Hong C.H., Park D.I., Choi W.H., Park J.H., Kim H.J., Cho Y.K., Sohn C.I., Jeon W.K. et al. The clinical usefulness of focally enhanced gastritis in Korean patients with Crohn’s disease. Korean J Gastroenterol. 2009; 53 (1): 23–8.

30. Magalhães-Costa M.H., Reis B.R., Chagas V.L., Nunes T., Souza H.S., Zaltman C.