X-ray shows a formation in the antrum of the stomach. Antral gastritis

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Abnormalities of the stomach on x-ray. X-ray diagnostics of functional disorders of the stomach

Abnormalities of the stomach are quite rare, especially compared to abnormalities of the esophagus. They usually become noticeable at older ages. Abnormalities of the stomach may not appear at all during life. However, sometimes they can be the cause of urgent surgical interventions in newborns and infants. If an anomaly is suspected, perform x-ray of the stomach using the required amount of contrast agent.

Among the stomach anomalies are:

• doubling of the stomach;
• narrowing of the antrum;
• pyloric stenosis;
• fold gigantism;
• congenital and acquired gastric diverticula;
• reverse position of the stomach and other internal organs;
• "chest" stomach.

Gastric abnormalities are rarely life-threatening. However, such conditions increase the risk of developing peptic ulcers and chronic gastritis. Abnormalities of the stomach can theoretically be combined with anomalies of other organs, therefore for such people it is necessary to carry out preventive examinations, which include x-ray, and it is recommended to be registered with a dispensary.

Functional disorders of the stomach are divided into the following groups:

• disturbance of gastric tone;
• change in peristalsis;
• secretion disorder.

Functional disorders of the stomach can be observed in various pathological conditions, for example, with gastritis. However, dysfunction of the stomach itself can cause diseases. Thus, an increase in gastric secretion leads to the appearance of ulcers. To detect functional disorders of the stomach, x-rays are a fairly effective diagnostic method.

Complete and partial duplication of the stomach on x-ray

Duplication of the stomach is a very rare anomaly that is usually discovered in childhood. Duplication of the stomach is the presence in the body of an abnormal formation that in one way or another resembles the structure of the stomach. Such a formation has a lumen connected to the main stomach, as well as a wall consisting of all layers of a normal stomach. The accessory stomach can be either functional or not involved in digestion.

There are the following options for doubling the stomach:

• Full doubling. In this case, the second part of the stomach is fully involved in digestion.
• Partial doubling. With partial doubling, tubes or cysts are formed in which digestion does not occur.

Duplications are most often located at the left and posterior wall of the stomach. If the mucous membrane retains the ability to secrete enzymes and hydrochloric acid, then a cyst may form. View of this education on x-ray depends on the possibility of the contrast agent getting into the double stomach. Using X-rays, it can be difficult to distinguish between a doubling of the stomach and, for example, a tumor process.

X-ray picture of gastric diverticula

Diverticula are protrusions of the stomach wall in the form of a bag. Their appearance is associated with weakness of the muscle layer. Gastric diverticula can be congenital or acquired, but much more often they appear after 40 years.
Diverticula can range in size from a few millimeters to 5 centimeters in diameter.

Most often, diverticula are located in the following parts of the stomach:

• cardiac section ( 75% );
• pyloric region;
• body of the stomach.

Diverticula have a typical x-ray appearance, but on x-ray they can be confused with an ulcerative defect of the mucous membrane. Unlike an ulcer, a diverticulum is connected to the stomach cavity by a narrow neck, in which folds are preserved. The wall of the diverticulum is elastic and retains the ability to contract. The diverticulum is filled with a completely contrasting suspension, and its contour is smooth and oval, while in an ulcer it is usually jagged or irregular.

A complication of diverticulum is inflammation of the stomach wall - diverticulitis. In this case, the wall of the diverticulum becomes inflamed and swollen. Barium mass is retained in the cavity of the diverticulum, liquid and gas accumulate. These areas create a three-layer effect. When the neck of a diverticulum spasms, necrosis of its contents may occur, so in this case an operation is performed to remove it.

Diagnosis of gastric hernia using x-ray

A gastric hernia is nothing more than a hernia of the esophageal diaphragm. With this disease, part of the stomach penetrates into the chest cavity through a hole in the diaphragm. Sometimes the abdominal esophagus enters the chest cavity along with the stomach. Such a hernia is formed due to a short-term increase in pressure in the abdominal cavity. Hernias are more common in old age, when muscles lose strength and elasticity.

A gastric hernia is easily diagnosed using an X-ray with a contrast agent. The hernial sac is well stained with a contrast agent. The difference between a hernia and a diverticulum is that the hernia is located not in the abdominal cavity, but in the chest. To clarify the diagnosis and exclude complications, a biopsy or computed tomography is sometimes performed ( CT) abdominal cavity.

Hiatal hernia is controlled through diet. Surgical treatment of a hernia is also quite effective, but if possible, it is better not to perform surgery, but to treat it conservatively. Gastric hernia long time may be asymptomatic.

Congenital and acquired pyloric stenosis on an x-ray of the stomach

The pylorus is an important part of the stomach, since the quality of its functioning determines the quality of food digestion in the stomach and intestines. The work of the pylorus is regulated both by neuromuscular mechanisms and by local hormones ( motilin). When the pylorus is affected, the risk of peptic ulcer disease increases and, conversely, ulcers of this section often cause acquired stenosis.

Pyloric stenosis can be of two types:

• congenital;
• acquired.

Congenital pyloric stenosis is caused by hypertrophy of the muscle wall. The narrowing of the pylorus is accompanied by its lengthening to 4 centimeters. In adults, pyloric stenosis is caused by scar deformation after an ulcer, as well as local spasm. While with congenital pyloric stenosis there may be no complaints, in adults pyloric stenosis is accompanied by pain.

Radiological signs of pyloric stenosis are:

• narrowing of the pyloric lumen of 0.5 cm or less;
• lengthening of the pyloric canal;
• increased peristaltic waves;
• thickening of the folds of the mucous membrane or their deformation;
• slow evacuation of barium mass from the stomach;
• slow filling of the intestines with barium mass.

Regardless of the cause of the pathology, narrowing of the pylorus is controlled through diet, as well as the prevention and treatment of gastric ulcers. In children and adults, in severe cases, they resort to surgical treatment, during which the patency of the final section of the stomach is ensured.

Aperture ( partial narrowing) antrum on x-ray

Anomalies in the structure of the stomach include the formation of membranes that divide the stomach cavity into several chambers. This anomaly is quite rare, its formation mechanism is similar to the formation of membranes in the esophagus. Such membranes are usually detected before age 7. They consist of a mucous membrane and a submucosa and are most often located in the antrum. The diameter of the hole in the membrane is about 1 centimeter, which causes difficulty in feeding the child, lack of appetite, and rapid satiety.

An x-ray reveals difficulty in filling the part of the stomach lying behind the diaphragm. If its lumen is large enough, then without double contrast the diaphragm may be invisible. If a gastric diaphragm is suspected, a small amount of barium mass is used to color its outline, but not to completely block it. The diaphragm of the antrum may be combined with an ulcer, and may appear following symptoms- pain, burning associated with eating.

Atony and hypotension of the stomach on x-ray

The wall of the stomach is constantly in a state of tonic contraction due to the presence of a muscle layer. Intestinal atony is a condition in which gastric tone is almost completely absent. Hypotension is characterized by a partial weakening of the tone of the muscular wall of the stomach. These conditions are manifested by distension and bloating. Atony occurs suddenly, while gastric hypotension can go unnoticed for a long time.

The following reasons for decreased gastric tone are identified:

• abdominal trauma;
• cachexia ( exhaustion due to malnutrition or various diseases);
• postoperative period;
• stress, emotional overstrain;
• intoxication ( including alcohol);
• infectious diseases;
• chronic gastritis and other stomach diseases.

On x-ray, reduced tone is diagnosed when the barium mass first enters the stomach. With reduced tone, it quickly descends down to the corner of the stomach and does not linger in the upper section. The stomach is elongated and expanded, the pyloric sphincter does not retain food in the stomach, as is normal, but is opened. When pressing on the abdomen, the shape of the stomach can change dramatically.

Gastric hypotension - dangerous condition. Food in such a stomach cannot be completely digested; as a result, a person does not receive enough vitamins and nutrients. The effect of the acidic environment of the stomach sharply increases the risk of gastric and intestinal ulcers. To eliminate gastric hypotension, it is necessary to treat its root cause. After surgical interventions, it should be used in dosage physical activity. It will help restore the tone of skeletal muscles and muscles of internal organs.

Increased tone ( hypertension) stomach on x-ray. Stomach spasm

The tone of the stomach increases in some diseases, which is a specific protective reaction. Gastric hypertension is observed during intoxication, as well as peptic ulcer disease. With strong muscle contraction, a spasm occurs, which is accompanied by pain in the upper abdominal cavity. Pain due to stomach diseases is most often explained by spasmodic contraction of the stomach muscles.

In case of hypertension, an x-ray reveals a small horn-shaped stomach. The gas bubble is spherical, and the contrast mass penetrates into its lower sections for a very long time. The evacuation time of the barium mass is also increased. Atypical transverse folds may be observed in the stomach.

A spasm of the stomach can deform its wall. Local spasm is usually associated with a stomach ulcer. In this case, on an x-ray, the stomach takes the shape of an “hourglass” - a local narrowing between two wider areas. In order to distinguish gastric spasm from cicatricial deformity, the subject is given atropine, after which the spasm goes away for a short time. To reduce tone and relieve stomach spasms, antispasmodics are used ( no-shpa), diet, gastric lavage with potassium permanganate, chamomile decoction.

Is it possible to detect increased or decreased secretion of gastric juice using an x-ray?

The amount of gastric juice secreted is regulated nervous mechanisms and is determined by the body quite accurately. With its deficiency, the food consumed is not digested well enough, and with an increase in gastric juice, there is a danger of damage to the gastric wall. Organic disorders of the peripheral or central nervous system are to blame for the disruption of secretion. These are the causes of many pathological conditions.

Hypersecretion of gastric juice is a symptom of the following diseases:

• peptic ulcer;
• antral gastritis;
• spasm and stenosis of the pyloric sphincter.

With increased secretion, the amount of gastric juice released can be up to 1 liter within half an hour. Gastric juice can be released spontaneously or in response to food intake. In any case, the patient suffers from heartburn, poor appetite, and sometimes even vomiting gastric juice. Conclusions about hypersecretion can be made from an x-ray. An x-ray shows a horizontal level of liquid, and when the stomach is filled with a contrast mass, there are areas near the folds where the contrast mass does not penetrate. Today there are drugs that artificially reduce the secretion of gastric juice, normalizing the function of the stomach.

A decrease in the secretion of gastric juice is called achylia. Achylia cannot be diagnosed using x-rays, but it is often accompanied by decreased gastric tone and weakened peristalsis, which has certain x-ray signs. Achylia is diagnosed using a histamine test. Reduced gastric secretion leads to the formation of polyps of the mucous membrane, chronic gastritis.

Duodenogastric reflux on x-ray

Duodenogastric reflux is called reflux of contents small intestine into the stomach. The reverse flow of food into the stomach is caused by insufficiency of the muscular pyloric valve. The intestinal contents contain digestive gland enzymes that can damage the stomach lining. Despite this, duodenogastric reflux observed in half healthy people. This condition is not considered a disease, but it is believed that reflux may cause various diseases stomach.

Duodenogastric reflux can cause the following diseases stomach:

• peptic ulcer;
• chronic gastritis;
• pyloric stenosis;
• malignant tumors.

Duodenogastric reflux is detected using endoscopic examination. Quite rarely, X-rays show reverse movement of the contrast mass after complete emptying of the stomach. However, with the help of x-rays, you can see the changes in the mucous membrane that were caused by this phenomenon. They are characterized by a defect in the mucous membrane in the form of a niche, as well as an increase or, conversely, a decrease in the folds of the mucous membrane as they atrophy.

Diagnosis of acute and chronic gastritis using x-rays

Diagnosing gastritis is a difficult task. This is due to the fact that this disease does not have specific symptoms. Abdominal pain, vomiting and nausea can occur with a large number of diseases. On an x-ray you can see changes in the mucous membrane, but they are also not permanent with gastritis. Therefore, in order to make a diagnosis of chronic gastritis, the doctor carefully studies the patient’s complaints and uses various diagnostic methods. All this is necessary for successful treatment gastritis.

Chronic gastritis on an x-ray of the stomach

Inflammation of the gastric mucosa is a common disease. It is believed that it occurs in almost 50% of the world's population. This is due to the accelerated pace of life and nutritional disorders of modern man. Spicy foods, alcohol, medications - all of this, to a certain extent, destroys the gastric mucosa.
The bacterial flora of the stomach plays a certain role. In this case, inflammation of the gastric mucosa has subtle symptoms and does not appear for a long time. Therefore, gastritis most often has a chronic form.

Chronic gastritis is manifested by indigestion, changes in stool, and insufficient digestion of food. During exacerbations, discomfort and pain in the stomach may appear. These symptoms suggest chronic gastritis and are an indication for x-ray examination. It is with the help of X-rays that one can study the relief of the mucous membrane, which changes significantly during chronic gastritis. Visual diagnosis of the mucous membrane can be carried out using gastric endoscopy.

Chronic gastritis can have the following clinical forms:

• Catarrhal. Characterized by swelling and inflammatory enlargement of the folds of the mucous membrane.
• Erosive. Inflammation includes the formation of mucosal defects in the form of erosions.
• Polypoid. The proliferation of the mucous membrane, which is observed in response to inflammation, takes on the appearance of polyps. They may disappear completely when the condition returns to normal.
• Sclerosing ( rigid). With this type of chronic gastritis, deformation of the stomach wall and disruption of its contraction occur.

Chronic gastritis can be local or widespread throughout the gastric mucosa. Most often, chronic gastritis begins in the antrum of the stomach. This disease, despite the variety of forms, is distinguished by characteristic radiological signs. To identify them, it is necessary to fill the stomach with barium mass using double contrast, which improves the staining of the folds of the stomach.

The main radiological signs of chronic gastritis are:

• Increased gastric fields. The gastric fields, located in the body of the stomach, are the exit ducts of the glands of the mucous membrane. With chronic gastritis, the diameter of these fields becomes more than 3–5 mm; on an x-ray, they take on a granular appearance due to the penetration of the contrast mass deep into the dilated ducts.
• Expansion of folds of the mucous membrane. Chronic gastritis is characterized by disruption of the folds of the mucous membrane. There is more space between them, which creates a jagged appearance on the x-ray. However, chronic gastritis can also be observed with normal relief of the mucous membrane.
• Increased mucus secretion. Mucus is a protective layer between the epithelium of the stomach wall and the acidic environment of the gastric contents. With chronic gastritis, its amount increases. Mucus can interfere with the contrasting mass staining the folds. This effect of blurred folds is called marble relief of the mucous membrane.
• Violation of stomach tone. With chronic gastritis, the tone of the stomach decreases, and the rate of its clearing of barium mass is reduced. With exacerbations of gastritis, the tone may increase. The patient may feel an increase in tone in the form of spastic pain.

Erosive chronic gastritis on x-ray

Erosive gastritis is characterized by the formation of defects in the mucous membrane. Erosions form if the irritant in chronic gastritis lasts long enough. The mechanism of formation of erosions resembles the principle of development of peptic ulcers, however, erosions have a smaller depth and diameter and are located within the mucous membrane. The presence of erosions does not affect the symptoms of the disease, since there is no innervation in the mucous membrane.

Erosions are usually located on the anterior or back wall. On an X-ray, such erosions look like a spot up to 1 centimeter in size. When located in the area of ​​the left or right contour of the stomach, erosions look like a small accumulation of barium mass. However, more often such erosions are not visible due to their small size. Taking pictures in different projections helps in determining them. Erosion of the mucous membrane must be distinguished from an ulcerative defect and from tumor processes. Examination of the gastric mucosa using endoscopy can help with this.

The erosive process, unlike stomach ulcers, is reversible. The mucous membrane can be restored, since the epithelium has the ability to regenerate. To treat erosive chronic gastritis, drugs are used that reduce the activity of microflora, as well as medications that reduce the secretion of gastric juice. In addition to a special diet, gels can be used that envelop the wall of the stomach and protect it from irritants.

Polypoid and rigid chronic gastritis on x-ray

The formation of polyps and rigidity of the stomach wall are late manifestations of chronic gastritis. Chronic inflammation sooner or later leads to atrophy of the mucous membrane. Because of this, the gastric mucosa becomes less functional and is replaced by other structures. In order to prevent this, it is necessary to monitor the diet and promptly treat chronic gastritis.

Warty growths of the mucous membrane appear against the background of smoothed folds of the mucous membrane. Their size does not exceed 5 mm. They are also covered with mucus and may not be visible when located between the folds. On x-ray, polyp-shaped gastritis is characterized by small protrusions with unclear boundaries inside the stomach against the background of a changed mucous membrane. This form of the stomach must be distinguished from tumor formations of the mucosa. They are large in size, and the mucous membrane around them is not changed.

Rigid chronic gastritis develops in the antrum. It occurs slowly and leads to a decrease in muscle activity in the area. Chronic inflammation in rigid gastritis leads to the formation of excess connective tissue in the deep layers of the gastric wall.

Rigid chronic gastritis is characterized by the following radiological signs:

• antral deformation;
• disturbance of gastric tone and peristalsis;
• change in the relief of the mucous membrane.

The deformity of the antrum has the shape of a cone. The pyloric section is also lengthened. Over time, this deformation becomes stable; a peristaltic wave does not pass through this section. The mucous membrane has a jagged appearance, the folds are located chaotically. Rigid chronic gastritis tends to degenerate into a malignant tumor located inside the stomach wall.

Acute gastritis. Diagnosis of acute gastritis using x-rays

Acute gastritis is caused by short-term exposure to strong irritants on the gastric mucosa. Acute gastritis is caused by chemicals, some medications if used incorrectly, and food contaminated with microorganisms. Unlike chronic gastritis, acute form passes without a trace and usually leaves no reminders behind. In acute gastritis, the patient is bothered by severe pain in the upper abdomen, which can be eliminated by gastric lavage, painkillers and antispasmodics.

Acute gastritis has the following forms:

• Catarrhal gastritis. This is the most light form, since only the superficial layers of the mucous membrane are affected. They are quickly replaced by new cells when the irritants are removed. Catarrhal gastritis is accompanied by swelling of the mucous membrane and large mucus formation.
• Erosive gastritis. Acids and alkalis can form defects in the mucous membrane in high concentrations. If the defect reaches the submucosa, then over time scarring and narrowing of the lumen of the stomach occurs.
• Phlegmonous gastritis. Bacteria rarely develop in the stomach due to the acidic environment of gastric juice. However, when they develop, an accumulation of pus forms in the wall of the stomach ( phlegmon). This dangerous condition is accompanied by pain, nausea and vomiting and requires surgical treatment.

X-ray acute gastritis differs from chronic form. Barium mass in acute gastritis does not fill the stomach well. The folds of the mucous membrane are practically invisible, since they are shrouded in mucus and are inaccessible to the contrast agent. The stomach is reduced in size, as its wall is in tonic contraction. Inflammatory edema may look like a uniform protrusion of a section of the wall into the lumen of the stomach. In the presence of erosions, filling defects are detected.

Diagnosis of peptic ulcers and tumor formations of the stomach using x-rays

Peptic ulcer is a very common disease of the gastrointestinal tract. It manifests itself at a young age, around 25 - 30 years, and significantly reduces the quality of life at an older age. The main way to prevent stomach ulcers is to follow correct mode nutrition. Frequent, fractional meals in small portions 4 to 5 times a day are considered optimal.

The X-ray method is a very convenient way to diagnose stomach ulcers. A large number of direct and indirect signs make it possible to almost accurately diagnose a stomach ulcer. Gastric ulcers are diagnosed using contrast agents. To do this, a series of images is taken to examine the gastric mucosa at varying degrees of filling.

Tumor diseases of the stomach are detected on x-ray if their size is more than 3 mm. Difficulties also arise in distinguishing between benign and malignant tumors. Therefore, if necessary, an X-ray of the stomach with contrast is supplemented with computed tomography, endoscopy or biopsy ( microscopy of a piece of tissue). Only with the help of a biopsy can the exact nature of the tumor be established.

Peptic ulcer disease. X-ray signs of a stomach ulcer

Gastric ulcer is a condition in which a defect forms in the mucous membrane under the influence of hydrochloric acid and gastric juice enzymes. Stomach ulcers are often multiple, so they speak of peptic ulcer disease. The biggest role Bacteria of the genus Helicobacter play a role in the development of peptic ulcers. These bacteria grow comfortably in acidic gastric contents, reduce the resistance of the epithelium to acids and enzymes and cause local inflammation. A significant role plays an increase in gastric secretion.

During peptic ulcer disease, the following stages are distinguished:

• pre-ulcerative condition;
• initial stage;
• formed ulcer;
• complications of peptic ulcer.

Peptic ulcer disease is diagnosed using an x-ray or endoscopy of the stomach. An X-ray examination should be performed if a peptic ulcer is suspected, preferably in a pre-ulcerative state. However, more often the ulcer is discovered only after the appearance clinical picture. It can manifest itself as belching, heartburn, pain after eating. In severe cases, nausea and vomiting may occur.

Radiological signs of an ulcer on x-ray are:

• A niche in the area of ​​the contour of the stomach wall. A niche is the shadow of a contrast agent that has penetrated into the ulcerative defect. It can be round or oval, have different sizes ( from 0.5 cm to 5 cm or more).
• Uneven contour of the mucous membrane. The edges of the ulcer are pitted and uneven. They contain granulation tissue, blood, and food. However, small ulcers may have smooth edges.
• Increasing the number and volume of folds. The folds are enlarged due to inflammation of the area of ​​the wall around the ulcerative defect. When using double contrast, you can see that the folds are directed towards the ulcerative defect.
• Increased secretion of gastric juice. A sign of hypersecretion is the presence in the stomach of a horizontal level of liquid located under the gas bubble.
• Local spasm of the gastric wall. The spasm occurs at the level of the ulcer, but on the opposite side. It looks like a small, persistent retraction of the stomach wall.
• Rapid advancement of contrast agent in the area of ​​the ulcerative defect. This is due to the fact that, under the control of nervous and reflex mechanisms, the gastric wall tries to reduce the time of contact of the affected area with a potential irritant.

Of the listed signs of an ulcer, only a niche in the wall of the stomach is direct, and the rest are indirect. If an x-ray fails to identify a direct sign of an ulcer—a niche—then the radiologist will continue to search for it if indirect evidence of its existence is found. The niche may not appear on the x-ray because it may be filled with food or mucus. With the help of modern X-ray equipment, ulcers measuring 2–3 mm can be detected.

Complications of peptic ulcer. Cicatricial deformities of the stomach on x-ray. Cascade stomach

Peptic ulcer disease is dangerous, first of all, because of its complications. They are the outcome of almost any ulcerative defect. Even if the ulcer heals, it is replaced by a scar, which is not a complete replacement for this tissue. Therefore, in the case of peptic ulcer disease, like any other, the statement is true that it is easier to prevent a disease than to treat it. Peptic ulcer disease can be prevented if you pay attention to the symptoms in time and conduct a stomach examination. Patients with peptic ulcer disease are usually registered at a dispensary and undergo preventive examinations at certain intervals, which helps prevent the development of complications.

Complications of peptic ulcer disease are:

• scarring and deformation of the stomach wall;
• pyloric stenosis;
• gastric perforation;
• penetration of ulcers into neighboring organs;
• cancerous degeneration of an ulcer.

Scar deformities are the most noticeable and frequent complications of peptic ulcer disease. They form at the site of long-existing ulcers. Ulcers usually have a bottom in the submucosa, which consists of connective tissue. It is from this that scar tissue develops, since the epithelium cannot completely regenerate in the area of ​​the defect.

Today it is rare to see serious deformities on x-rays. This is due to the fact that modern methods Treatments help prevent major complications. For example, an hourglass deformity appears if scarring occurs along the circular muscle fibers with a constriction in the center of the stomach and its division into two parts. With minor curvature deformation, the output and initial sections are pulled towards each other. Such a stomach is called a purse-string or snail-shaped stomach.

Cascade stomach is a deformation in which a constriction is formed separating the cardiac section ( upper section) stomach from the rest. Thus, the stomach is divided into two levels ( cascade). This deformation greatly impedes the passage of food through the gastrointestinal tract and usually requires surgery to correct.

Despite the fact that massive deformations are becoming less common in modern world, small areas of scarring can be found in the stomach even in people who consider themselves healthy. This is due to the fact that the ulcer can be asymptomatic and heal on its own. On an x-ray, small stomach scars look like irregularities in the contour of the shadow of the stomach and the area where the folds converge. There are no folds in the scar area itself. In the area of ​​the scar, the peristaltic wave is not detected or is weakened.

X-ray diagnosis of penetration and perforation of ulcers

Penetration of an ulcer is its penetration into neighboring organs. An ulcerative cavity is formed in a neighboring organ, which communicates with the stomach cavity. Penetration is always noticed by the patient and is the reason for seeking treatment. medical care. Pain that occurs when this complication, very strong and are accompanied by nausea, vomiting, weakness, even loss of consciousness.

Penetration of the ulcer into the following formations is observed:

• spleen;
• abdominal wall;
• stomach ligaments.

X-ray reveals a large ulcerative defect in the stomach. The contours of the ulcer niche become uneven. The contrast mass penetrates beyond the stomach into the neighboring organ, where a three-layer picture is observed, consisting of barium suspension, liquid and gas. The same picture can be observed with inflammation of the gastric diverticulum. Palpation of the abdomen helps to clarify the penetration of the ulcer. In the area of ​​penetration of the ulcerative defect into a neighboring organ, severe compaction caused by inflammation is observed.

Perforation of an ulcer is a communication between the stomach and the abdominal cavity through an ulcerative defect. In this case, free gas is detected in the abdominal cavity, which looks like a crescent-shaped clearing under the diaphragm. To detect it, it is enough to perform a survey x-ray of the abdominal cavity. Exact time The patient can indicate perforation independently, as it is accompanied by severe pain. After 2 hours, gas can already be detected in the abdominal cavity, which initially accumulates on the right side under the diaphragm. The pain of a perforated stomach ulcer is very similar to heart pain, so the perforation can be confused with a myocardial infarction, which can cost valuable time.

Diagnosis of stomach cancer at the site of an ulcerative process using x-rays

One of the main conditions for the formation of a malignant tumor is chronic inflammation. In the case of peptic ulcer it is present. Transition of the ulcer to cancerous tumor It is not so rare and accounts for about 10% in the case of large ulcers. With stomach cancer, a person's ability to eat food significantly deteriorates, he loses weight and is exhausted. In order to avoid this, it is necessary to undergo timely treatment for peptic ulcer.

With the development of cancer, the ulcerative defect acquires the following radiological signs:

• an increase in the size of the ulcer up to 3 centimeters;
• uneven edges of a cancerous ulcer;
• complete immobility of the stomach walls in the area of ​​the ulcer;
• formation of a shaft around the ulcer and undermined edges of the ulcer niche.

X-rays are not the most reliable way to detect cancer. Accurate diagnosis of cancer is carried out only through histological analysis of a section of gastric tissue. A piece of tissue is removed during an endoscopic examination and then examined under a microscope. Detection atypical cells with such a study is confirmation of cancer. Oncologists treat this disease. The patient may require surgery to remove part of the stomach.

Stomach cancer on x-ray. Saucer crayfish

Gastric cancer is a malignant tumor of the gastric mucosa. It occurs quite often; bad habits of a person play a large role in the development of stomach cancer ( smoking, alcoholism), poor nutrition, consumption of carcinogenic substances, smoked foods. The development of stomach cancer, as in the case of ulcers, is caused by infection with the Helicobacter bacterium. A cancerous tumor is a cluster of mutant cells that grow uncontrollably, depleting capabilities and disrupting the functioning of all organs of the body.

Stomach cancer has a variety of forms and courses. Initially, the tumor is a small island tumor cells on the surface of the mucous membrane. It can protrude into the lumen of the stomach or be located in its thickness. Subsequently, an area of ​​necrosis and ulceration forms in the center of the tumor. At this point, the cancerous tumor is very similar to an ulcerative defect. If cancer develops at the site of the ulcer, it goes through the initial stages. In most cases, it is impossible to distinguish cancer from ulcers using x-rays. To do this, it is necessary to conduct an endoscopic examination. But with the help of x-rays it is possible to identify those who really need endoscopic examination ( FEGDS).
The diversity of cancerous tumors means that it is rare to see cancerous tumors that look the same on X-rays.

Using X-rays, the following types of stomach cancer can be distinguished:

• Exophytic cancer. Protrudes into the lumen of the stomach. It looks like a deepening of the contour of the shadow of the stomach, in which there is no peristalsis. Exophytic cancer may appear as a plaque ( flat spot) or polyp ( mushroom on a thin or wide base).
• Infiltrative-ulcerative ( endophytic) cancer. In this form of cancer, part of the mucosa is destroyed, which looks like a filling defect. The contours of the defect are uneven, the folds in the tumor area are destroyed, this area does not participate in peristalsis.
• Diffuse cancer. With this form of cancer, the stomach narrows evenly due to changes within its wall. The deformation is permanent, that is, the stomach does not straighten when it is full. To diagnose this type of cancer, it is necessary to examine a piece of tissue under a microscope.

A separate form of stomach cancer is saucer cancer. Such a tumor has raised edges in the form of a dense shaft, and in the center there is a small depression. An x-ray reveals a filling defect, in the center of which there is an accumulation of barium mass with uneven outlines. Saucer-shaped cancer is clearly limited by a shaft from the healthy mucous membrane, however, due to its shallow depth and small tumor size, it can be missed when studying an x-ray.

Stomach cancer first manifests itself as loss of appetite, weight loss, and aversion to meat foods. Subsequently, pain appears in the upper abdomen, vomiting, and bleeding. Almost the only treatment for stomach cancer is surgery to remove part of the stomach wall. In order to prevent the appearance of malignant tumors, you need to carefully monitor the condition of your body, especially chronic diseases such as gastritis or peptic ulcers.

Benign stomach tumors on x-ray

Benign stomach tumors are rare and are usually detected incidentally during X-ray examination. Benign tumors consist of cells that do not differ from healthy ones and do not have mutations in the genetic material. This is the main difference between benign and malignant tumors. Benign stomach tumors grow slowly and do not cause any symptoms.

Benign tumors can be of the following types:

• Epithelial. They grow in the form of polyps inside the lumen of the stomach. Whether they can be detected on x-ray depends on their size. Polyps larger than 3 mm look like depressions in the contour of a rounded contrasting mass. In this case, an expansion of one of the folds is observed, while other folds move away from it. Peristalsis is not disturbed, and the contours of this formation are smooth and clear.
• Non-epithelial. They are made up of muscle cells, nerve tissue or connective tissue cells. These tumors are located inside the wall of the stomach. The mucous membrane is not changed, but the folds of the mucous membrane are smoothed and flattened. The lumen of the stomach uniformly narrows by a small amount. Peristalsis is also preserved, but with large sizes tumors may have difficulty passing food.

Benign tumors are not a cause for concern and usually do not require treatment. However, in order to ensure the benign nature of the formations, it may be necessary additional diagnostics. It can be carried out using computed tomography, ultrasound ( Ultrasound) or endoscopy. In any case, benign tumors require observation, since rapid growth of tumors can change their prognosis.

Where can I get an X-ray of the stomach and esophagus?

X-rays of the stomach and esophagus can be performed in various medical institutions. The necessary equipment - an X-ray machine - can be found in private and public medical centers. Specialized medical personnel work in diagnostic centers or gastroenterology hospitals. High-quality diagnostics are carried out by private medical clinics. Price for X-ray examination of the stomach and esophagus differs in different cities of Russia and also depends on the equipment used.

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Patients are often interested in: focal antral gastritis, what is it? Today, gastrointestinal diseases are among the most common. The culprit is not only the modern lifestyle of humans, but also a less than favorable environment, as well as poor-quality food products and water.

Most often, people experience gastritis in various departments stomach. The disease can proceed latently for a long time, only occasionally becoming aggravated. It must be remembered that each form of gastritis has its own individual characteristics, symptoms and further course of treatment.

If a patient has focal antral gastritis, treatment should be carried out immediately. Otherwise, the disease can provoke serious complications.

Gastroenterologist Mikhail Vasilievich:

Features of antral gastritis

Antral gastritis (antral gastritis group B) is a type of stomach disease. This disease is considered one of the most common forms of chronic gastritis. The inflammatory process is localized purely in the antrum of the stomach, which is responsible for reducing the acidity of digested food, as well as for motility.

With antral gastritis, an inflammatory process occurs, which primarily affects the mucous membrane of the organ. This leads to the appearance of atrophic areas and disruption of the normal functioning of the organ. Over time, antral gastritis can develop into a focal atrophic form.

Causes of antral gastritis

Gastritis of the antrum of the stomach mainly appears due to negative influence microorganisms. The main cause of the disease is considered to be the bacteria Helicobacter pylori. The thing is that the antrum is an area in which ideal conditions have been created for the contamination of this microbe. Subsequently, there is a rapid development of infection, which within a short period of time causes the appearance of a peptic ulcer.

Helicobacter is an extremely insidious microorganism. It quickly penetrates into the epithelium of the stomach, causing inflammation, followed by atrophy of individual areas. Having affected the tissues, Helicobacter rapidly reduces the secretion of bicarbonates by the glands of the pyloric region.

In this regard, the food that enters the stomach is not sufficiently oxidized - its acidity turns out to be excessively high. Once in the initial sections of the intestine, the acid begins to irritate the walls of the organ. Such constant exposure disrupts digestive process, leading to the formation of inflammation.

Already in the initial stages of the disease, a person begins to feel significant discomfort in the stomach. With absence surgical treatment, atrophic changes significantly worsen. This leads to the death of glands in areas of atrophy and the appearance of scar tissue, which is extremely undesirable.

In more rare cases, focal atrophic gastritis appears in the presence of autoimmune processes in the body. In this regard, the disease becomes chronic.

Symptoms

Focal gastritis can manifest itself in different ways. The set of symptoms directly depends on the type of factor that provoked the disease and the degree of its neglect. Also, the severity of symptoms of the disease is based on the following reasons:

• the degree of change in the tissues of the gastric mucosa;
• presence of reflux;
• stomach acidity level;
• presence of Helicobacter pylori contamination.

Most often, patients at doctor's appointments complain of pain that occurs some time after eating. Also of great concern are the so-called “hunger pains” that appear due to improper planning of meals.

Due to the fact that the glands can no longer produce the required amount of substances necessary to reduce acidity, a gradual deterioration of the integrity of the mucosal tissue occurs. Thus, with superficial gastritis of the antral type, it is the main cause of erosions and ulcers.

Also, atrophied gastritis can manifest itself in this way:

• stomach discomfort;
• sour belching;
• bloating;
• nausea;
• vomit;
• constipation;
• diarrhea;
• malaise.

In complicated cases, the disease can occur in the presence of internal gastric bleeding. This symptom indicates the need for urgent hospitalization of the patient and the use of radical treatment measures.

Pain in the gastrointestinal tract may subside during periods. Most often, improvement is observed if the sick person follows a diet. However, if the diet is reintroduced heavy products(smoked meats, fried meats, fish, carbonated drinks, chocolate, apples, citrus fruits), then the disease worsens with even greater force.

Classification

Antral gastritis is divided into several types. In medicine, the following types are distinguished:

1. Superficial - characterized by damage to the upper layer of the epithelium. Symptoms are mild. The disease proceeds without any painful attacks.
2. Erosive is a complicated disease process that affects the deeper layers of the mucous membrane. It manifests itself as extensive inflammation, which causes the appearance of erosions with further formation of scar tissue.
3. Hyperplastic - characterized by hypertrophic enlargement of the mucous region. Cysts and polyps also form in small numbers.
4. Focal - manifested by individual foci of the affected epithelium of the organ.
5. Catarrhal - affects the lower part of the gastric mucosa.

How to treat antral gastritis

First of all, treatment for antral gastritis involves the destruction of the causative bacteria - Helicobacter. Next, the doctor prescribes a whole range of medications. Among them:

• antibiotics to combat Helicobacter;
• antacids that reduce the level of gastric juice, which negatively affects the mucous membrane of the stomach and esophagus;
• enveloping drugs that can help heal the walls of the stomach;
• painkillers to relieve pain;
• drugs to eliminate diarrhea.

Description of the disease

Antral gastritis, called antrum gastritis, is a gastric pathology with characteristic inflammation of the lower antral (or pyloric) part of the organ adjacent to the duodenum, which is provoked by infection of the gastric epithelium with a pathogenic microorganism Helicobacter pylori.

Antral gastritis is divided into acute (or active) and chronic according to the form of its course.
And also by type, including:

Basic symptoms for different forms antral pathology are largely the same. For catarrhal form characteristic:

stomach bleeding(this symptom manifests itself in advanced erosive pathology).

Diagnostics

Confirmation of the diagnosis if antrum gastritis is suspected is carried out using:

• intragastric pH-metry for instrumental measurement (2 – 3 hours) of the level of acidity in the stomach and duodenum);
• gastrofibroscopy using “targeted” biopsy;
• additional radiography.

After identifying the form and severity of symptoms of antral gastritis, adequate treatment tactics are developed.

The first stage involves the most complete destruction of the main “enemy” - the microorganism Helicobacter pylori.

The course is continued for 10–14 days.

Consultation with a doctor is required, dosages depend on many factors, the information is for informational purposes only and is not used for self-treatment.

• Products with enveloping properties to protect the mucous membranes: Almagel, Alugastrin, Rutacid, Vikalin, Rother, Kaolin, Rennie
• Medicines that relieve spasms and pain: Duspatalin, Dicetel (additionally suppress acid production), No-Shpa, Papaverine.
• Gastrofarm before meals, 1 - 2 tablets three times a day for 1 month.

The second stage of therapy involves the use of agents with the properties of regeneration of mucosal cells during erosion: Solcoseryl, Actovegin.

• stimulants for the synthesis of protein compounds, including Riboxin;
• to eliminate nausea, vomiting, prevent the reflux of food into the esophagus: Metoclopramide, Cisapride, Cerucal, Domperidone;
• enzymes that facilitate the digestion of food: Mezim, Panzinorm, Enzistal, Festal.

Physiotherapy and diet

Physiotherapy in the complex treatment of antral gastritis:

• Galvanization of the stomach using electrophoresis of drugs (for spasm of the antral-pyloric region).
• UHF, ultrasound treatment for pain relief.
• Diadynamic Bernard currents, sinusoidal modulated currents (relief of pain and dyspepsia).
• After the exacerbation period ends, therapeutic mud, paraffin therapy, and mineral waters are recommended.

Diet for antral gastritis is the most important component of therapy.
During the treatment period, exclude from the diet:

• coffee, alcohol, soda, sour juices, chocolate;
• coarse, spicy foods, smoked meats and sausages, marinades, pickles;
• cabbage, radishes, black bread;
• onions and garlic, horseradish and mustard, mayonnaise and ketchup, pepper, sauces;
• fatty meat products, mushrooms, lard;
• ice cream, creams, cream;
• hot and cold dishes;
• foods fried in oil.

• boiled, pureed, steamed dishes from rabbit, chicken, lean fish;
• boiled, stewed vegetables without oil in the form of puree, cream soup;
• long-cooked porridge;
• jelly only from natural fruits, berries, dried fruits (not sour), compotes;
• milk, cottage cheese (low-fat), jelly, soft-boiled eggs, steamed omelettes;
• with high acidity - mineral waters without gas (Essentuki No. 4).

Meals are multiple (5 – 7 times a day), in small portions.

Antral gastritis, prevention

Following a diet is the main thing that is recommended for prevention purposes. Steam dishes that do not irritate the stomach, baked dishes without fat, mucous decoctions of flax, jelly, oat porridge allow the mucous membrane to recover. Acidic, fried, fatty foods that have an aggressive effect on the walls of the stomach, especially if reflux syndrome is confirmed, are not allowed.

• Wobenzym (has a pronounced anti-inflammatory and immune-stimulating effect);
• probiotic agents to prevent the suppression of beneficial gastric and intestinal microflora: Baktistatin, Bififor, RioFlora, Maxilak.

Tired of pain in the abdomen, stomach.

• I have a stomachache;
• vomit;
• diarrhea;
• heartburn;

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Yes, digestive system problems can seriously ruin your life!

Antral gastritis(or antrum gastritis) is a chronic inflammatory process concentrated in the mucous membrane of the outlet (lower) section of the stomach. According to ICD-10 – gastritis type B, that is, caused by bacterial activity in the organ. It is insidious due to its “blurred” symptoms, which is why it is rarely detected during targeted diagnostics. It is dangerous due to serious complications, including stomach cancer.

Antrum gastritis is provoked by penetration into the outlet of the stomach Helicobacter pylori (Helicobacter pylori)- a specific bacterium with which the vast majority of diseases of the stomach and duodenum, including ulcers and tumor processes, are etiologically associated.

The outlet section of the stomach (antrum) performs important functions. It alkalizes gastric juice before it enters the intestines. In addition, mucus is produced in the antrum of the stomach (its epithelium), covering the organ cavity as a protective lubricant. By producing bicarbonates, the antrum epithelium reduces the acidity of gastric juice. At chronic inflammation this process is disrupted, and therefore acidic chyme (stomach juice) penetrates into duodenum, destroying its walls and forming ulcers.

With chronic antral gastritis, an outbreak of Helicobacter pylori activity occurs - a record amount of it is noted in the outlet section. As the inflammatory process spreads to other parts of the stomach, the number of pathogenic microorganisms decreases.

Antrum gastritis without Helicobacter pylori occurs only in 5% of 100% cases.

Helicobacter gastritis is also provoked by “indirect” triggers:

• History of duodenogastric reflux;
• Allergic reactions to food;
• Systematic intake of non-steroidal anti-inflammatory drugs;
• Long-term treatment with salicylic acid preparations;
• Iron deficiency in the body and iron deficiency anemia as its consequence;
• Hormonal imbalance;
• Pulmonary, cardiac or renal failure;
• Decompensated diabetes mellitus;
• Chronic cholecystitis;
• Unauthorized use of systemic antibiotics;
• Severe infectious pathologies;
• Alcohol abuse;
• Active smoking.

Although the main cause of chronic gastritis type B lies in the infection of the stomach by Helicobacter pylori, its development and progression is largely facilitated by irrational nutrition. This applies to addiction to fast food and other junk food, frequent snacking with snacks and baked goods, high speed eating, as well as the habit of including overly hot and spicy dishes in the menu.

- the main cause of the development of chronic gastritis type B

Antrum gastritis develops according to the following algorithm:

• The organ becomes infected with a bacterium;
• Bacteria that have penetrated the stomach produce specific enzymes - urease and mucinase;
• The produced enzymes locally alkalize the environment and “loose” the normal structure of gastric mucus;
• Having created a comfortable environment, bacteria penetrate the epithelium of the organ’s outlet and penetrate into it, causing constant irritation of the mucous membrane and destabilizing the activity of the glands;
• In the affected part of the stomach, persistent glandular dysfunction occurs, and therefore the acidity of the chyme increases, further damaging the walls of the organ.

Helicobacter pylori gastritis, ignored by the patient, leads to a number of serious complications, so if there is the slightest suspicion of the disease, you should undergo comprehensive examination from a gastroenterologist.

Antral gastritis: symptoms and signs

A feature of Helicobacter pylori gastritis is its frequent asymptomatic course. More precisely, signs of pathology appear, but very mildly - so that the patient writes them off as a banal ailment or mild poisoning from a stale product.

According to WHO statistics, this disease accounts for over 87% of all stomach diseases, but timely medical assistance Approximately 10 patients out of 100 apply.

Antrum gastritis occurs mainly at the age of 45-55 years, in most cases in men. Therefore, people at risk should be vigilant and undergo preventive diagnostics once every 6 months.

Signs of chronic Helicobacter gastritis:

• Pulling or constricting sensations in the epigastric zone ( top part abdomen closer to the center);
• Attacks of cramps and stomach cramps;
• Minor dull pain in the stomach area;
• Regular occurrence of nausea (rarely accompanied by vomiting);
• Feeling of heaviness, fullness, distension in the stomach;
• Stool disorders - diarrhea or constipation;
• Anorexia (loss of appetite);
• Heartburn;
• Flatulence;
• Coating of the tongue with a gray or whitish coating;
• Dryness and elevated temperature language;
• Low-grade fever;
• Fatigue, weakness and drowsiness (associated with eating).

Acute symptoms occur at the initial stage of disease development. In this case, the symptoms may be similar to those of an ulcer. A person experiences severe pain in the left hypochondrium, “hunger pains,” nausea after eating, persistent constipation, belching with a sour odor and a sour taste in the mouth.

Types of pathology and their clinical features

Gastritis caused by Helicobacter pylori is conventionally divided into three types:

• Superficial (non-atrophic);
• Erosive;
• Atrophic.

First form - the simplest. It affects only the surface of the gastric mucosa. But you should not consider it completely “harmless” - along with other types of the disease, it destabilizes the functioning of the organ and the gastrointestinal tract as a whole, forms scar defects on the surface and progresses over time if not treated.

Second form characterized by a more aggressive course and affects deep layers epithelial tissue. Erosive gastritis is a consequence of superficial gastritis. Occurs with erosions - single or multiple. The symptoms are standard, but become more obvious. Sometimes there is vomiting with bloody inclusions, as well as the inclusion of black blood in the stool, which signals ulceration of erosions.

Third form the most dangerous and severe of all listed. It is distinguished by the addition of autoimmune reactions to the typical mechanism of development of antrum gastritis. The latter negatively affect the cells of the gastric glands, completely suppressing their secretory functions. Pathological regeneration of organ cells occurs, leading to the formation of a malignant tumor. Most gastroenterologists express the opinion that already atrophied stomach cells cannot be restored and cured. However, drug therapy and a therapeutic diet help patients with gastric atrophy protect themselves from cancer.

Focal atrophic gastritis, localized in the antrum, is almost always accompanied by the formation of ulcers. Its course is complicated by intolerance to a number of foods:

• Milk fats;
• Red meat;
• Chicken eggs.

Also, with this form of the disease, there is increased pain in the solar plexus area, increased heart rate, a feeling of weakness, and seizures. morning sickness, rapid weight loss.

Diagnosis of Helicobacter-associated gastritis

Diagnosis of pathology begins with an in-person examination, study and assessment of clinical history, and questioning of the patient regarding the duration and severity of complaints. For differential diagnosis, functional, laboratory and instrumental studies are used.

When diagnosing gastritis of the antrum of the stomach, the most informative research methods are those that involve contrast. Classic ultrasound and even MRI do not give the doctor an idea of ​​the location, specificity and shape of the lesion. In some cases (for example, with focal atrophic antrum gastritis), changes are not visualized at all.

In the diagnosis of diffuse and focal antral gastritis, the following procedures are relevant:

• X-ray of the stomach with contrast;
• Endoscopic examinations (gastroscopy, esophagogastroduodenoscopy, chromoscopy);
• Urease tests with a biopsy sample taken during endoscopy;
• C-urease breath test for Helicobacter Pylori;
• Analysis of blood, saliva and chyme using ELISA;
• Blood test for gastropanel (determination of antibodies to bacteria, gastrin 17 and pepsinogen I);
• Electrometric intragastric pH-metry.

When performing gastroscopy, the color, density, structure of the gastric mucosa is assessed, the presence of erosive defects is identified, the degree of swelling is established, and individual areas of the organ are examined for hemorrhages.

When conducting endoscopic examinations, a biopsy specimen is necessarily taken from the gastric mucosa for subsequent histological examination. Rigid antral gastritis is characterized by thickening and enlargement of the tissues of the gastric outlet, so it is often confused with a cancerous tumor. The final verdict is made after histology.

General diagnostic purposes:

• Determination of the pathological focus;
• Assessment of the degree of spread of the disease (focal or diffuse form);
• Establishing the nature and duration of the pathology;
• Study of fermentation and secretory functions of the stomach;
• Differentiation from peptic ulcer disease.

Based on the results of the completed studies, an individual treatment regimen for gastritis with Helicobacter pylori is developed for the patient.

Antral gastritis: treatment

During exacerbations, it is customary to treat antral gastritis in a hospital setting. After hospitalization, the patient is prescribed a therapeutic diet (table No. 1B). Depending on the course and dynamics of the disease, the diet expands to treatment table No. 1 in 2-3 weeks or 1-2 months.

The diet for antral gastritis includes the following products:

• Pureed cereals cooked in a slimy broth;
• Crackers in an amount of no more than 100 g per day;
• Fish and meat only of low-fat varieties;
• Dairy products, with the exception of fermented milk drinks, low-fat cottage cheese and cheeses;
• Buckwheat, semolina, pureed oatmeal;
• Chicken eggs in quantities of no more than 3 per day;
• Starchy vegetables in the form of puree;
• Berry and fruit souffles, jellies and mousses (fresh fruits are not allowed);
• Vegetable or butter as an additive to main dishes;
• Weak teas, milk jelly, natural juices diluted with water (in a 1:1 ratio), rosehip decoction.

When expanding the diet to treatment table No. 1, the menu includes light vegetable and meat soups, dry biscuits and dried bread, biscuits, curdled milk and acidophilus, fatty non-acidic kefir, some vegetables - zucchini, pumpkin, green peas, cauliflower. Cold and warm snacks with a creamy texture on a protein basis are allowed: pates, doctor's sausage, mincemeat, etc.

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A prerequisite for effective therapy is the treatment of antral gastritis with medications aimed at destroying pathogenic microorganisms that cause the disease. Unfortunately, Helicobacter pylori quickly adapts to common antibacterial drugs, so they have to be varied and dosed.

The treatment regimen for Helicobacter pylori includes taking the following groups of antibiotics:

• Nitroimidazoles;
• Macrolides;
• Penicillins;
• Tetracyclines.

Proton pump inhibitors can be added to antibiotics for gastritis of the antrum - omeprazole, lansoprazole, esomeprazole, rabeprazole, etc. (trade names - “Omez”, “Neo-Zext”, “Hairabezol”, “Emanera”, etc.).

Patients are prescribed anti-inflammatory therapy. For severe spasms, antispasmodics are prescribed - mainly papaverine and drotaverine. To optimize peristalsis, antiemetic drugs are indicated, for example, dopamine receptor antagonists. Nucleosides and anabolic steroids are used as reparative drugs.

Physiotherapy plays an important role in the treatment of type B gastritis:

• Medicinal electrophoresis and galvanization of the stomach;
• Pain-relieving ultrasound therapy;
• Diadynamic therapy to eliminate dyspeptic symptoms;
• Drinking therapy with mineral waters;
• Mud therapy.

For gastritis with high acidity, the following is additionally prescribed:

• Antisecretory agents (Almagel, Ranitidine, Gastrin, Piren, etc.);
• Enzymatic agents (“Festal”, “Mezim”, “Pancreatin”, etc.);
• Enveloping agents (“Smecta”, “Diosmectite”, etc.).

Otherwise, therapy follows the classical scheme.

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Gastritis with low acidity is atrophic. Its treatment is fundamentally different and involves taking the following medications:

• Chyme enzymes;
• Hydrochloric acid preparations;
• "Plantaglucid" (a preparation based on plantain);
• Injection vitamin therapy (for B12 deficiency);
• Preparations of bismuth or aluminum.

The similarity with the treatment of the first type of pathology lies only in the use of antibiotics and proton pump inhibitors, and sometimes dopamine receptor antagonists.

Often in traditional therapeutic tactics include funds traditional medicine. It should be understood that they are only an additional and auxiliary option, and cannot fully replace drug treatment.

Among folk remedies In the treatment of Helicobacter gastritis, the following are used:

• Decoctions of flax seeds;
• Decoctions of chamomile, mint and St. John's wort;
• Sea buckthorn oil;
• Koalin (white clay);
• Carnitine;
• Potato and cabbage juice;
• Infusion of burdock roots.

The listed products are taken orally. The frequency, dosage and duration of the course are agreed with the doctor, as well as the advisability of using traditional medicine.

Complications, prognosis and prevention of the disease

The main complications of antral gastritis are peptic ulcer (including perforated), pangastritis, cancer of the gastric outlet (in 1-2% of cases).

If you consult a doctor in a timely manner, the prognosis is considered favorable. In other situations, the disease takes on a diffuse form and spreads to the entire organ, is more aggressive, and increases the likelihood severe complications. As a preventive measure, it is recommended to correct the diet, give up bad habits, and avoid stress and overwork.

In the human stomach, food is broken down and mixed, crushed, forming small lumps, which then move further to the intestines. In case of gastrointestinal diseases, it is important to understand in which organ the pathology arose and where exactly it is localized. Below are diseases of the antrum of the stomach, as well as prevention methods that will help maintain its health.

What is the antrum of the stomach

The stomach has five sections, each of which plays its role in the complex process of digesting food. The antral part is located after the part that is responsible for the production of hydrochloric acid and the breakdown of products. Therefore, the task of the antrum is mixing, grinding food, as well as further pushing it through the sphincter. The volume of the resulting lumps is small and measured in millimeters.

In the area where food passes to the duodenum, the antral glands produce mucus, which neutralizes aggressive hydrochloric acid. Thanks to this function, the formed lumps of food are prepared for further processing in an alkaline environment.

In addition to hydrochloric acid, the stomach produces another digestive enzyme - gastrin. Its production occurs in the lower part of the hollow organ. Serotonin and somatostatin are also formed here. Together, these substances are responsible for the complete digestion of food and its further promotion.

Thus, the antrum of the stomach is a section that performs the following functions:

• mechanical;
• neutralizing;
• endocrine.

Where is the antrum located?

The stomach consists of three main parts:

• cardiac;
• main(body);
• pyloric.

In the last (lower) section there are two sections - the antrum and the pylorus. There is no clear boundary between the antrum and the body, so the transition zone is lined with two types of cells. The stomach ends with a sphincter, after which the formed pieces of food enter the duodenum.

Diseases of the lower section occur when any of the functions are insufficient. Both incomplete digestion and slow movement of food are dangerous, as this leads to stagnation and fermentation. Subsequently, an inflammatory process occurs, which often acquires chronic course.

Antrum diseases

Most gastrointestinal problems appear as a result of poor nutrition or a person’s inattention to their health. Pathological processes in the digestive tract are successfully treated with initial stage, but become chronic if you do not consult a doctor in a timely manner. Diseases that result from antral dysfunction are described below.

Erosion

Represent benign neoplasms. They can appear in any part of the gastrointestinal tract and are also found in the antrum. These projections of the glandular epithelium are located both singly and in colonies.

Polyps are a relatively new disease. Their appearance is associated with a genetic predisposition or a consequence of chronic gastritis. Lesions are found predominantly in elderly patients.

Ulcers

The mechanism of pathogenic action is based on the ability to penetrate the mucous membrane, gain a foothold there and produce toxic ammonia, causing ulcers or more serious complications. The result of this impact is a large lesion, inflammatory processes and organ dysfunction.

Provoking factors for gastritis are also:

The antrum of the stomach is located after the body and in front of the duodenum. Signs of inflammation in this part may include:

• Digestion of food.
• Stomach bleeding.
• The appearance of an unpleasant taste or odor in the mouth.
• Epigastric discomfort, nausea.
• Constipation or diarrhea.
• Spasmodic pain.

This is the name for a pathological increase in cell growth, which leads to a change in their functional ability and neoplasms. The antrum is the lower part of the stomach, which bears a fairly heavy load.

Often, if available accompanying pathologies, the mucous membrane grows, revealing multiple small growths. Provoking factors include:

• Hormonal imbalances.
• Infectious diseases.
• Exposure to carcinogens or toxic substances.
• Prolonged inflammation.
• Hereditary predisposition.
• Secretory function disorders.

Oncology

A certain percentage of neoplasms are malignant in nature. The following symptoms will help you suspect cancer:

• Dramatic weight loss.
• Systematic vomiting.
• Aversion to protein foods.
• Soreness after eating.

More often to consequences, life-threatening, lead to polyps, erosions and ulcers that were not eliminated at the initial stage of development. The prognosis of treatment depends on the detected phase of the cancer, as well as the presence of metastases. Modern medicine continues to search for effective drugs in this area and improve methods of radiation and radiotherapy, however, not a single approach provides a 100% guarantee.

Disease Prevention

Inflammatory processes and erosion over time lead to changes in tissue structure and functional failure, which can no longer be cured. Doctors recommend thinking about the health of the digestive tract in time. Since the functioning of other organs and a person’s well-being depend on the quality of breakdown of products, absorption of nutrients and elimination of toxins.

To prevent damage to the gastric mucosa, follow these rules:

1. Eat regularly, preferably by the hour. This will help regulate the production of gastric juice and synchronize it with intestinal peristalsis.
2. It is better to eat more often, but in small portions. Fractional meals does not overload the work of the gastrointestinal tract and prevents bile stagnation.
3. Take into account possible mechanical irritants - spicy seasonings, high temperature of food, alcohol content in alcohol.
4. Make fermented milk products and fiber predominant in your diet. They are useful for maintaining motor function and the balance of gastrointestinal microflora.
5. Water is the basis of the diet. Drink enough of it throughout the day to prevent constipation, thickening of bile, or difficulties with digestion.
6. Do not self-medicate - many drugs are used as side effect negatively affect the gastric mucosa, causing gastritis or erosions. These include nonsteroidal anti-inflammatory drugs, antibiotics, and analgesics.

Contents of the article:

The antrum of the stomach is the most Bottom part this organ. It has no defined boundaries, but, as experts say, it occupies approximately a third of it. The antrum gradually passes into the duodenum, but they are separated from each other by the pyloric sphincter.

Location

We have already told where the antrum of the stomach is located - this is the lowest section of this organ. But in the medical literature there are no instructions by which it would be possible to delimit all parts of the stomach with millimeter accuracy. This is explained by the fact that there are no visible boundaries on the surface of the stomach, so doctors of different specialties (surgeons, radiologists, etc.) can designate its various sections in their own way.

Only some of them, for example, the pylorus and the cardinal foramen, have clear boundaries. But, if you examine this organ under a microscope, you can more accurately tell where each department is located. So, in the antrum there are no cells that produce hydrochloric acid and pepsinogen, but the hormone gastrin is produced there.

There are 4 sections of the stomach in total:

1. Cardiac department. It is adjacent to the sphincter, which separates the esophagus and stomach.
2. Bottom. This is the upper, dome-shaped part of the organ, which, despite the name, rises above the rest, and is located on the left side of the cardinal section.
3. Body. The main part of the stomach, located between the cardinal and pyloric.
   Pyloric department. This is the lowest part, which consists of the pylorus and the antrum, as the antrum is also called.
4. The antrum occupies about 30% of the volume of the entire stomach (if we talk about an empty organ).

Functions

The antrum has many functions:

1. Mechanical. The antrum is responsible for finally grinding the food so that it looks like mush, with particles whose size does not exceed 2 mm. At the same time, food is stirred. When the food mass becomes homogeneous, it passes through the sphincter and ends up in the duodenum.
2. Reducing the acidity of food. The main part of the stomach produces hydrochloric acid, which causes processed food to become sour. But it is not suitable for the duodenum, which has an alkaline environment. To ensure that the transition from an acidic to an alkaline environment is not too abrupt, the acidity of food is partially neutralized in the antrum. There are many glandular cells on its surface; they produce bicarbonates and mucus, which help neutralize hydrochloric acid.
3. Motor. The antrum must deliver processed food to the intestines. A wave-like muscle contraction occurs. To activate peristalsis, the hormone serotonin is needed. It is also produced by the cells of this department.
4. Endocrine. There are cells located in the same section that produce the hormone gastrin. It is necessary to increase the secretion of hydrochloric acid and pepsin. If food entering the antrum is poorly processed, the production of this hormone begins. It has other functions as well.

Antrum diseases

There are many diseases of the antrum of the stomach. Let's talk about the most common ones. Some of them are bacterial in nature, that is, Helicobacter pylori becomes the culprit of the pathology. It reduces acidity because it accumulates ammonia, which can neutralize hydrochloric acid. It also releases toxins that gradually destroy the mucous membrane.

Gastritis

When the mucous membrane of the antrum becomes inflamed, gastritis of the antrum is diagnosed. This is a fairly common disease. If gastritis of the anstom appears, which is located near the duodenum, then most often it is accompanied by disturbances in the intestines, for example, bulbitis may appear.

The cause of gastritis is Helicobacter pylori. But if a person has a strong immune system, it does not make itself felt until factors appear that cause a decrease in immunity. Bad habits, stress, too spicy food, and so on can trigger the onset of the disease.

If a person has antrum gastritis, the following symptoms appear:

• spasms that go away if the patient has eaten;
• sour belching and heartburn;
• the patient suffers from constipation or diarrhea;
• there is nausea, sometimes vomiting, bad taste in the mouth.

Antrum gastritis can be of several types. There is a superficial form that affects only the upper layers of the mucosa. It may also occur erosive gastritis, in which the mucous membrane turns red and erosions appear on its surface. Sometimes there is bleeding. Atrophic gastritis is considered one of the most dangerous. If the cells secretory glands do not secrete gastric juice, the stomach becomes vulnerable and cannot protect itself from carcinogens, which can lead to swelling.

Erosion

If the integrity of the mucous membrane is compromised, erosion appears; later, without proper treatment, it can turn into an ulcer. Erosion can occur due to a violation of the diet, taking certain medicines, stomach diseases and so on. There are acute erosions, which can be cured in 10 days, and chronic ones, which are not so easy to get rid of. Erosions that are accompanied by bleeding are especially dangerous.

Ulcer

Stomach ulcers are a common disease, and sometimes the antrum is also affected. Often the cause of its appearance is a violation of the contractile activity of this part of the stomach, due to which food does not move into the intestines, and the fermentation process begins. Ulcers can be caused by blood diseases, infectious or endocrine diseases, hormonal imbalances, severe stress, and so on. Severe abdominal pain, nausea, persistent heartburn, blood in the stool and vomit may indicate the presence of an ulcer.

Oncology

Cancer often appears in this part of the stomach. A tumor that arises in the antrum is especially dangerous, since it is very aggressive and quickly metastasizes. Most often, patients develop adenocarcinoma, which can form on glandular tissue. If it was non-glandular tissue, it is a solid cancer. Very rarely, but there is a tumor of the connective tissue, which is called “skyr”. Cancer appears where there were previously ulcers, erosions or polyps. If we are talking about oncology, then the patient develops the following symptoms: the person loses weight sharply, his appetite disappears, and protein foods are especially disgusting. He may vomit blood and have black stools. Cancer can be cured if it is detected at the first stage, then 9 out of 10 patients recover.

Polyps

New growths in the stomach are not always cancer; there are also benign ones, which are called polyps. These are small (up to 3 cm) seals. But they are also dangerous, as they can degenerate into a tumor. The reasons for their appearance are hereditary predisposition, as well as inflammatory processes; poor nutrition also plays a role. The symptoms of the disease are similar to those of other gastrointestinal diseases - stomach pain, flatulence, nausea, and sometimes bleeding. To prevent polyps from degenerating into cancer, they are most often removed.

Antrum hyperplasia

This is a disease in which the tissues of this part of the stomach grow, the number of its normal cells increases, the mucous membrane becomes thicker, and polyps may appear. Symptoms of this disease are either completely absent or very mild: pain, upset stomach.

Of course, these are not all diseases of the antrum. There are a lot of them, but the ones we have listed are the most common. If unpleasant symptoms appear, you should consult a doctor and, after diagnosis, begin treatment before the disease progresses.

The antrum, like all other parts of the stomach, plays an important role in the body; without it, the digestion process will be disrupted. Fortunately, now it is not so difficult to diagnose this or that stomach disease, you just need to undergo an examination. Doctors will help you cope with the disease, especially since many stomach pathologies have been well studied and have already been invented effective methods treatment.