Differential diagnosis of gastritis: basic methods

Inflammatory changes in the stomach are observed in most people. In some cases, a person does not even know about the presence of the disease. The high incidence of gastritis is associated with the nature of nutrition. After all, irritation of the mucous membrane of the stomach is caused by such factors as the use of sharp, fatty and fried foods. In addition, one of the causes of gastritis is stress. Since the stomach is innervated by the vagus nerve. Often gastritis develops in people who smoke a lot and consume alcoholic beverages. Symptoms of this pathology are similar to manifestations of many diseases. Therefore, the diagnosis of gastritis is very important. First, the detection of this disease is necessary for the purpose of treatment. Secondly, the diagnosis is needed to distinguish gastritis from other pathologies. Thanks to special studies, it is possible to detect not only inflammation of the stomach, but also its stage.

What is gastritis: varieties

The inflammatory process of the gastric mucosa is called gastritis. The disease can have acute and chronic course. In the first case, inflammation occurs under the influence of a provoking factor and is completely treatable. If the pathology is chronic, then the thickening of the organ wall and the replacement of the mucous membrane with a connective tissue are observed. In this case there are both periods of recovery (remission), both periodic and exacerbations. Diagnosis and treatment of gastritis depends on the type of inflammation. There are several forms of the disease. Among them:

1. Catarrhal gastritis. This form of inflammation is easy. It occurs in most patients. Often, catarrhal gastritis does not have severe clinical symptoms, especially in chronic conditions.
2. Fibrinous inflammation. It can develop due to damage to the stomach with chemicals (burns with acids, alkalis).
3. Phlegmonous gastritis. It occurs with injuries of the abdominal cavity, the spread of infection.

Chronic inflammation is superficial, erosive, hyperplastic, autoimmune, atrophic, etc. Similar forms of gastritis should be diagnosed as early as possible, as against their background often there is stomach ulcer, GERD, cancer.

What are the methods for diagnosing gastritis?

With timely detection of the disease and treatment, you can achieve full recovery or long-term remission. Diagnosis of gastritis of the stomach includes several stages. The first of these is the collection of complaints and anamnesis. The doctor specifies what symptoms the patient has (duration, localization, nature of pain), when they occur (how long does it take after eating). It is also important to know about the patient's diet, the presence of stressful situations, other manifestations of pathology.

The next stage of diagnosis is an objective examination. Attention is paid to the organs of the digestive system. It is important to assess the condition of the tongue, to palpate the abdomen. Gastritis is characterized by unpleasant sensations in the epigastric region, as well as in the left hypochondrium. Most often, pain appears 15-40 minutes after eating. Thanks to this, it is possible to understand in which part of the stomach the inflammatory process predominates.

In addition, the diagnosis of gastritis includes laboratory and instrumental methods of investigation. The first include OAK, OAM, analysis of gastric contents, microscopy of organ tissue. Among the instrumental studies, the PHAGS is of particular importance.

Diagnosis of gastritis by laboratory methods

First of all, if you suspect any inflammatory disease, general blood and urine tests are performed. With acute gastritis (or exacerbation), leukocytosis and a slight acceleration of ESR are observed. If the pathogens of inflammation are bacteria, then in the UAC there is neutrophilia. In viral inflammation, an increase in the number of lymphocytes. In some cases, analysis of gastric contents is performed. Laboratory diagnostics of gastritis includes the study of biopsy specimens (pieces of tissue taken during the execution of PHAGS). This method is carried out only with suspicion of hyperplastic processes in the stomach. These include cytological and histological research. Also, some patients undergo a urease test. It allows to detect the presence of Helicobacter pylori. This study is conducted in 2 ways (breath test or microscopy).

Methods of instrumental gastritis diagnostics

Instrumental methods include x-ray, ultrasound and endoscopic diagnostics of gastritis. "Golden standard" is considered to be FEGDS. Due to this procedure it is possible to determine the nature of the inflammation, its localization, the presence of complications (ulcers, hyperplasia). In addition, when carrying out a gastroscopy, a biopsy of the "suspicious" tissue is performed. In some countries, a similar study is included in screening programs. This allows you to warn several pathologies at once. Among them - gastritis, peptic ulcer and duodenum, benign tumors and cancer.

X-ray diagnosis is not very informative in inflammatory processes. Nevertheless, it is necessary for an accurate diagnosis. X-ray of the stomach is carried out with suspicion of peptic ulcer and its complications. For the purpose of differential diagnosis, ultrasound of the abdominal cavity is performed. It helps to identify diseases such as pancreatitis, cholecystitis and hepatitis. All these pathologies can have similar symptoms with inflammation of the stomach.

How to diagnose gastritis in children?

Diagnosis of gastritis in children is the same as in adults. However, it is more difficult to suspect this disease in a child. Especially this applies to young children, who can not explain what exactly bothers them. Most often, acute gastritis occurs against a background of poisoning (food poisoning). Chronic inflammation in most cases occurs in the middle childhood, in the adolescent period. This is due to the fact that parents do not control the diet of their child, as he begins to spend a lot of time away from home. The development of gastritis is facilitated by eating fatty foods (fast food), chips, crackers, etc. Diagnostic methods include X-ray, endoscopic and ultrasound examinations. When washing the stomach, examine its contents to exclude infectious pathologies. Microscopy of stool is also performed. Differential diagnosis is carried out with parasitic invasions, dyskinesia of the biliary tract, acute appendicitis. These pathologies occur in children most often.

With what diseases of the abdominal cavity differentiate acute gastritis?

The most important stage is the differential diagnosis of gastritis. After all, it depends on the correctness of treatment and further prognosis. It is worth noting that with acute gastritis, clinical manifestations are more pronounced, in contrast to chronic pathology. Characteristic manifestations are: nausea and vomiting, pain in the upper abdomen, increased body temperature, increased heart rate. These symptoms are especially pronounced in young children. Differential diagnosis of acute gastritis is carried out with surgical, infectious and cardiovascular pathologies, peptic ulcer disease.

Chronic inflammatory process is not as pronounced as acute. Symptoms of gastritis may resemble aggravation of other gastrointestinal pathologies. Among them - chronic cholecystitis, pancreatitis, hepatitis, peptic ulcer and duodenal ulcer. Also gastritis is differentiated with helminthic invasions. To distinguish inflammation of the stomach from other diseases, it is necessary to carry out PHAGS.

Features of diagnosis in atrophic gastritis

Atrophic gastritis is more dangerous in comparison with other forms of the disease. This is due to the fact that it often leads to a tumor degeneration of the stomach tissues. More often atrophic gastritis develops in elderly people. The clinical feature of this form of the disease is the erasure of symptoms. Sometimes there may be a belching, nausea, unpleasant sensations in the stomach.

Diagnosis of atrophic gastritis is based on the endoscopic picture. Typically, the thinning of the walls of the stomach, destructive processes, signs of inflammation - swelling, hyperemia of the tissue. In this case, a biopsy of the affected areas is necessary. Histological examination reveals a depletion of the cellular composition, a decrease in the elements in size, functional insufficiency.

Difference of acute gastritis from infectious pathologies

It should be remembered that some food poisoning occurs with the syndrome of gastric dyspepsia, which is characteristic of acute gastritis. A distinctive feature is the specificity of the disease. Infectious pathologies are always caused by a particular pathogen. They are characterized by rapid development of symptoms of intoxication (nausea, fever, headache, general weakness). Often gastritis is combined with enteritis and colitis. That is, in addition to the defeat of the stomach, there is inflammation of the intestine. This is manifested by diarrhea, the appearance of pathological impurities in feces (veins of blood, pus), pain in the lower abdomen.

How to distinguish gastritis from appendicitis?

Acute gastritis must be differentiated from appendicitis. After all, in the beginning of the disease these pathologies have the same manifestations. With appendicitis, pain in epigastrium, subfebrile body temperature, nausea, vomiting, and lack of appetite are noted. However, the clinical picture begins to change in a few hours. Pain "moves" to the right iliac region, the temperature becomes higher. In children of early age, it is impossible to distinguish these diseases from the clinical picture, so appendicitis should be excluded first. To this end, the JAB and general urinalysis are performed, as well as the testing of specific symptoms.

Differential diagnosis between gastritis and myocardial infarction

You should know that a disease such as myocardial infarction can occur atypically. In some cases, its symptoms resemble manifestations of acute gastritis. Therefore, elderly people should first of all make an electrocardiogram. In addition, you need to find out whether the patient has had pain in the heart, increased blood pressure, tachycardia.

Treatment of acute gastritis

Diagnosis of gastritis is important for medical treatment. Depending on the form of the disease, there may be differences in medication. With acute gastritis, the main method of treatment is diet (table number 1). Etiological therapy is also important. To this end, prescribe antibiotics ("Azithromycin", "Metronidazole"). With an increase in acidity, the use of medicines "Omez", "Pantoprazole" is necessary. Also enveloping agents are prescribed. These include the drugs "Almagel", "De-nol".