Causes and Treatments – Center for Advanced GI

Patients suffering from gastritis can experience a range of symptoms, from mild nausea or a feeling of fullness in the upper abdomen after eating, to more severe symptoms like severe pain, a burning sensation, and vomiting. The root of these symptoms is an inflammation of the mucus lining of the stomach.

For people experiencing chronic gastritis, symptoms appear gradually over a long period of time and don’t go away quickly on their own. Acute gastritis, on the other hand, appears suddenly, usually after eating. Gastritis, left untreated, can lead to stomach ulcers and bleeding. Though rare, chronic gastritis can even increase the risk of stomach cancer.

What triggers gastritis?

One of the most common causes of gastritis is an H. pylori infection. This is the same type of bacteria that causes most stomach ulcers. It is uniquely suited to withstand the destructive affects of gastric acids and penetrate the mucus lining to infect the stomach tissue, causing inflammation.

Gastritis can also be caused by ingesting certain pain relievers or drinking alcohol to excess. Chronic stress is another potential trigger for the worsening of existing gastritis symptoms because it causes a fight-or-flight reaction that includes spasms in the esophagus and an increase in stomach acids, which can aggravate existing symptoms.

Other potential causes of gastritis include:

• As we age, the lining of the stomach tends to get thinner, increasing the risk of gastritis. That leaves the stomach less able to fight off other causes such as a bacterial infection or excessive use of alcohol.
• Autoimmune disease. In some people, the body’s immune system attacks the cells in the stomach lining, causing autoimmune gastritis. This is more common in people who have other autoimmune disorders such as type 1 diabetes or Hashimoto’s disease. It can also be linked to a deficiency in vitamin B-12.

What you should do.

If your symptoms of gastritis are infrequent, mild, and only last a day or two before clearing up on their own, you probably don’t need medical attention. Stick to a bland, healthy diet and avoid greasy or spicy food for a few days until the symptoms pass.

On the other hand, you should make an appointment with a physician as quickly as possible if your symptoms are accompanied by signs of internal bleeding, such as vomiting blood, blood in your stool, or stools that appear black. You should also see a doctor if you have suffered from gastritis for a week or longer.

The Center for Advanced Gastroenterology

At the Center for Advanced Gastroenterology, we have dedicated our practice to providing effective diagnostic and treatment solutions for issues of the upper and lower gastrointestinal tract and liver for our patients. These issues include such conditions as:

• Viral hepatitis
• Irritable bowel syndrome (IBS)
• Crohn’s disease
• Persistent diarrhea
• Rectal bleeding
• Acid reflux/GERD (gastroesophageal reflux disease)
• Gastritis/abdominal pain
• Hemorrhoids
• Constipation
• Severe nausea
• Ulcerative colitis

Convenient Locations and Caring Staff

In addition to the treatment we provide, we are also committed to your physical and emotional comfort. We have six locations throughout Central Florida for your convenience, and our highly specialized physicians and clinical staff members take the time to listen to you and make sure you understand your diagnosis and any treatment we may prescribe.

Procedures Offered

The procedures we offer include:

• Diagnostic colonoscopy
• Colon cancer screening
• Upper endoscopy
• Capsule endoscopy
• Banding of internal hemorrhoids

Gut Feelings About Gastritis | NIH News in Health

November 2012

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When Your Stomach’s Sick

Your stomach lining has an important job. It makes acid and enzymesA type of protein that does work around the cell. that help break down food so you can extract the nutrients you need. The lining also protects itself from acid damage by secreting mucus. But sometimes the lining gets inflamed and starts making less acid, enzymes and mucus. This type of inflammationSwelling and redness caused by the body’s protective response to injury or infection. is called gastritis, and it can cause long-term problems.

Some people think they have gastritis when they have pain or an uncomfortable feeling in their upper stomach. But many other conditions can cause these symptoms. Gastritis can sometimes lead to pain, nausea and vomiting. But it often has no symptoms at all. If left untreated, though, some types of gastritis can lead to ulcers (sores in the stomach lining) or even stomach cancer.

People used to think gastritis and ulcers were caused by stress and spicy foods. But research studies show that bacteria called Helicobacter pylori are often to blame. Usually, these bacteria cause no symptoms. In the United States, 20% to 50% of the population may be infected with H. pylori.

H. pylori breaks down the inner protective coating in some people’s stomachs and causes inflammation. “I tell people H. pylori is like having termites in your stomach,” says Dr. David Graham, an expert in digestive diseases at Baylor College of Medicine in Texas. “You usually don’t know you have termites until someone tells you, and you ignore it at your own risk.” H. pylori can spread by passing from person to person or through contaminated food or water. Infections can be treated with bacteria-killing drugs called antibiotics.

One type of gastritis, called erosive gastritis, wears away the stomach lining. The most common cause of erosive gastritis is long-term use of medications called non-steroidal anti-inflammatory drugs. These include aspirin and ibuprofen. “When you stop taking the drugs, the condition usually goes away,” says Graham. Doctors might also recommend reducing the dose or switching to another class of pain medication.

Less common causes of gastritis include certain digestive disorders (such as Crohn’s disease) and autoimmune disorders, in which the body’s protective immune cells mistakenly attack healthy cells in the stomach lining.

Gastritis can be diagnosed with an endoscope, a thin tube with a tiny camera on the end, which is inserted through the patient’s mouth or nose and into the stomach. The doctor will look at the stomach lining and may also remove some tissue samples for testing. Treatment will depend on the type of gastritis you have.

Although stress and spicy foods don’t cause gastritis and ulcers, they can make symptoms worse. Milk might provide brief relief, but it also increases stomach acid, which can worsen symptoms. Your doctor may recommend taking antacids or other drugs to reduce acid in the stomach.

Talk with a health care provider if you’re concerned about ongoing pain or discomfort in your stomach. These symptoms can have many causes. Your doctor can help determine the best course of action for you.

Gastritis | healthdirect

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What is gastritis?

Gastritis is when the stomach lining becomes inflamed (swollen and red). The stomach lining may also erode (wear down) because of the inflammation.

Gastritis can happen suddenly and be short-lived (acute gastritis), or develop gradually and last over a few months or years (chronic gastritis). While gastritis can be mild and heal on its own, sometimes treatment may be needed, depending on the cause and symptoms.

What are the symptoms of gastritis?

Not everyone with gastritis will experience symptoms. If you have symptoms, they may include:

• a burning pain in the upper stomach area (such as in heartburn) — which may improve or worsen with eating
• nausea
• vomiting
• loss of appetite
• bloating and burping
• hiccups
• diarrhoea
• feeling uncomfortably full after eating
• weight loss
• bad breath
• blood in the vomit or stools (poo)

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes gastritis?

There are many things that can increase the risk of gastritis. The most common causes are infection with a type of bacteria, taking some medications, and drinking too much alcohol.

Infection with bacteria

The bacteria that may cause gastritis are called Helicobacter pylori (H. pylori). These bacteria are found in 4 in every 10 Australian adults over 60. Even so, many of those infected with H. pylori don’t develop any gastritis symptoms or ulcers. The reason for this is not clear.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, are commonly used for pain relief, but they can also increase acidic gastric juices produced in the stomach. The increased stomach acid can inflame and wear down the stomach lining.

Drinking alcohol excessively

Excessive drinking can erode the lining of the stomach, making it weaker and more likely to be damaged by the stomach’s acidic digestive juices.

Other causes of gastritis include:

• having too much acid in the stomach
• intense stress
• backflow of bile into the stomach (known as ‘bile reflux’)
• diabetes
• an infection
• diseases of the intestines or stomach, such as Crohn’s disease
• an allergic reaction
• some cancer treatments

When should I see my doctor?

Gastritis often clears up by itself. You should see your doctor if you have:

• gastritis symptoms that last more than a week
• vomit that contains blood or a black, tarry substance (dried blood)
• blood in your stool (poo), or stool that is black
• your pain gets worse
• you have a fever

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

How is gastritis diagnosed?

To confirm the cause of the symptoms, your doctor is likely to talk to you and examine you. They may also ask you to have some tests, such as blood tests, breath tests or stool tests.

Your doctor may also refer you to a specialist who is an expert in the digestive tract (gastroenterologist).

You may also be asked to have an endoscopy. An endoscopy involves inserting a flexible tube with a tiny camera down the throat into the upper digestive tract to have a look for signs of inflammation and ulcers. This is usually done with some sedation. A small tissue sample may be taken to examined in the laboratory.

How is gastritis treated?

Treatment of gastritis depends on its cause. Your doctor may prescribe a mix of prescription and non-prescription (over the counter) medicines, and recommend lifestyle changes.

Common gastritis treatments are:

• antibiotic medicines to kill the H. pylori bacteria. If prescribed, it’s important you complete the full course
• prescription medicines that reduce the amount of acid made in the stomach, called h3 blockers or proton pump inhibitors
• over the counter antacids, which neutralise stomach acid (these should be taken separately from some other medicines — ask your pharmacist)

You can also make some lifestyle changes to help improve your healing process, and reduce any further chances of irritation. You could try to:

• eat smaller meals more often
• avoid foods that can irritate your stomach, such as foods that are spicy, acidic (e.g. citrus and tomatoes), fried or fatty
• avoid alcohol and coffee
• avoid non-steroidal anti-inflammatory drugs (NSAIDs) — ask your doctor or pharmacist for alternative pain relievers
• reduce stress
• stop smoking

It’s also important take your medicines as directed and to learn what triggers your symptoms.

Complications of gastritis

If left untreated, gastritis can lead to stomach ulcers and bleeding. While rare, it can also increase the risk of stomach cancer.

Gastritis – Digestive Disorders – Merck Manuals Consumer Version

The specific types of gastritis are caused by many factors, including infection, stress resulting from severe illness, injury, certain drugs, and disorders of the immune system.

Erosive gastritis is commonly caused by alcohol, stress resulting from severe illness, and irritants such as drugs, especially aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs Nonsteroidal Anti-Inflammatory Drugs In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain…. read more ). Less common causes include Crohn disease Crohn Disease Crohn disease is an inflammatory bowel disease where chronic inflammation typically involves the lower part of the small intestine, the large intestine, or both and may affect any part of the… read more , radiation, bacterial and viral infections (such as cytomegalovirus Cytomegalovirus (CMV) Infection Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms: from no symptoms to fever and fatigue (resembling infectious mononucleosis) to severe symptoms involving… read more ), the ingestion of corrosive substances, and direct injuries (such as by the insertion of a nasogastric tube). In some people, even a baby aspirin taken daily can injure the stomach lining.

Infectious gastritis not caused by Helicobacter pylori is rare.

Acute stress gastritis, a form of erosive gastritis, is caused by a sudden illness or injury. The injury may not even be to the stomach. For example, extensive skin burns, head injuries, and injuries involving major bleeding are typical causes. Exactly why serious illness can lead to gastritis is not known but may be related to decreased blood flow to the stomach, an increase in the amount of acid in the stomach, and/or to impairment of the stomach lining’s ability to protect and renew itself.

Postgastrectomy gastritis occurs in people who have had part of their stomach surgically removed (a procedure called partial gastrectomy). The inflammation usually occurs where tissue has been sewn back together. Postgastrectomy gastritis is thought to result when surgery impairs blood flow to the stomach lining or exposes the stomach lining to an excessive amount of bile (the greenish yellow digestive fluid produced by the liver).

Eosinophilic gastritis may result from an allergic reaction to an infestation with roundworms, but usually the cause is unknown. In this type of gastritis, eosinophils (a type of white blood cell) accumulate in the stomach wall.

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.

Bowel Diseases and Disorders (That Aren’t IBD)

It’s easy to pin digestive symptoms on inflammatory bowel disease (IBD) when you learn that it’s an overarching name for disorders related to chronic inflammation of the digestive tract. But IBD is specific to Crohn’s disease and ulcerative colitis. And while it can produce symptoms such as abdominal pain and diarrhea, there are other digestive diseases and disorders that can do the same (and then some).

It’s difficult (and ill-advised) to venture a guess as to what is affecting you until you’ve been formally diagnosed. Get to know more about these common digestive disorders.

 Verywell / Brianna Gilmartin

When Digestive Symptoms Arise

When new symptoms start, the first step is always to make an appointment to see a healthcare provider and get help figuring out what to do next. In some cases, a digestive problem might need a referral to a specialist in digestive disease, called a gastroenterologist. Those who were already diagnosed with a digestive issue should also reach out to their gastroenterologist for symptoms that are mild and typical of a flare-up.

It’s important to put any signs or symptoms in perspective. An occasional symptom might be treated with a lifestyle change such as eating more fiber, drinking more water, or getting some exercise.

While most digestive problems aren’t an emergency, there are some symptoms that should be treated with more concern. Seek emergency care if any of the following apply: 

• Severe abdominal pain
• Blood being passed with a bowel movement
• Non-stop rectal bleeding
• Fever
• Vomiting
• Fainting
• Severe diarrhea

Change in Stool Color

The color of a bowel movement is often influenced by diet. In some cases, eating foods with strong coloring (either natural or artificial) can cause a temporary change in stool color. When such a change is able to be traced back to a food or a supplement, there’s usually no cause for worry. When the stool color change goes on for more than a few days or can’t be explained by a food, it could be time to look for another cause.

In the case of suspected bleeding, a doctor should be seen right away, even for people who have a condition that commonly causes bleeding, such as inflammatory bowel disease or diverticular disease. Some stool colors that could be caused by diet, but are sometimes the result of a digestive disease or condition, include:

Change in Stool Frequency

Diarrhea and constipation are fairly common problems, and they happen to everyone from time to time. In many cases, a cause can’t be found, and the issues go away on their own without any special treatment.

In the case of diarrhea, some people may be more comfortable changing their diet for a little while until the loose stools pass. For constipation, eating fiber, drinking water, or getting some exercise may do the trick.

For either diarrhea or constipation, if it goes on for more than a few days or keeps happening even after making some diet and lifestyle changes, seeing a healthcare provider is the next step.

When either constipation or diarrhea are accompanied by fever, bleeding, or severe abdominal pain, a doctor should be consulted. A doctor should make a recommendation about medication to either slow down the bowel movements or get them to start up again, as over-the-counter drugs may not be appropriate or even helpful for some conditions (such as certain types of IBD or bacterial infections).

Heartburn and GERD

Heartburn or gastroesophageal reflux disease (GERD) is a problem where the muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), doesn’t work as it should.

The LES is supposed to stop stomach acid from coming out of the stomach and into the esophagus, and when it doesn’t, the acid can cause symptoms of heartburn, such as burning or discomfort.

Even if heartburn only happens once in a while, it should be discussed with a physician, because a change in diet or some over-the-counter medications may be able to stop the symptoms or prevent them from happening in the first place.

Occasional heartburn isn’t typically a cause for concern. However, when it happens frequently (more than two times a week), it could be GERD. GERD requires treatment because, over time, the stomach acid can harm the LES and the esophagus. In many cases, GERD can be diagnosed by a doctor without a lot of testing and can be treated effectively with over-the-counter or prescription medications.

Peptic Ulcer or Stomach Ulcer

An ulcer is a break in the skin or the mucus membrane of an organ that causes a sore, and a peptic ulcer is a sore either in the stomach or in the first part of the small intestine (the duodenum).

Most peptic ulcers are caused by an infection with a bacteria called Helicobacter pylori (H. pylori). Another common cause of peptic ulcers is taking nonsteroidal anti-inflammatory drugs (NSAIDs) daily or several times a week. Very rarely, in one in a million people, peptic ulcers can be associated with a condition called Zollinger-Ellison syndrome, which causes tumors in the digestive tract.

A diagnosis of peptic ulcer may be made using an upper endoscopy—a common test done to look for problems in the upper digestive tract (the esophagus and the stomach). A flexible tool called an endoscope is passed through the esophagus and into the stomach.

Because an ulcer could lead to other, more serious problems, such as bleeding or a hole in the stomach or small intestine (perforation), ulcers require treatment. In the case of ulcers caused by H. pylori, antibiotics and other medications, such as acid reducers, will be prescribed to manage symptoms and kill the bacteria.

Gastritis

The term gastritis means that the lining of the stomach is inflamed. When this occurs, the stomach produces less mucus and is, therefore, less able to protect itself from digestive acids. Gastritis also causes the stomach lining to produce fewer of the normal acids and enzymes that are used in digestion.

There are two main types of gastritis: erosive and non-erosive. Over time, erosive gastritis can cause the lining of the stomach to become damaged and ulcers can form.

Symptoms of gastritis can include stomach pain (in the upper abdomen), indigestion, nausea, vomiting, and dark stools, but some people have no symptoms.

Causes of gastritis include infection with the bacteria H. pylori, the use of NSAIDs, and drinking alcohol. People with Crohn’s disease that affects the stomach may also develop gastritis.

Gastritis may be diagnosed through an upper endoscopy. Gastritis is often treated with medications to reduce stomach acids (antacids, h3 blockers, and proton pump inhibitors). If the gastritis is caused by another condition, like Crohn’s disease, treating that problem may improve the gastritis.

Gastroparesis

Gastroparesis is a disorder where food moves too slowly, or not at all, from the stomach into the small intestine. In many cases, it’s not known why a person develops gastroparesis, but some known causes include diabetes, Parkinson’s disease, multiple sclerosis, and prior surgery on the digestive tract.

The nerve that’s responsible for moving food along is called the vagus nerve, and if this nerve is damaged, gastroparesis can occur. Gastroparesis is more common in women, and symptoms can include feeling full after eating, vomiting, GERD, bloating, and stomach pain (upper abdominal pain). It is a chronic condition, which means that symptoms can improve and then come back again.

Diagnosis might be made using a variety of different tests, which can include upper endoscopy and an upper GI series, among others.

If gastroparesis is associated with diabetes, a change in diabetes treatment to improve blood sugar control may be needed. For other causes of gastroparesis, one or more of a variety of medications might be used to stimulate the muscles that move food out of the stomach and into the small intestine. Some people may need a change to their diet, which can include anything from eating smaller meals to using a liquid diet for a time or even receiving nutrition through an IV.

Gallstones

Gallstones are common and tend to affect women more than men. The gallbladder is a small organ attached to the liver that stores bile. Gallstones can form when bile doesn’t have the right concentration of bile salts, cholesterol, and bilirubin.

Gallstones can vary significantly in size (from a grain of sand to a golf ball) and can range in number from just one to in the hundreds. People more at risk of developing gallstones include women, those over the age of 40, those who are obese, those who have lost a lot of weight, and those with other digestive conditions, such as Crohn’s disease.

Many people with gallstones do not have any symptoms, but gallstones can cause pain after eating that can last several hours, along with nausea, vomiting, jaundice, and light-colored stools. Gallstones that get stuck in the bile ducts can lead to inflammation of the gallbladder and inflammation in the ducts, gallbladder, or liver. Inflammation of the pancreas (pancreatitis) can occur if a blockage occurs in one particular bile duct called the common bile duct.

Treatment for gallstones that are causing symptoms is typically a cholecystectomy, which is the surgical removal of the gallbladder. In many cases, this can be done laparoscopically, in which the surgery is performed using only small incisions and recovery is relatively quicker.

Diverticular Disease

Diverticular disease includes both diverticulosis and diverticulitis. The former is when small outpouchings occur in the inner wall of the colon (large intestine). When these get infected or inflamed, that is known as diverticulitis.

People more at risk for diverticular disease include those over the age of 40 and people who live in countries where the diet includes less fiber, such as the United States, the United Kingdom, and Australia. Many people with diverticula in their colon do not have any symptoms, but those who do can experience pain, bleeding, and a change in bowel habits.

Diverticulitis is not common (it happens in only about 5% of people with diverticula disease), but it can lead to other complications, such as an abscess (an infected area that fills with pus), fistula (an abnormal connection between two organs), peritonitis (an abdominal infection), or a perforation (hole) in the intestine.

Seeing a gastroenterologist for regular treatment and monitoring will help. Lifestyle changes that are often recommended for managing diverticulosis are eating more fiber and taking a fiber supplement.

Celiac Disease

Celiac disease (which used to be called celiac sprue) was thought of as a childhood disease, but it’s now known that it is a lifelong condition that people do not “grow out of.”

People with celiac disease have an autoimmune response when they eat foods containing gluten—a type of protein found in wheat, barley, and rye—which can lead to problems digesting food and cause a host of symptoms outside the digestive tract. If celiac disease is suspected, a physician may do testing such as a blood test, a genetic test, or biopsies from the small intestine to confirm the diagnosis or rule it out.

Treatment for celiac is avoiding gluten, which can help manage the symptoms. A gluten-free diet is best done under the supervision and guidance of a registered dietitian. Once gluten is out of the diet, most people feel better. A gluten-free diet is becoming easier to sustain, with the introduction of new, mass-market foods and gluten being clearly labeled on food packaging.

A Word From Verywell

The most important thing to remember when having digestive symptoms is that many problems are not serious and may also be treatable. The key is to see a doctor as soon as possible (or immediately if there are any red-flag symptoms) to get a diagnosis. The sooner the problem is identified, the quicker a treatment plan can be put into place and your symptoms controlled.

Common Causes of Abdominal Pain

Intense abdominal pain can be as trivial as a belly ache, or may even be life-threatening. How do you know for certain if your abdominal pain is a symptom of a serious condition? After you experience abdominal distress, you should discuss it with your doctor and make an appointment for analysis. While visiting your doctor, these two questions are very helpful:

When Did the Pain Begin?

Unexpected, intense abdominal pain could be a sign from your body that something is seriously wrong. Dull, gradual pain is often an indication of a developing condition.

Where Is That the Pain Located?

There are several areas at intervals in the abdominal region. Identifying the origin of the pain will aid in discovering the cause. Acute pain on the lower right side of the abdomen can be from the appendix. Whereas pain on the lower left side may indicate diverticulitis, constipation, or a variety of different bowel issues.

Although this is not a comprehensive list, here are some common causes of abdominal pain:

UPPER ABDOMINAL PAIN

Gastrointestinal Reflux Disease (GERD)

Chronic acid reflux, also known as GERD, causes a painful, burning sensation within the higher abdomen and chest, and commonly into the throat. Symptoms also include a dry cough and difficulty swallowing. GERD is the aftermath from the loosening of the lower esophageal sphincter (LES), which is important to the passage of food and drink between the esophagus and stomach.

Treatment for GERD includes over-the-counter antacids, proton pump inhibitors (PPIs), and h3 blockers. You can manage symptoms by making certain lifestyle changes, such as consuming smaller meals, avoiding fatty or spicy foods, avoiding smoking, and maintaining a healthy weight.

Stomach Ulcers

Also referred to as gastric ulcers, are painful sores within the lining of the stomach. Ulcers can also develop within the small intestine and are often caused by:

• Overuse of nonsteroidal, anti-inflammatory medication like aspirin or ibuprofen
• Excess stomach acid from tumors referred to as gastrinomas
• Infection by the bacteria H. pylori

Besides abdominal pain, ulcers might cause issues such as heartburn, nausea, and bloating. Severe ulcers can cause bleeding, perforation, or obstruction from scar tissue accumulation. One of our board-certified gastroenterologists will diagnose ulcers by testing for the H. pylori microorganism, or through associate examination. If ulcers are caused by H. pylori, antibiotics are often administered for treatment. When the ulcer is not from bacteria, your doctor might suggest acid-blocking medication.

LOWER ABDOMINAL PAIN

Diverticulitis

This occurs when pouches develop within the wall of the colon and become inflamed. It’s unclear what causes diverticulitis, but it appears that a low-fiber diet may contribute to the condition. Symptoms of diverticulitis include pain on the left side of the abdomen, fever, chills, gas, constipation or diarrhea, nausea, and loss of appetite.

Many people notice relief with over-the-counter pain medication, antibiotics, and diet adjustments. For serious cases, surgery may also be necessary.

What Is Celiac Disease?

Celiac disease is an autoimmune disorder that causes harm to the lining of the small intestine once foods containing gluten are consumed. Gluten is a type of protein that’s found in several grains. Once protein damages the intestinal lining, it’s tough for the body to absorb nutrients. Besides abdominal pain and bloating, celiac disease sufferers might experience symptoms such as severe skin rash, iron deficiency, diarrhea, weight loss, seizures, muscle cramps, joint pain, and mouth ulcers.

Blood tests are able to detect the presence of certain antibodies in individuals with celiac disease, as well as low iron levels. Your doctor may collect a stool sample to search for fat within the stool, since celiac sufferers absorb fats from food less effectively. Or, he/she may prefer to take a biopsy of the intestine to examine the for tissue harm. Once the patient switches to a gluten-free diet, full restoration of the intestinal lining is possible.

Inflammatory Bowel Disease (IBD)

Crohn’s disease and ulcerative colitis are possible causes of lower abdominal pain. Both conditions are inflammatory bowel diseases where the body’s immune system attacks the lining of the intestine. Other than abdominal pain, other symptoms can include diarrhea, bloody stool, fatigue, fever, malnutrition, and weight loss.

Endoscopy (an examination of the digestive tract with a skinny, flexible tube containing a camera) and specialized X-rays can diagnose inflammatory bowel disease. When managing IBD, steroids, and medicines that suppress the immune response are useful.

Colon Cancer

Colon cancer is the second leading cause of cancer-related death for both men and women in America. According to the American Cancer Society, about 150,000 individuals are diagnosed with colon cancer annually. It begins with little clumps of cells, referred to as polyps, that are typically benign at first. If those polyps are not removed during a colonoscopy, they may become cancerous.

Many people don’t notice symptoms of colon cancer until the illness is in advanced stages. Some symptoms related to colon cancer are:

• Abdominal pain
• Blood within the stool
• Change in bowel habits
• Cramping
• Bloating
• Vomiting
• Unexplained weight loss

The best way to prevent and detect colon cancer is a colonoscopy. Utilizing a lighted tube, a gastroenterologist is able to examine the entire colon for abnormalities, and they can even remove polyps during the same procedure. All adults who are at average risk for colon cancer should screen for colon cancer at the age of fifty. Discuss your colon cancer risk with your doctor, and schedule your colonoscopy.

LOWER RIGHT ABDOMINAL PAIN

Appendicitis

The appendix is a three and a half-inch tube of tissue connected to the large intestine. Appendicitis is inflammation of the appendix, and it’s quite common. About one in fifteen individuals get appendicitis; however, it can be fatal. If left untreated, an infected appendix will eventually burst and unleash infectious materials into the abdomen. Appendicitis usually begins with a dull pain close to the belly button, but the pain typically becomes sharper as it moves to the lower right abdomen. Other common symptoms include loss of appetite, nausea, vomiting, low-grade fever, muscle tension, and resistance within the lower abdomen.

If you are experiencing any of these symptoms, call your doctor immediately. An appendectomy is a standard, low-risk procedure, but it is time-sensitive.

Get an Expert Opinion

Abdominal pain is a common symptom that needs a gastroenterologist’s expert opinion for proper diagnosis. If you are experiencing abdominal pain, do not ignore your symptoms. While reading a list of symptoms in a book or website may be helpful in suggesting certain conditions, it is not sufficient in identifying the cause. Set an appointment with your board-certified gastroenterologist today for guidance, testing, and diagnosis.

Duodenitis, symptoms, diagnosis and treatment | Alpha

Duodenitis: symptoms, treatment, diet

Duodenitis is a duodenal disease characterized by inflammation of the mucous membrane. Pathology can be acute and chronic. Duodenitis has similar symptoms with other diseases of the gastrointestinal tract, such as ulcers and gastritis, therefore, for successful treatment, consultation of an experienced gastroenterologist and high-quality diagnostics are required.

Causes of the disease

Primary duodenitis occurs against the background of poor nutrition and bad habits. Sour, spicy, fried foods, alcohol stimulate the secretion of hyperacid gastric juice, which enters the intestine with food and damages its wall.

Primary duodenitis is rare. The secondary form of the disease is more often diagnosed when signs of duodenal inflammation appear for the following reasons:

• Helicobacter pylori infection.
• Chronic gastritis and other gastrointestinal diseases.
• Violation of the blood supply to the duodenum, for example, after surgery.
• Digestive disorders.
• Adhesion processes in the intestine.
• Compression bowel obstruction.

There are also specific forms of duodenitis, when the cause of duodenal inflammation is Crohn’s disease, tuberculosis, immunodeficiency, Whipple’s disease and other pathologies.

Symptoms of duodenitis

The signs of the disease are nonspecific. With the localization of pathological foci in the upper sections, the symptoms of duodenal inflammation are often confused with a stomach ulcer. The defeat of the lower sections has signs of cholecystitis or pancreatitis.

There is a classification of the symptoms of duodenal inflammation according to where it hurts and what manifestations are accompanied by:

• Ulcerative duodenitis.The patient complains of a pulling pain in the stomach, which worsens at night and on an empty stomach. Symptoms subside after eating. Bitter belching and heartburn are common.
• Gastritis-like duodenitis. The stomach begins to ache 15-20 minutes after eating. Signs of duodenitis: flatulence, loose stools, rumbling in the abdomen, nausea, loss of appetite.
• Pancreatic and cholecystoid duodenitis. The pain is acute, occurs in the hypochondrium as biliary colic.Disorders of stool and digestion are observed.
• Neurovegetative duodenitis. The patient falls ill against the background of chronic stress, which results in hormonal imbalance, various autonomic disorders of internal organs and systems.
• Duodenitis of mixed form. There are clinical signs of several types of diseases.
• Asymptomatic duodenitis. The disease is diagnosed in adults and the elderly during examination for other complaints.

Chronic duodenitis during periods of exacerbation is manifested by night pains. Patients also complain of weakness, nervousness, headaches, tachycardia, shortness of breath. Symptoms are associated with the fact that inflammation of the duodenum disrupts its hormonal function.

Diagnosis of duodenitis

The main diagnostic method is gastroscopy. Based on the endoscopic picture, the doctor can confidently talk about the development of duodenitis and determine its shape.

As part of evidence-based medicine, histology is required to make a diagnosis of inflammation.

To clarify the diagnosis, appoint:

• X-ray of the stomach and duodenum

with contrast.

• pH-metry of the digestive juice.
• General and biochemical blood tests.
• Duodenal intubation, during which samples of gastric juice are taken.
• Coprogram.
• Biopsy for suspected malignancy of mucosal defects.

Duodenitis treatment

Treatment of duodenal inflammation is selected individually, taking into account the clinical form of the disease.

Duodenitis of an infectious nature requires the use of antibiotics – the drug is selected individually to relieve the inflammatory process. The doctor also prescribes medicines to reduce gastric acid production and coatings to protect the mucous membranes.Enzymes help restore digestion.

Treatment of duodenitis with enteritis is based on a strict diet. The patient is advised to exclude cereals, milk, and other foods that are poorly digested from the diet. To maintain the digestive tract, the doctor prescribes probiotics. A balanced diet with duodenitis should become habitual – this is the only effective measure to prevent exacerbations. It is recommended to exclude spices, fresh baked goods, salty, spicy, fried foods, alcohol from the diet.It is better to steam or boil meat, vegetables and fish.

Inflammation against the background of duodenostasis requires clarification of the cause of intestinal obstruction. The patient is prescribed a diet, it is recommended to eat in small portions. Depending on the specific clinical picture, the doctor may prescribe medications that enhance intestinal motility, binding bile. A good result is obtained by intubation of the duodenum with washing.

In difficult cases, surgical treatment is indicated.During the operation, the doctor eliminates adhesions, mechanical barriers, and the intestinal patency is restored. Gradually, the symptoms of duodenitis weaken and disappear. Treatment is carried out in a stationary setting. After the operation, the patient is prescribed a constant diet.

For the prevention of duodenitis, in addition to diet, patients are advised to give up bad habits, observe the daily regimen, and avoid stress. Any diseases of the digestive system and parasitic infestations must be treated promptly.

Diagnostics and treatment of duodenitis in Nizhny Novgorod

You can make an appointment with a gastroenterologist on the website of the Alfa Health Center. Consultations are held at a time convenient for the patient. In our clinic, you can pass the necessary tests, undergo a comprehensive examination, and receive qualified treatment. Call us to schedule an appointment.

Inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic inflammatory process involving the entire intestine or part of the gastrointestinal tract (GI tract).This usually leads to abdominal pain and diarrhea, sometimes extraintestinal symptoms may occur: joint inflammation, skin rashes, and inflammatory eye lesions.

The causes of this pathology are still not known exactly, although the involvement of the immune system and genetic factors is assumed.

Major inflammatory bowel diseases: ulcerative colitis (UC) and Crohn’s disease.

Collagenous and lymphocytic colitis can also be referred to them, but they are usually considered separately from the main types of IBD.

The course of IBD can be long and debilitating, in addition, sometimes there are complications that are life-threatening: bleeding, the development of an oncological process, inflammation of the abdominal cavity due to the ingress of intestinal contents into it through a defect in the intestinal wall.

Drug therapy is often successful, leading to the disappearance of symptoms for a long time. If it is ineffective, surgical treatment is performed.

Synonyms Russian

VZK.

Synonyms English

Inflammatory bowel disease, IBD.

Symptoms

The manifestations of the disease depend on the severity of the process and its localization. In addition, there are periods of remission (complete disappearance of symptoms) that last for months or even years.

The most common symptoms of IBD are:

• chronic diarrhea with blood in the stool, sometimes mucus,
• abdominal pain, possibly cramping,
• intestinal bleeding (more typical for Crohn’s disease),
• feeling of incomplete bowel movement and false urge to defecate,
• anal fissures (typical of ulcerative colitis),
• fistulas (pathological passages connecting the intestine with the external environment or with another intestine in the wrong place; characteristic of Crohn’s disease)

In addition, there are a number of extraintestinal symptoms:

• general weakness and malaise,
• temperature rise,
• loss of appetite and body weight,
• anemia due to bleeding and malabsorption of iron.

Sometimes there are joint pains, inflammatory lesions of the eyes, red, lumpy, painful rashes on any part of the skin

General information about the disease

Inflammatory bowel disease is a chronic recurrent disease in which the lining of the gastrointestinal tract is affected.

The cause of IBD is currently unknown. They are believed to be mainly caused by:

• disorders in the immune system, leading to its increased activity and excessive production of antibodies (protective factors) against cells of its own mucous membrane,

90,013 genetic factors, due to which people with IBD are more susceptible to IBD.

Stress and eating habits can further increase the risk of IBD.

The main forms of this pathology are ulcerative colitis and Crohn’s disease. In ulcerative colitis, the pathological process is localized in the large intestine, the inflammation is continuous and affects only the upper layers of the mucous membrane, without penetrating deep into the tissues.

In Crohn’s disease, any part of the gastrointestinal tract, from the mouth to the rectum, can be affected, the inflammation penetrates deep into the tissue and is characterized by segmental lesions of the mucous membrane.

Chronic inflammation leads to impaired digestion and absorption of nutrients (malabsorption), as a result of which the level of trace elements, glucose, protein, vitamins in the blood decreases, which can cause depletion of the body.

Who is at risk?

• Persons whose relatives suffered from inflammatory bowel diseases.
• Young people under 30.
• Smokers (and smoking negatively affects the course of Crohn’s disease, but refusal from it can provoke its exacerbation).
• Individuals who frequently take pain relievers (non-steroidal anti-inflammatory drugs) such as ibuprofen, naproxen, aspirin.
• Inhabitants of megacities.

Diagnostics

If you have symptoms of inflammatory bowel disease, especially if you have frequent loose, bloody stools or severe abdominal pain, see your doctor.

The electrolyte composition of the blood may change, the level of total protein, glucose, vitamins may decrease.In a general blood test, a decrease in hemoglobin is likely, indicating the development of anemia and / or an increase in the level of leukocytes, which indicates an infection.

A fecal test is also used to detect digestive disorders and the amount of blood in the stool that is invisible to the eye.

The doctor can prescribe an X-ray or endoscopic examination of the intestine, the latter allows you to take a biopsy (a piece of the intestinal mucosa) for examination under a microscope, which often helps to make a definitive diagnosis.

Treatment

The treatment is based on the prescription of drugs that suppress the activity of the immune system. The synthesis of antibodies to the intestinal mucosa and the activity of inflammation are reduced.

In the absence of the effect of therapy, it is necessary to consult a surgeon to resolve the issue of surgical treatment.

Recommended analyzes

90,000 symptoms, causes, treatment, diet

Stomach ulcer is one of the most common diseases of the gastrointestinal tract.This is a chronic pathology in which defects occur in the gastric mucosa. With untimely treatment or its complete absence, it can cause a person’s disability or even death.

People between the ages of 20 and 65 suffer from gastric and duodenal ulcers. Men from 25 to 40 years old get sick 5-6 times more often than women for the reason that male sex hormones indirectly increase the acidity and aggressiveness of gastric juice, and female – lower it.

The structure of the human stomach

The stomach is an organ of the digestive system in which food accumulates, and under the influence of gastric juice, it undergoes primary digestion with the formation of a mushy mixture.

The stomach is mostly located in the upper left abdominal region. The stomach does not have a certain shape and size, since they depend on the degree of its filling, the state of its muscle wall (contracted or relaxed) and age. Organ capacity is about 3 liters, 21-25 cm long.

The stomach has two main functions:

• Secretory . Excretion of gastric juice, which contains the necessary components for the initial stages of digestion and the formation of chyme (food lump).About 2 liters of gastric juice are released per day. With a disorder of the secretory function of the stomach, a person’s acidity increases, i.e. the release of hydrochloric acid increases, or the acidity decreases, accompanied by a decrease in the release of hydrochloric acid.
• Motor . The muscular layer of the stomach contracts, as a result of which food is mixed with gastric juice, primary digestion and movement through the duodenum.

Disorders of gastric motility due to a violation of the tone of its muscle wall leads to indigestion and evacuation of gastric contents into the intestines.This is manifested by various dyspeptic disorders (nausea, vomiting, bloating, heartburn, and others).

The mechanism of formation of stomach ulcers

A stomach ulcer is a defect in the gastric mucosa, rarely less than 1 cm (sometimes submucosa), surrounded by an inflammatory zone.

The most common cause of stomach and duodenal ulcers is Helicobacter pylori infection. Various factors lead to an imbalance between the protective factors (gastric mucus, gastritis, secretin, hydrocarbons, mucous-epithelial barrier of the stomach and others) of the gastric mucosa and the factors of aggression (Helicobacter Pylori, hydrochloric acid and pepsin).

Under the action of treatment, the defect is overgrown with connective tissue (a scar is formed). The area where the scar has formed does not have a functional ability (secretory function).

Reasons for the development of pathology

Helicobacter Pylori bacterium (causative agent of ulcers) – has a destructive effect on the cells of the gastric mucosa, destroys local defense factors. As a result, a defect such as an ulcer is formed. Infection with a bacterium through the saliva of an infected person (non-observance of the rules of personal hygiene, the use of unwashed dishes after an infected person).

Increased acidity – develops as a result of increased release of hydrochloric acid, which has a corrosive effect on the gastric mucosa, with the subsequent formation of a defect.

What influences the formation of stomach ulcers?

• Nervous-emotional overstrain leads to increased secretion of gastric juice (hydrochloric acid).
• Genetic predisposition to the formation of stomach ulcers.
• Smoking, drinking alcoholic beverages, drinking large amounts of coffee, nicotine and ethyl alcohol stimulate the production of gastric juice, thereby increasing acidity.
• Presence of a pre-ulcer condition: chronic gastritis, chronic inflammation of the gastric mucosa.
• Disturbed diet: food in dry water, long breaks between meals lead to impaired secretion of gastric juice.
• Abuse of sour, spicy and rough foods.
• Long-term use of medications that have a destructive effect on the gastric mucosa.

Stomach ulcer symptoms

• Painful sensations .Ulcer pain can be troublesome day and night. Most often, pain in pathology manifests itself during hunger. It is localized in the upper abdomen, can decrease or increase immediately, or after a while after eating, depending on the location of the ulcer.

The unpleasant signs of stomach ulcers can be so pronounced that nausea or even vomiting appears, which intensifies in the morning and disappears after eating. The ulcer manifests itself more often in the autumn-spring periods.

• Feeling of heaviness in the stomach . A person often begins to reduce portions of food, since the absorption of even a small amount of food that gets on the inflamed areas of the gastric mucosa and ulcers can cause these unpleasant sensations.
• Odor from the mouth, plaque on the tongue . Frequent companions of any inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers most often appear.

Diagnosis of stomach ulcers

Diagnosis of a typical stomach ulcer is quite simple and is carried out by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies the complaints, the nature and characteristics of the course of the disease, with palpation, he clarifies the boundaries of the painful zones and their nature.

To form an accurate picture of the patient’s health, the doctor may prescribe a general blood test and instrumental examination.Most often this is an endoscopic examination (EGDS).

The procedure is safe, lasts a few minutes, and is accompanied by unpleasant, but quite bearable sensations. Allows you to examine the upper parts of the gastrointestinal tract, to establish the presence and nature of inflammatory and erosive-ulcerative processes, as well as the appearance of neoplasms.

Stomach ulcer treatment

A therapist or gastroenterologist deals with the treatment of peptic ulcer disease. It aims to treat symptoms, heal ulcers and eliminate the cause of the disease through diet, lifestyle changes and medication.

Drug therapy

To get rid of the Helicobacter Pylori infection, the doctor prescribes antibiotics, and to reduce the acidity of the gastric juice – acid-lowering drugs, etc. which have no ulcerative action.

Pain is first relieved with pain relievers.Drugs are taken only when there is discomfort in the stomach. Enterosorbents are also prescribed, which neutralize the negative effect of toxins. In addition, the patient needs to take a course of vitamins.

Power supply

It is important for stomach ulcers not to exacerbate symptoms with bad habits. Stop smoking and drinking alcohol. And also monitor your diet. For stomach ulcers, a special diet should be prescribed.

It involves good nutrition, divided into 5-6 meals a day. The use of strong irritants of gastric secretion (ketchup, hot spices), rough foods and dishes is limited. Food is prepared mostly pureed, steamed or in water, fish and non-coarse meats are served in chunks. Very cold and hot dishes are excluded from the diet. The intake of table salt is limited.

The appearance of an excess amount of hydrochloric acid in the stomach leads to pain, the patient suffers from heartburn.Water is needed, which has an alkalizing effect – when it is used, the harmful effects of hydrochloric acid are neutralized.

The opposite problem is low acidity. In this case, little gastric juice is produced. Bottom line: food is poorly digested, there is a feeling of fullness in the stomach.

Alkaline mineral waters speed up the processing of food and promote its rapid movement through the gastrointestinal tract.

Prevention of stomach ulcers

With a healthy lifestyle, proper nutrition, respect for your health, the likelihood of stomach ulcers is extremely low.As we have already found out, sleep and nutrition disorders, an overly active lifestyle, as well as non-compliance with the rules of personal hygiene lead to the development of stomach ulcers.

If relatives had a peptic ulcer, then, regardless of complaints, EGDS was recommended with determination of gastric acidity, clarifying biopsies to determine H. Pylori infection and histological examination of suspicious areas at least once every 2 years.

You also need to adhere to a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours at night.Avoid stressful situations, learn to perceive them correctly.

Regularly visit a doctor as part of a medical examination and eliminate foci of chronic infection. Starting from the age of 25, once every two years, undergo a planned comprehensive endoscopic examination – EGDS with the definition of H. Pylori.

Where to get diagnostics and treatment of gastric ulcer in Krasnoyarsk?

A private medical clinic “Medyunion” on Nikitina is working for you. We are engaged in the prevention, diagnosis and treatment of stomach ulcers.Our specialists will conduct a comprehensive examination using the latest devices, in sterile clean rooms.

To register, fill out the online feedback form indicated on the website, or call and specify the information on the clinic’s phone number 201-03-03.

Treatment of bleeding of the digestive tract – symptoms of bleeding from the upper or lower gastrointestinal tract

Digestive tract bleeding treatment

In medicine, bleeding from the digestive tract is called gastrointestinal.Their peculiarity is in the release of blood into the lumen of the gastrointestinal tract. If it enters the abdominal cavity from the digestive organs, then such bleeding is classified as abdominal. We will tell you about what may be causing the problem, what symptoms to look for, and how to provide first aid.

What happens when there is bleeding in the gastrointestinal tract

The problem is damage to the walls of blood vessels, in which tears are formed. In the vast majority of cases, this is a consequence or complication of various diseases.As a result, blood enters the lumen of the digestive tract. The most dangerous are ruptures of large vessels – veins, arteries. In such cases, blood loss can be more than 1 liter, which can be fatal (the total blood volume in the body of an adult male is about 5 liters).

How blood vessels bleed

Bleeding can be mild, moderate or severe. His character could be:

• arterial – strong, jet;
• venous – blood loss occurs gradually;
• capillary – slight discharge due to damage to small vessels.

The problem itself may be stable / unstable, recurrent. Vessels of the mucous membrane, submucosal and intermuscular plexus, as well as those located outside the digestive tract, can bleed.

Expiration can last for several hours or days. In medicine, a distinction is made between:

• profuse blood loss – the patient loses more than 1 liter of blood in 1-3 hours and needs urgent medical attention;
• acute – less than 1 liter expires in 1-2 days, the patient’s vital signs are relatively stable;
• chronic – developing slowly, often over several weeks or even months, the intensity of the symptoms gradually increases.

Views

• Bleeding from the upper digestive tract (esophagus, stomach, duodenum 12) accounts for about 80% of all cases.
• Bleeding from the lower gastrointestinal tract is less common and affects the rectum, small intestine, and large intestine.

Why is the problem

About 200 causes of bleeding in the digestive tract are known to medicine. At the first symptoms, you should seek professional help from a doctor and in no case self-medicate, as this will only aggravate the condition.

Ulcer

Most common reason. With an ulcer, the integrity of the mucous membrane of the organ is disrupted, and the main difference between the disease is deep tissue damage. The disease is chronic – with remission and exacerbations. On the mucous membrane of the stomach, esophagus or duodenum, areas of inflammation are formed, in which the protective function decreases (mucus secretion). Gradually, the tissues of the mucous membrane, including the walls of the vessels, become thinner, which leads to their rupture.

Varicose veins

The problem may occur in the esophagus or stomach due to increased pressure in the portal vein.Most often, cirrhosis of the liver becomes the root cause. The rupture of a large vessel with varicose veins is as dangerous as possible, since at this moment there is an abundant outflow of blood. According to statistics, in 40% of cases, it stops spontaneously. And the activity of bleeding depends on the degree of liver damage.

Diverticulosis of the large intestine

In this disease, the colon mucosa protrudes, forming diverticula. The reasons for their formation are not completely clear to medicine, in general, they are associated with increased intraluminal pressure.Basically, the pathology is typical for adult patients over 50 years old. In the acute course of the disease and rupture of intramural blood vessels in the area of ​​diverticulum, intestinal bleeding occurs.

Tumors and polyps

Occur in the small and large intestines, are benign neoplasms that grow in the intestinal lumen. Most often, the bleeding is minor and chronic. The danger lies in the possible degeneration into malignant tumors.

Hemorrhoids

This is the formation of venous nodes around the rectum in the anal area. The main reasons are thrombosis or tissue inflammation. The disease can be acute or chronic, and its common causes are a sedentary lifestyle, excessive physical exertion, and obesity. Bleeding (the color may be scarlet or dark) is minor and occurs most often after a bowel movement.

More rarely, esophagitis, acute hemorrhagic gastropathy, erosive duodenitis, Mallory-Weiss syndrome are found as a cause of bleeding in the upper gastrointestinal tract.In the lower part of the bleeding can cause tumors, vascular malformations, various inflammations.

Who is at risk?

Basically, diseases that lead to bleeding occur in adults. Moreover, according to statistics, men are 2 times more likely than women to diagnose problems with the organs of the gastrointestinal tract – stomach, duodenum 12. As we noted above, ulcerative pathologies hold the first place in terms of the number of diseases. The age peak of diseases is 40-45 years old.

However, the problem is not limited to adults. The diagnosis associated with ulcerative lesions of the gastrointestinal tract is often given to adolescents who uncontrollably consume junk food and drinks. There are also frequent cases of the formation of intestinal polyps.

Gastric and intestinal bleeding is increasingly found even in newborns. Basically, volvulus leads to them. In 3-year-old children, expiration can be caused by the formation of a diaphragmatic hernia, as well as abnormalities in the development of the organs of the lower gastrointestinal tract.

10 risk factors

• Improper nutrition;
• overweight;
• low physical activity;
• excessive addiction to tobacco, alcohol, leading to intoxication of the body;
• frequent consumption of carbonated drinks;
• taking medications;
• frequent stress;
• development of infection in the organs of the upper gastrointestinal tract;
• metabolic disorders;
• genetic predisposition.

What symptoms to look for

Patients with the diagnoses listed above should be especially monitored for the appearance of anxiety symptoms. If you are taking medications for the liver and gastrointestinal tract, carefully monitor your health. If you are alarmed by the changes discussed below, see your doctor. However, it is useful for every person to know these signs, since many diseases of the lower and upper gastrointestinal tract develop without obvious painful sensations.Often, bleeding symptoms may be the first manifestation.

1. Weakness

This is the main symptom of any prolonged bleeding. The weakness gradually increases, the patient’s skin turns pale, he feels cold sweat, hum in the ears, trembling of the limbs. The weakened state can last for several minutes, after which it passes and periodically returns. If the blood flows out actively, fainting or semi-fainting, and even a state of shock, is possible.

2.Vomiting

This symptom accompanies severe blood loss – more than 0.5 liters. If the vomit is dark cherry color, it is most likely coming from a vein near the esophagus. If unchanged blood is clearly visible in the vomit, the integrity of the artery in the esophagus is most likely broken. If the patient vomits the so-called brown “coffee grounds”, the problem lies in the gastric vessels. Only a doctor can accurately determine the nature, place and intensity of blood loss.

3.Chair

Blood traces in the feces may appear in a few hours or 1-2 days after the violation of the integrity of the vessels. With significant problems with the stomach or duodenal ulcer, as well as blood loss in a volume of more than 0.5 liters, melena can be observed – loose stools that resemble tar in color and consistency. If the blood loss is of a smaller volume, which often happens, for example, with intestinal bleeding, then the stool remains shaped, but its color darkens.

Please note that darkening of the stool can occur due to the consumption of foods that contain dark dyes, such as blueberries, cherries.Dark stools are not an absolute sign of blood in the stool and problems in the upper or lower GI tract. The diagnosis can only be made by a qualified specialist.

How is the diagnosis made

The doctor examines the patient, assessing his external condition, the shade of the skin, mucous membranes. Then he measures blood pressure – often it is reduced.

In a clinic, the patient undergoes a general blood test. From it, you can quickly get an idea of ​​the level of hemoglobin, the volume of other blood cells.Additionally, the diagnosis is made by biochemical analysis, however, it is usually prescribed several days after the onset of blood loss, since the chemical composition of the blood changes only over time.

The main diagnostics concerns the detection of the very cause of the violation of the integrity of the vessels. For this, doctors use the following hardware examinations.

• Endoscopy – examination of the esophagus, stomach, duodenum using a flexible tube with a miniature camera allows you to quickly find a problem area;
• Contrast radiography – an effective method for detecting bleeding in the gastrointestinal tract is the introduction of a safe contrast solution into the body, followed by an x-ray;
• Magnetic resonance imaging is a modern method that allows you to obtain comprehensive information about the state of all tissues of a particular organ of the gastrointestinal tract.

First aid

When the first warning signs appear, be sure to call an ambulance, as the bleeding may not stop on its own.

While the doctors arrive, place the patient in a horizontal position and raise his legs. If possible, put ice on your stomach. Doctors categorically do not recommend prescribing or taking any medications on their own at this moment, as they can increase bleeding.

It is strictly forbidden to use water! If you or the patient still needs to take a pill, crush it and swallow the powder along with ice cubes.In any case, do not prescribe drugs yourself. Wait for the ambulance to arrive – the doctors will provide specialized assistance. Be healthy!

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Tokareva Lyudmila Georgievna, therapist of medical offices 36.6

THERE ARE CONTRAINDICATIONS, BEFORE USING IT IS NECESSARY TO CONSULT A SPECIALIST

Ultrasound diagnostics of the stomach – DocDoc.ru

Some time ago, an ultrasound examination of the stomach was not possible,
because
the stomach is a hollow organ.But with the advent of a new generation
ultrasound equipment, conducting ultrasound
the stomach has become a routine examination in almost any clinic. This diagnostic method is more comfortable and
much easier for the patient than gastroscopy. However, if in front of a doctor
the question arises what is better to appoint
Ultrasound
or gastroscopy of the stomach, often the choice is made in favor of the latter due to
more informative. Currently, new endoscopic devices are used,
which are equipped with modern ultrasonic sensors.This greatly increases the information content.
and the accuracy of the survey.

Is stomach ultrasound done for children? Sometimes ultrasound of the stomach is prescribed for children
to determine the primary diagnosis. Therefore, for examining babies in
medicine, there are special indications. The doctor can send an ultrasound scan of the stomach for recurrent bronchitis or, if
the child often has abdominal pain accompanied by stool disorders, and
also attacks of nausea for no particular apparent reason.

Indications for the appointment of ultrasound of the esophagus and stomach

Stress, malnutrition and abuse
smoking and alcohol often leads to disruptions in work
gastrointestinal tract, diseases of the esophagus and stomach.

At
the occurrence of discomfort in the stomach, pain, indigestion, frequent
vomiting and other similar phenomena should be addressed as soon as possible
doctor and not self-medicate
.

As a rule, a gastroenterologist prescribes a diagnosis using
ultrasound equipment for suspected pathological
processes and diseases such as:

• gastritis, gastric ulcer and duodenal ulcer;
• diaphragmatic hernia;
• cysts, benign and
  malignant neoplasms;
• gastric pyloric stenosis;
• esophageal or intestinal obstruction;
• abnormalities in the structure and function of the stomach.

Follows
remember that ultrasound examination of one stomach separately
ineffective, since it will not give a complete picture of the state of the organ. Based
this, endoscopy is usually preferred as one of the most
effective types of diagnostics of pathology of the gastrointestinal tract
.

If you are worried about a health problem, sign up for a diagnosis. The success of treatment depends on the correct diagnosis.

Preparation for ultrasound of the stomach. Can I eat and drink before the procedure?

For the most accurate diagnosis a few days before the procedure, patients are advised to:

• adhere to a low-calorie diet;
• Do not eat foods that cause
  increased gas production, such as baked goods, kefir, legumes, cabbage, lemonade
  and sparkling mineral water or fresh fruit;
• to eat the day before,
  scheduled for examination, it is recommended no later than five to six o’clock in the evening;
• Do not eat, drink or abstain before the ultrasound scan on the day of the diagnosis
  from smoking.Sometimes, exceptionally, children and patients with discomfort in
  the stomach area may be allowed to drink some tea or eat a crouton.

What does ultrasound of the stomach show in adults and children

By ultrasound, you can determine the state of the stomach, and
also the sphincter and
duodenum. In these zones, more often
all problems arise, therefore, ultrasound plays an important role in the diagnosis of pathologies
and diseases of the gastrointestinal tract.

What
seen on ultrasound of the stomach is normal

In the absence of any deviations from the norm, diseases and
pathologies, ultrasound of the stomach shows the following parameters:

• the stomach has the form of a ring, which has a rim,
  and the walls are about 5-7 millimeters thick;
• the stomach wall has five layers that differ
  by the degree of echogenicity;
• hyperechoic serous membrane located
  outside of the stomach;
• the dimensions of the submucosal membrane are about three
  millimeters;
• gastric mucosa in thickness of about one and a half
  millimeters.

To assess the function of peristalsis
stomach, the patient is asked to turn to the right side. To exclude
tumor processes, it is important to correctly assess the uniformity of the wall thickness
stomach.

What
pathology can be detected using ultrasound of the stomach? Will ultrasound show stomach cancer?

When examining the stomach by ultrasound, the sonologist can see
pathologies such as:

• thickening of the stomach walls, edema;
• the presence of a foreign object in the stomach;
• any benign tumors and cysts;
• polyps, hernias;
• aberrantly developed tumor vessels;
• ulcers of the stomach and duodenum;
• stomach cancer;
• inflammation of the gastric mucosa;
• gastroesophageal reflux and others
  pathology.With this type of examination, the accuracy of ultrasound is almost equivalent to radiological
  examination of the digestive system using barium.

During ultrasound examination of the stomach by a doctor
assesses, among other things, the condition of the surrounding tissues, such as
pancreas and liver. In addition, lymph nodes and blood vessels are also in the area of ​​his attention.

Examination Procedure

Gastric Ultrasound Examination Procedure
carried out transabdominal or external, method.The man is in
position on the side or on
back, and sometimes sits down and exposes the stomach. As soon as a sonologist
or the gastroenterologist begins the examination using an ultrasound probe, on the screen
apparatus, an image of the stomach cavity appears.

Sometimes, in order to improve the image quality, liquid is used,
injected into the stomach. For this, water is used, as well as a special solution. Contrasting
with the help of liquid allows you to make a five-step structure of the stomach wall
more visible and allows the doctor to follow the function of the esophagus and the process
filling the stomach.

To enhance the conductivity of ultrasound, the doctor applies a special
water-based gel and, moving the device over the abdomen, examines the abdominal cavity organs
from different angles.

The usual duration of the procedure is about half an hour. At the end
examination, the patient receives a qualified analysis of the results
examination and a complete echo picture obtained on the screen of the apparatus. In custody
a gastroenterologist describes the condition of the stomach and gives descriptions of pathological
states.Upon detection of deviations from the norm, diseases and disorders in
the condition of the stomach, as a rule, images are attached to the decoding
affected areas of the organ.

How is gastric ultrasound done with a water-siphon test?

Diagnostics is carried out in two stages:

1. Research on an empty stomach without food and water.

2. Investigation during filling of the stomach. The patient should drink up to 1 liter of liquid from a container with a straw. The doctor assesses how the liquid goes through the esophagus, at what speed, evaluates peristalsis and other indicators.

This article is posted for educational purposes only, does not replace an appointment with a doctor and cannot be used for self-diagnosis.

19 April 2017

Stomach cancer: a description of the disease | Clinic Rassvet

Fast passage

Stomach cancer is a malignant formation of the gastric mucosa, which is on the 6th place in the structure of the incidence of oncological diseases in Russia (in 2017 -in the Russian Federation 37291 people fell ill with stomach cancer).

Stomach cancer usually develops in cells that produce mucous secretions, these cells are located in the lining of the stomach. This type of cancer is called adenocarcinoma.

Over the past few decades, the incidence of stomach cancer has been declining worldwide. At the same time, cancer in the area where the upper stomach (cardia) meets the lower esophagus is becoming much more common.

This area of ​​the stomach is called the gastroesophageal junction. And the cancer in this area is gastroesophageal cancer.

What are the symptoms of stomach cancer?

Signs and symptoms of gastroesophageal cancer and stomach cancer:

• Bloating after eating
• Feeling full after eating a small amount of food
• Severe, persistent heartburn
• Severe, frequent gastric disorders
• Unexplained persistent nausea
• Abdominal pain
• Frequent vomiting, usually associated with eating
• Unintentional weight loss
• Fatigue

When to see a doctor?

If you have signs and symptoms that bother you, make an appointment with your doctor.Rassvet Clinic employs a multidisciplinary team of highly qualified specialists – gastroenterologists, therapists, nutritionists, to whom you can turn for help.

The doctor will first study the more common causes of these signs and symptoms, and if a tumor process is detected, he will refer you to an oncologist at the Rassvet Clinic for consultation.

Causes of stomach cancer

Cancer occurs when the number of acquired mutations in the DNA of a certain population of cells, caused by various reasons, allows them to divide uncontrollably and “hide” from the immune system.

The accumulating cancer cells form a tumor that is able to invade nearby structures. Cancer cells can separate from the tumor and spread throughout the body. This is called metastasis.

Although the underlying cause of gastric cancer is still unclear, there is a clear understanding of the risk factors and predisposing factors.

In recent years, the evidence base for the connection of stomach cancer with infection with the bacterium Helicobacter pillory, which often causes chronic gastritis and gastric ulcer, has been gaining momentum.

There is a proven link between a diet high in salty and smoked foods and cancer located in the main body (body) of the stomach. As the use of refrigeration technology to preserve food has increased worldwide, the incidence of stomach cancer has declined.

Risk factors

The main risk factors for the development of cardioesophageal cancer are GERD and a history of obesity.

Factors that increase your risk of stomach cancer of the body include:

• Diet high in salty and smoked foods
• Diet low in fruits and vegetables
• Family history of stomach cancer
• Helicobacter pylori infection
• Long-term inflammation of the stomach
• Pernicious (B12) anemia
• Smoking
• Stomach polyps

Recommendations of the doctors of the Dawn clinic for the prevention of stomach cancer

It remains unclear exactly which key factor causes gastroesophageal cancer or cancer of the body of the stomach, so it cannot be prevented.But you can take steps to reduce your risk of developing this formidable disease.

To do this, you need to make small changes in your daily life:

• Monitor your weight. If you have signs of obesity, talk to your dietitian about eating habits.
• Try to be physically active most of the days of the week. Regular exercise has been linked to a lower risk of stomach cancer.
• Eat more fruits and vegetables. Try to add more fruits and vegetables to your diet every day. Not only the quantity is important, but also the variety, it has been proven that the consumption of 5 or more types of vegetables and / or fruits during the day significantly reduces the risk of stomach cancer.
• Reduce your intake of salty and smoked foods.
• Stop smoking. If you smoke, quit. If you don’t smoke, don’t start. Smoking increases the risk of not only stomach cancer but many other cancers as well.Quitting smoking on your own can be very difficult, you can contact the doctors at the Rassvet Clinic, they will provide you with practical advice and information about existing medications to make it easier to quit smoking.

Diagnostics of stomach cancer

Tests and procedures used to diagnose gastroesophageal and gastric body cancers include the following:

EGDS is an esophagogastroduodenoscopy, a study in which the mucous membranes of the esophagus, stomach, duodenum are examined using a small video camera.

During this study, using a special video camera, the doctor examines the mucous membranes and looks for signs of a tumor process. If suspicious areas are found, a piece of tissue is taken for analysis, this is a biopsy.

Tissue biopsy is extremely important, since the tissue undergoes modern pathomorphological diagnostics, with histological, and in some cases immunohistochemical and molecular genetic studies – this allows you to make the correct diagnosis and prescribe treatment.

Endoscopic ultrasonography is an ultrasound examination performed with a special probe built into the endoscope, that is, the examination is performed directly on the stomach wall. This is necessary to assess the true depth of germination, which is not visible by other methods, to identify patients who can undergo endoscopic resection of the mucosa with dissection of the submucosa – a modern minimally invasive type of treatment for early (only!) Gastric cancer.

Radiation diagnostics . To detect stomach cancer, methods such as computed tomography (CT) and a special type of X-ray examination, contrast-enhanced fluoroscopy, are used, when the patient swallows a special X-ray contrast agent that can detect tumor changes. This study makes it possible to assess the patency of the esophagus and stomach, which is especially important in cases of stenosis – the difficulty of passing food and water through the stomach lumen narrowed due to tumor growth.

Additional studies required to determine the prevalence of the tumor process. They may include CT and MRI of other parts of the body to exclude distant metastasis. Determining the stage of cancer development is necessary for your doctor to select the most suitable treatment for you.

Radionuclide study , which can be performed with the appearance of pain in the bones – bone scintigraphy, which allows to assess the damage to the bones of the skeleton.

The following techniques and procedures are used to determine the stage of cancer:

• Radiation diagnostics, which includes techniques, computed tomography, magnetic resonance imaging, positron emission tomography (PET).
• Various clinical blood tests are required to assess the general condition of the patient.
• Diagnostic operation. If other methods cannot reliably establish the extent of the tumor, the doctor may recommend surgery to look for signs that the cancer has spread beyond the esophagus or stomach, into the chest or abdominal cavity.This operation is usually performed laparoscopically. This means that the surgeon makes several small incisions through which a special camera is inserted into the abdomen, which transmits images to a monitor in the operating room.

Other methods may be used depending on the situation.

Stages of stomach cancer

The following stages of adenocarcinoma of the stomach or esophagus are distinguished:

• I stage. At this stage, the tumor is confined to the mucous membrane that covers the inside of the esophagus or stomach.
• II stage. The cancer at this stage has spread deeper, growing into the deeper muscle layer of the esophagus or the stomach wall. Cancer can spread to the lymph nodes lying next to the stomach, these are regional metastases.
• III stage. At this stage, the cancer can spread through all layers of the esophagus or stomach and spread to nearby structures. Or it may be a smaller tumor that has spread more widely to the lymph nodes.
• IV stage. She indicates that the cancer has spread to distant parts of the body and there are distant metastases.

How to treat stomach cancer

In the Rassvet clinic, for the treatment of gastric malignant tumors, a multidisciplinary approach is used with the discussion of complex cases at a consultation with the involvement of a surgeon, chemotherapist and radiotherapist.

We have everything you need to conduct chemotherapy according to Russian and Western protocols, conduct concomitant therapy and, if necessary, route the patient to other treatment methods.

Author:

90,000 Feline Inflammatory Bowel Disease (IBD)

Feline inflammatory bowel disease (IBD) is a condition in which a feline’s gastrointestinal tract becomes chronically irritated and inflamed.

Inflammatory cells invade the walls of the gastrointestinal tract, thickening them and disrupting the ability of the gastrointestinal tract to properly digest and absorb food.IBD can affect cats of all ages, but the disease is most common in middle-aged and older cats.

Although the cause of IBD is unknown, current evidence suggests that it results from complex, abnormal interactions between the immune system, diet, bacterial populations in the gut, and other environmental factors. Based on the similarities of IBD in humans and dogs, genetic disorders of the immune system also play a role in feline IBD.

Forms of inflammatory bowel disease (gastritis, enteritis, colitis)

Inflammatory bowel disease can take various forms depending on the region of the gastrointestinal tract and the type of inflammatory cells involved.If the stomach is inflamed, the condition is called gastritis. If the small intestine is inflamed, it is called enteritis; and if the colon (colon) is inflamed, it is called colitis. The most common form of IBD, called lymphocytic plasmacytic enteritis, includes inflammatory lymphocytes and plasma cells that invade the small intestine. Eosinophils are another type of inflammatory white blood cell commonly involved in feline IBD. They can sometimes be the predominant cell type, as in eosinophilic gastroenteritis, but they are more often part of a mixed population of inflammatory cells.Two less common forms of IBD are neutrophilic IBD, in which neutrophils are involved, and granulomatous IBD, in which macrophages are involved.

Clinical signs
Common signs of inflammatory bowel disease in cats include vomiting, weight loss, diarrhea, bloody stools, lethargy, and decreased appetite. These signs can vary in severity and frequency, and the prevailing signs depend on which parts of the gastrointestinal tract are affected.For example, if the stomach or upper small intestine is inflamed, the cat may experience chronic vomiting. In contrast, inflammation in the colon is more likely to cause diarrhea with or without blood in the stool.

Diagnosis
Diagnosis of IBD in cats requires extensive testing because many of the signs of IBD are commonly seen in other conditions. Your veterinarian will most likely recommend a baseline blood test, stool exam, x-ray, or abdominal ultrasound to check for metabolic diseases, feline leukemia, parasitic or bacterial infections, hyperthyroidism, and some cancers.Intestinal lymphoma, a form of cancer, can be especially difficult to distinguish from IBD in cats. Your veterinarian can also measure blood levels of B vitamins and folate, as IBD can interfere with the absorption of these vitamins from the gastrointestinal tract. A hypoallergenic food test can also be done to rule out food allergies.

Accurate diagnosis of feline IBD requires intestinal or gastric biopsy and microscopic examination of the tissue. In a patient with IBD, the number of inflammatory cells in the intestinal wall will increase.The types of cells found will indicate what type of IBD is present and help with treatment. Gastrointestinal biopsies can be performed using a flexible camera called an endoscope, which is passed through the mouth or rectum, or with abdominal surgery. Endoscopy is less invasive; however, surgery may be recommended for patients who also suspect liver or pancreatic disease, so that these organs may also be biopsied.Both endoscopy and surgical biopsy require general anesthesia, and the associated risks must be considered when deciding whether to perform these tests.

Treatment
The veterinarian usually recommends treatment of intestinal parasites, if not recently done, and a combination of dietary modification and various medications as first steps. There is no single best treatment, so your veterinarian may have to try several different diet or drug combinations to determine the best therapy.

Diet selection

Because dietary allergens may play a role in IBD, your veterinarian may recommend a trial meal using hypoallergenic diets. These diets contain sources of protein or carbohydrates that your cat has never eaten before. Rabbit, duck, or venison based diets are common starting options. If symptoms do not improve with a hypoallergenic diet, your cat may benefit from a diet high in fiber, low in fat, and easily digestible.It may take several weeks or longer for cats to recover from the diet change. All other food sources, including table scraps, flavored medicines, and treats, should be excluded during any food trial.

Medical treatment

Metronidazole can be recommended along with dietary modification as the first medical therapy. Metronidazole has antibiotic, anti-inflammatory and antiprotozoal properties and is generally fairly well tolerated.Some cats may lose their appetite while taking this drug.

If diet therapy or metronidazole is not effective, corticosteroids, which are potent anti-inflammatory and immunosuppressive agents, may be recommended alone or in combination with metronidazole. Cats should be closely monitored while on corticosteroids. Since diabetes and immune suppression are some of their potential side effects. However, cats generally tolerate these drugs well if they receive the appropriate dose.

Cats usually take oral corticosteroids, starting at a higher dose and decreasing gradually over several weeks. In cats that will not take medications by mouth, or in cases where vomiting is severe, your veterinarian may give the medication by injection.

If none of these drugs successfully control IBD symptoms, more potent immunosuppressants such as chlorambucil or azathioprine may be needed. These drugs can suppress the production of white blood cells, red blood cells, and, less commonly, platelets in the bone marrow.The veterinarian should closely monitor cats taking these medications.

Because GI bacteria may play a role in IBD, new therapies include prebiotics, which are substances that promote the spread of certain bacterial populations, and probiotics, which are bacterial strains that promote GI health. Adding soluble fiber to the diets of cats with inflammatory colitis can be beneficial. You should also consider getting the cat vitamin B12 if the sick cat has a deficiency of B vitamins.

Prognosis
IBD can often be controlled to keep sick cats healthy and comfortable. However, even with the right treatment, symptoms can come and go. Disease control requires strict adherence to dietary and medical treatments.