Treatment of gastritis during pregnancy. Gastritis during pregnancy: symptoms. Symptoms of chronic gastritis in pregnant women

Pregnant women have a lot of problems: toxicosis has just ended, as varicose veins and aching lower back pain appeared. And for women with gastrointestinal diseases, the health issue is even more acute. After all, it is known that 75% of expectant mothers complain of gastritis during pregnancy. Therefore, the question arises how to treat the disease. Today we will talk about the effect of the disease on the mother's condition and the development of the fetus, what drugs can be used to treat gastritis in pregnant women, and what symptoms may bother the expectant mother.

According to statistics, 50% of expectant mothers suffer from exacerbation of chronic diseases of the gastrointestinal tract. And the most common are gastritis and ulcers during pregnancy. From the article you will learn about the causes of these diseases during pregnancy, as well as how to treat them. Can I take medication? What herbs for gastritis should not be used during the period of bearing a child?

Causes

Before moving on to the topic of how to treat gastritis and ulcers during pregnancy, it is necessary to talk about the factors that lead to the development of the disease.

• Exacerbation of gastritis during pregnancy can happen due to changes in hormonal levels.
• Stress and poor metabolism. It has been proven that gastritis and peptic ulcer disease during pregnancy are more common in overweight women. To avoid problems, you should adhere to the nutritional recommendations for expectant mothers.
• Unbalanced menu. We think that many have heard about food perversions of pregnant women. Overeating also leads to an exacerbation of gastritis during pregnancy. The expectant mother should eat fractionally (5-6 times a day).
• The use of foods stuffed with preservatives and emulsifiers, flavor enhancers, damage the gastric mucosa.
• Smoking is dangerous not only for the intrauterine development of the fetus, but also for the well-being of the mother. A bad habit can cause a relapse of peptic ulcer and gastritis.
• Also one of the most common causes is Helicobacter Pylori infection.

Most women begin to complain of exacerbation of diseases of the gastrointestinal tract at 10-14 weeks of pregnancy. This is due to the peculiarities of physiology. The fact is that the enlarged uterus displaces the stomach, which automatically changes the pressure gradient between the abdominal cavity and the chest. No joke, by the 12th week of pregnancy, the uterus increases 4 times! This same feature causes heartburn and makes it difficult to empty the bowels.

But the exacerbation of ulcers during pregnancy is much less common. Doctors even came to the conclusion that the "interesting" position of a woman reduces the frequency of relapses of the disease. Physiologists explain such a strange phenomenon by the fact that expectant mothers have increased levels of progesterone. And recent studies show that this hormone reduces the production of hydrochloric acid. It is also believed that an increase in the level of histaminase produced by the placenta also reduces the secretion of aggressive acid.

Types of gastritis

Most often, expectant mothers experience an exacerbation of a chronic illness. There are two types of disease:

• Atrophic gastritis occurs against the background of atrophy of the glands of the stomach. The cause of this type of disease is damage to the cells of the autoimmune system.
• Infectious type of gastritis associated with damage to the stomach by bacteria. It is known that the activity of Helicobacter Pylori can lead to stomach diseases. The bacterial variety of the disease during pregnancy can occur without symptoms at all.

Every third pregnant woman with gastritis has a H. pylori infection in the body.

Symptoms of the disease

Before talking about the safe methods of diagnosing the disease and the principles of treatment during pregnancy, it is necessary to describe in detail the main symptoms. These include:

• painful sensations in the upper abdomen;
• spasms occur not only after eating, but also at night and in the morning on an empty stomach;
• upset stomach, which may be accompanied by pain;
• severe toxicosis with profuse vomiting and weight loss;
• frequent heartburn;
• the taste of rotten eggs in the mouth.

Features of diagnosis in pregnant women

Not all diagnostic methods are recommended for a woman in an "interesting" position. For example, an examination called fibrogastroduodenoscopy for pregnant women is performed if there are certain indications. This type of diagnosis is not contraindicated for girls expecting a baby. Therefore, if the doctor, knowing about your condition, referred you to EGD, do not worry. Remember that this is the only 100% diagnostic method today.

If you have a very high gag reflex (for example, due to toxicosis) or there are risks of termination of pregnancy, most likely, this research method will have to be temporarily abandoned. The most harmless examination option during the period of gestation is considered a non-invasive diagnostic method aimed at determining the presence or absence of H. pylori infection.

In addition to this type of diagnosis, for a clearer picture, the doctor often prescribes an ultrasound of the abdominal organs, urine, feces and blood tests. All these methods are not prohibited to be used while waiting for the child.

If a woman had an ulcer or gastritis before pregnancy, then she should tell the gynecologist about the presence of the disease, and also visit the therapist and gastrologist in advance. This will help doctors predict the course of pregnancy and provide helpful advice.

Consequences of gastritis during pregnancy

If the expectant mother does not care about her health and tries not to notice the signs of the disease, then gastritis during pregnancy can lead to:

• ulcers of the stomach and duodenum;
• the formation of polyps on the gastric mucosa;
• the appearance of erosion;
• tumors.

To avoid further development of gastritis, it is recommended to adhere to a balanced diet and consult a doctor for advice in a timely manner.

Many women believe that having Helicobacter Pylori during pregnancy does not harm either the mother or the baby. However, this is not quite true. Scientists have proven that a stomach ulcer during pregnancy is fraught with the following consequences:

• The activity of the bacteria threatens the development of anemia in the mother (due to poor absorption of iron and vitamin B12).
• Leads to fetal neural tube defects.
• Toxicosis is more pronounced and is accompanied by profuse vomiting. For some, symptoms persist even into the third trimester of pregnancy.
• Leads to the birth of a low birth weight baby. Scientists have proven that mothers with Helicobacter pylori infection give birth to babies 300-400 less than healthy women.

How to treat

The expectant mother needs to remember that not all drugs recommended for taking gastritis can be used during pregnancy.

During the period of childbearing, it is forbidden to take antibacterial drugs aimed at combating Helicobacter pylori (for example, De-Nol or Tetracycline). They can negatively affect the intrauterine development of the fetus. Therefore, treatment should be considered before planning a pregnancy. Indeed, in some cases, an infection caused by a bacterium leads to miscarriages and infertility.

It is very important that the future father is also treated for Helicobacter pylori infection. Recent studies have shown that the presence of bacteria in a man's stomach reduces sperm motility and leads to damage by inflammatory cytokines.

Remember that gastritis during early pregnancy cannot be treated with medication. From the second trimester, the use of a number of drugs is permissible:

• Antispasmodics (No-shpy and Papaverine). Although you can find information about the harmlessness of these drugs for a woman and a fetus, we recommend taking them only as directed by a doctor and in no case exceeding the dosage. These funds relieve painful spasms and give an analgesic effect.
• Taking prokinetics stimulates the motor activity of the stomach. Such drugs help with nausea (for example, Itomed, Ganaton). Some doctors prescribe them for severe toxicosis in a pregnant woman. However, this group of medicines belongs to those that are contraindicated to take while waiting for the baby, so it can only be used as directed by a doctor.
• To reduce the aggressive effects of hydrochloric acid, it is recommended to take medications that have enveloping action... These include Almagel and Fosfalugel.
• To improve the digestive process, it is recommended to take enzyme preparations (Mezim, Pangrol, Creon). For the treatment of digestive disorders caused by gastritis, these drugs can be taken for a long time (but only for strict indications).
• Treatment for gastritis during pregnancy includes magnesium and calcium antacids... The funds are not contraindicated during the period of bearing the baby and do not harm the development of the fetus. Also, the doctor may prescribe antacids with aluminum. But they should not be taken for kidney failure. During pregnancy, you can use Maalox, which saves from heartburn.

The use of proton pump inhibitors (Omeprazole, Lansoprazole, etc.) is not recommended for pregnant women. They lead to metabolic alkalosis (increased blood PH) in both the mother and the baby.

Treatment of exacerbated gastritis with herbs

If usually women and men are advised to use various herbal infusions for the treatment of diseases of the gastrointestinal tract, then during pregnancy, most of them are undesirable. Before entrusting yourself and your child's health to folk recipes, we recommend that you consult with a gynecologist.

For example, mint, which is so popular among traditional healers, contains a large amount of estrogen. Infusions based on this plant can stimulate labor. The same applies to St. John's wort, which causes bleeding and miscarriage in early pregnancy.

Flaxseed, which is an excellent assistant in the treatment and prevention of gastritis and ulcers, should also be used with great caution during pregnancy and only after consulting a doctor.

If you nevertheless decide to resort to folk recipes based on herbs, then be sure to consult a doctor. After all, herbs have different effects on the gastrointestinal tract: some reduce the secretion of hydrochloric acid, while others increase it. In addition, many of them are prohibited from taking while waiting for the baby, as they can lead to uterine tone and other serious side effects.

Eating behavior in diseases of the gastrointestinal tract

If, while waiting for the baby, you are overtaken by such unpleasant diseases as gastritis or an ulcer (regardless of whether they appeared for the first time or there was an exacerbation of chronic diseases), you must adhere to the basic rules of nutrition and lifestyle. Together with the medication prescribed by the doctor, they will help to quickly relieve the exacerbation and relieve symptoms. In addition, these recommendations will help to prevent relapse.

1. Eat small meals often (at least 5 times a day).
2. Avoid prohibited foods: fried, salty, spicy, smoked, fatty foods, foods with preservatives and GMOs.
3. Avoid any foods that trigger heartburn, nausea, or stomach pain.
4. During an exacerbation, do not consume fresh fruits and vegetables.
5. Don't overeat or starve.
6. Drink 1-2 glasses of warm water in the morning on an empty stomach.
7. Dinner should be light. Afterwards, a short walk is recommended.
8. Do not eat at night. At least 2 hours should pass from the last meal to sleep.

Be careful when taking vitamin complexes. They are often contraindicated during exacerbation of gastrointestinal diseases. Be sure to consult a doctor, observe the reaction of the body. Do not take these drugs on an empty stomach!

The three best foods for gastritis

Of course, every pregnant woman knows that it is necessary to monitor nutrition. This is especially true for girls who suffer from diseases of the gastrointestinal tract. During this period, many products are prohibited, so most of the folk remedies are contraindicated. Expectant mothers need not only to adjust their nutrition, but also to include in their daily diet such foods as:

• Garlic Its regular use in small quantities (two cloves are enough) stops the multiplication of pathogenic bacteria. The product reduces the production of hydrochloric acid and relieves irritation of the mucous membranes. It can be consumed only if it is well tolerated, without exacerbations.
• Tandem carrot and spinach juices It is also considered one of the best home remedies for gastritis. Mix 200 ml. spinach and 300 ml. carrot drinks. This recipe will help with chronic stomach inflammation and relieve painful cramps. Freshly squeezed juices can be drunk only during remission of gastrointestinal diseases.
• Fig. It is possible to treat gastritis during pregnancy, the alarming symptoms of which do not allow a woman to live normally, with the help of rice water. 0.5 tbsp. pour 1.5 liters of washed rice. water, cook over low heat until smooth. You can dilute the broth with a little milk. But only with low acidity. Such a "dish" relieves of increased gas production while carrying a child. Starch envelops the stomach walls and protects them from the effects of hydrochloric acid.

How to prevent Helicobacter infection

• Do not eat foods that have not been sufficiently heat-treated (foie gras, sushi, lightly fried meat).
• Rinse food thoroughly (laundry soap can be used). There is also a recommendation to process seasonal vegetables and fruits with a vinegar solution.
• Cooking in the oven is healthy and delicious. Just do not forget to bake food at a temperature not lower than 160-180 degrees.
• Set the temperature in the refrigerator compartment to no higher than zero.
• Try to eat less in catering establishments. Whenever possible, when visiting cafes and canteens, wipe cutlery with a damp cloth and wash your hands thoroughly.

Medical research has shown that pregnant women are more susceptible to H. pylori infection than others.

Now you know how the presence of gastritis during pregnancy, the timely treatment of which is not always acceptable, can complicate the life of an expectant mother. We talked about the symptoms that indicate that it is time for you to undergo an examination of the gastrointestinal tract, as well as how to treat the disease. If you are just planning a pregnancy, we advise you to first undergo a course of treatment for gastritis or ulcers. This measure will help the expectant mother feel good and give birth to a healthy baby.

Classmates

Gastritis is a disease of the gastric mucosa, accompanied by a malfunction of the digestive tract. During pregnancy, this disease can become a serious problem and significantly complicate the course of such a crucial period. Exacerbation of gastritis in expectant mothers requires a special approach in the diagnosis and treatment of this disease.

Acute gastritis

This term refers to inflammation of the stomach caused by a single exposure to a substance. It can be low-quality food, drugs, or various chemical compounds. Quite often, acute gastritis occurs with various infections and is one of the signs of a general disease.

Symptoms of acute gastritis:

• pain in the projection of the stomach;
• nausea;
• single or repeated vomiting.

In severe cases, an increase in body temperature, chills and other signs of intoxication of the body are possible.

Treatment of acute gastritis in pregnant women does not differ from its therapy outside of pregnancy. In case of poisoning, enterosorbents are used - drugs that remove dangerous toxic substances from the body. According to indications, antibiotics are prescribed that are approved for use during pregnancy. To replenish fluid, it is recommended to drink as much fluid as possible. Best suited for this purpose are special water-salt solutions ("Regidron").

Gastric lavage in expectant mothers is practically not carried out. This procedure can provoke an increase in the tone of the uterus and cause termination of pregnancy. Gastric lavage is done only under strict indications and in compliance with all safety rules. Observation of the gynecologist during and after the procedure is mandatory.

Chronic gastritis

During pregnancy, doctors most often have to deal with an exacerbation of chronic gastritis. According to statistics, inflammation of the gastric mucosa occurs in half of all women of reproductive age. The first episode of gastritis usually occurs during adolescence, and by the time of pregnancy, a woman usually knows about her diagnosis. With an exacerbation of the disease, such a patient already knows which doctor to contact and what to do when the first symptoms of gastritis appear.

The situation in which the first attack of the disease occurs precisely after the conception of a child is quite rare. Symptoms develop gradually over many years. Much more often, women simply ignore the signs of gastritis, attributing them to poisoning or discomfort after eating any special food. The primary manifestation of stomach disease during pregnancy is more characteristic of young primiparous women under the age of 25.

One of the reasons for the development of chronic gastritis is considered Helicobacter pylori... These spiral-shaped bacteria live in the stomach and intestines of most of the world's inhabitants. Moreover, 90% of all carriers of Helicobacter pylori do not have any manifestations of gastritis or peptic ulcer disease. At the moment, scientists have not been able to find out whether chronic gastritis always proceeds against the background of infection with these bacteria, or other ways of acquiring a dangerous disease are possible.

Factors provoking the development of gastritis:

• inaccuracies in nutrition (in particular, a deficiency of protein, vitamins and iron);
• long-term uncontrolled intake of medications (anti-inflammatory and antibacterial agents, corticosteroids);
• bad habits (smoking and drinking alcohol);
• harmful factors at work;
• diseases that provoke tissue hypoxia (anemia, pneumosclerosis);
• autoimmune disorders;
• constant stress;
• heredity.

In pregnant women, exacerbation of chronic gastritis most often occurs against the background of inaccuracies in nutrition. Eating spicy, fried, fatty, or salty foods can lead to typical gastritis symptoms at any time during pregnancy. In half of expectant mothers, stomach disease is combined with cholecystitis (inflammation of the gallbladder) and colitis (inflammation of the intestines).

Symptoms

Exacerbation of chronic gastritis is characterized by a variety of symptoms and depends on the type of disease. Gastritis with increased secretion is characterized by pain in the epigastric region that occurs soon after eating. Pain is often associated with a certain type of food. Pregnant women notice that after consuming any product, the symptoms of the disease intensify. Most often, pain occurs in response to fatty, fried, or salty foods.

With gastritis with increased secretion, pain in the stomach is accompanied by heaviness and a feeling of fullness. Discomfort often extends to the navel or goes into the right hypochondrium. Characterized by nausea and vomiting, upset stools in the form of diarrhea. The manifestations of the disease can vary depending on the severity of gastritis and the individual reaction of the body.

With gastritis with reduced secretion dyspeptic disorders come to the fore. Almost all pregnant women experience nausea, vomiting, belching, and flatulence. With a long course, any form of gastritis sooner or later leads to a decrease or complete loss of the secretory activity of the stomach and the development of all characteristic symptoms.

Complications of pregnancy

Chronic gastritis in early pregnancy almost always becomes cause of severe toxicosis... There is no single theory to explain this phenomenon. Experts agree on only one thing: nausea and vomiting against the background of gastritis in the first trimester of pregnancy can persist for a long time. If in a pregnant woman the manifestations of toxicosis have not stopped after 12 weeks, the cause should be sought in inflammation of the gastric mucosa.

In the second half of pregnancy, chronic gastritis does not have a pronounced effect on the condition of the woman and the fetus. Inflammation of the stomach cannot cause malformations or provoke complications from the placenta. Even in the case of an exacerbation of gastritis, pregnancy usually proceeds safely and ends with the birth of a child on time.

A certain danger is gastritis, proceeding with complications.... With a severe course of the disease, bleeding from the stomach may develop. This condition poses a threat to a woman's life and requires immediate assistance from specialists. It is rather difficult to predict the course of pregnancy with the development of bleeding. With severe blood loss, miscarriage or premature birth is possible.

Diagnostics

Diagnosis in pregnant women is somewhat difficult. The traditional method for detecting gastritis is fibrogastroscopy. This examination allows you to assess the state of the gastric mucosa from the inside, detect ulcers, bleeding foci and other pathological changes. Also, during the procedure, a section of stomach tissue is taken for targeted histological examination.

During pregnancy, an endoscopic examination of the stomach is performed only under strict indications. If it is not possible to identify gastritis with the help of other methods, the doctor carries out the procedure in compliance with all safety measures. The procedure is quite difficult for pregnant women and can even provoke a miscarriage. Doctors try, if possible, to do without endoscopic examination in expectant mothers and make a diagnosis based on clinical data.

An ultrasound examination of the stomach can help in the diagnosis of gastritis. Ultrasound is performed on an empty stomach and allows you to assess the size of the organ and the thickness of its walls. Also, using an ultrasound scan, you can determine the amount of mucus in the stomach and thereby identify a malfunction in the organ.

What to do in case of exacerbation of gastritis?

In the treatment of chronic gastritis in pregnant women, proper nutrition is of great importance. When the first signs of illness appear, you should switch to fractional meals: up to 6 times a day in small portions. This approach allows you to reduce the load on the stomach and gives the organ the opportunity to gradually restore its performance.

With gastritis with increased secrecy the following dietary meals are recommended:

• dairy and vegetable soups;
• steamed or oven-baked vegetable dishes;
• porridge with milk or water;
• boiled meat and fish of low-fat varieties;
• vegetable, berry and fruit juices.

With low secretion gastritis the diet of a pregnant woman should include the following dishes:

• soups with meat broths;
• lean boiled or stewed meat;
• boiled not fatty fish;
• dairy products;
• milk;
• flour dishes (except for baked goods).

Any form of gastritis is prohibited.:

• fried foods;
• spicy and spicy food;
• salty dishes (including homemade pickles);
• smoked meats;
• semi-finished products;
• carbonated sweet drinks;
• fresh baked goods;
• alcohol.

During an exacerbation of the disease, pregnant women need to eat slowly, carefully chewing each piece. You should give up sandwiches, chips, crackers and other unhealthy snacks. At the same time, it is strictly forbidden for expectant mothers to starve! If you feel hungry, you can drink a glass of kefir or other fermented milk drink. As snacks, you can use fruits, cottage cheese, cheese and other foods from the list of allowed for gastritis.

Well relieves pain and eliminates other symptoms of gastritis mineral water... With increased gastric secretion, you should turn your attention to Jermuk or Smirnovskaya mineral water. In case of secretory insufficiency, it is advised to drink Essentuki No. 4 or No. 17, as well as Arzin. Mineral water not only helps to relieve the manifestations of the disease, but also eliminates the signs of early toxicosis. When nausea and vomiting occur, pregnant women need to drink mineral water daily.

Drug treatment

The classic treatment for gastritis involves the use of antibacterial drugs. The purpose of such therapy is to eliminate Helicobacter pylori and thereby remove the main cause of the development of the disease. Antibiotics are not prescribed during pregnancy... The drugs used to eliminate the causative agent of the disease are prohibited for use in expectant mothers as potentially dangerous to the fetus. Specific antibiotic therapy for gastritis is carried out only after childbirth.

To reduce the secretion of gastric juice during pregnancy, they are prescribed antacids... Maalox is a good example. This remedy not only reduces the production of stomach juice, but also has an analgesic and anti-inflammatory effect. Maalox should be taken 1 hour after meals.

During pregnancy, to eliminate the symptoms of gastritis are actively used sorbents... These drugs eliminate excess hydrochloric acid in the stomach, relieve pain and stabilize the enzymatic activity of the stomach. Sorbents are prescribed up to 6 times a day 1 hour after meals.

To relieve pain at any stage of pregnancy, use antispasmodic drugs... The well-known "No-shpa" copes well with pain syndrome by relaxing the smooth muscles of the stomach. To eliminate nausea, "Cerucal" and its analogues are used. This drug will be especially relevant in the first trimester in case of severe toxicosis.

Treatment of gastritis in pregnant women is carried out under the supervision of two doctors at once: a gastroenterologist and a gynecologist. Hospitalization in a hospital is carried out in the event of complications, as well as in case of severe toxicosis. In the rest of the situation, gastritis therapy is possible at home.

Gastritis that occurs in the first trimester often resolves in the second half of pregnancy. In some women, the symptoms of stomach lesions make themselves felt until the very birth. If the signs of gastritis do not disappear after the baby is born, you should definitely consult a doctor.

Chronic gastritis is a chronic lesion of the gastric mucosa, accompanied by its structural restructuring with progressive atrophy and impairment of the secretory, motor and partially endocrine functions of the stomach.

ICD-10 CODE
K29.3 Chronic superficial gastritis
K29.4 Chronic atrophic gastritis
K29.5 Chronic gastritis, unspecified

EPIDEMIOLOGY

According to numerous epidemiological studies, chronic gastritis is diagnosed in more than 50% of the adult population of developed countries of the world; in the structure of diseases of the digestive system, it is 35%. However, the frequency of this disease in pregnant women has not yet been established.

PREVENTION OF EXCERING GASTRITIS DURING PREGNANCY

The main importance is a balanced diet, refusal to use strong alcoholic beverages, smoking.

It is necessary to monitor the state of the oral cavity, timely treat diseases of other abdominal organs, and eliminate occupational hazards. Patients with chronic gastritis, especially those with atrophic-dysregenerative changes, should be registered at the dispensary and undergo a comprehensive examination at least twice a year.

CLASSIFICATION OF GASTRITES

There are two forms of gastritis:
• acute - arises for the first time, proceeds violently;
· Chronic - proceeds with frequent relapses.

The main forms of gastritis are currently considered chronic gastritis A (it accounts for 15-18% of cases of the disease) and chronic gastritis B caused by Helicobacter pylori (70% of all chronic gastritis).

Other forms of gastritis are observed much less frequently.

Distinguish between chronic gastritis as the main and as a concomitant disease (secondary gastritis).

According to the etiological criterion, exogenous and endogenous chronic gastritis are distinguished. According to the degree of secretory disorders, chronic gastritis with secretory insufficiency is distinguished.

Based on biopsy data, superficial gastritis, gastritis with lesions of the glands (without atrophy), atrophic gastritis (moderately pronounced), gastritis with symptoms of restructuring of the gastric mucosa are isolated.

According to the localization of morphological changes, common chronic gastritis, antral and isolated gastritis of the body (bottom) of the stomach are distinguished. Special forms of chronic gastritis include hemorrhagic, rigid, giant hypertrophic and polyposis.

ETIOLOGY (CAUSES) OF GASTRITIS

Chronic gastritis is sometimes the result of "prolonged" acute gastritis, but more often develops under the influence of various exogenous factors (repeated and prolonged malnutrition, the use of spicy and rough food, addiction to hot food, poor chewing of food, the use of strong alcoholic beverages - alcoholic gastritis ).

Chronic gastritis can be caused by:

· Qualitatively malnutrition (especially deficiency of protein, iron and vitamins);
· Long-term uncontrolled intake of drugs that have an irritating effect on the gastric mucosa (salicylates, phenylbutazone, prednisolone, some antibiotics, sulfonamides and other drugs);
· Industrial hazards (lead compounds, coal, metal dust);
· Diseases that cause tissue hypoxia (chronic circulatory failure, pneumosclerosis, anemia);
Endogenous intoxication with kidney disease, gout (urea, uric acid, indole, skatole and other substances are secreted by the gastric mucosa);
· The effect of toxins in infectious diseases and local chronic foci of infection (the so-called elimination chronic gastritis);
· Hereditary predisposition.

In 75% of cases, chronic gastritis is combined with chronic cholecystitis, chronic appendicitis, colitis and other diseases of the digestive system.

PATHOGENESIS

Under the influence of prolonged exposure to endogenous and exogenous etiological factors, functional secretory and motor disorders of the stomach develop, and later on, dystrophic and inflammatory changes and disorders of regeneration processes. These structural changes develop primarily in the epithelium of the surface layers of the mucous membrane, and later in the pathological process the stomach glands are involved, which gradually atrophy or rebuild like crypts. Autoimmune processes play a role in the progression of the disease.

PATHOGENESIS OF GESTION COMPLICATIONS

There is no single theory explaining the causes of toxicosis. Opinions agree only on one thing - toxicosis occurs in those women who have diseases of the gastrointestinal tract, liver, thyroid gland, as well as those who work hard, smoke, eat improperly, and whose psyche is overstrained.

Complications of pregnancy that occur in the first trimester up to 13-14 weeks, characterized by dyspeptic disorders and various metabolic disorders are called "early toxicosis". Vomiting in pregnant women is the most common form of this complication. It is assumed that the most likely cause of vomiting in early pregnancy is a violation of the interaction of the central nervous system and internal organs. In this case, the activity of the subcortical structures of the central nervous system is excited, where the vomiting center is located, as well as the centers of regulation of vascular tone, salivation, and smell. The close location of these centers determines that the emetic act is preceded by a feeling of nausea, increased salivation, deepening breathing, increased heart rate, pale skin due to spasm of peripheral capillaries.

CLINICAL PICTURE (SYMPTOMS) OF GASTRITIS IN PREGNANT WOMEN

Chronic gastritis A initially occurs with normal gastric secretion (secretion of gastric juice); at this stage, patients do not present complaints and treatment is not required. The need for treatment arises when the inflammatory process in the gastric mucosa deepens, as a result of which the secretion of gastric juice decreases.

With the development of chronic gastritis B, the secretion of gastric juice in the lower parts of the stomach is increased or within normal limits, however, with widespread chronic gastritis B, the secretory function of the stomach is sharply reduced up to its pronounced insufficiency.

Chronic gastritis has no specific symptoms, the clinical picture of the disease is diverse. In most cases, symptoms of the disease are pain in the epigastric region and dyspepsia (nausea, vomiting, belching, upset stools). In chronic gastritis with secretory insufficiency (a low level of hydrochloric acid in the gastric juice), the phenomena of gastric dyspepsia (belching, nausea, vomiting) and intestinal dyspepsia (flatulence, rumbling in the abdomen, stool disorder) are more often observed.

With gastritis with preserved or increased secretion of gastric juice - the forms most often observed at a young age - pain prevails. Most often, there is recurrent pain in the upper abdomen. Basically, patients complain of pain in the epigastric region, around the navel or in the right hypochondrium. Pain occurs after eating, often associated with a certain type of food, less often appears on an empty stomach, at night or regardless of food intake. The pain can be both moderate and severe (with an increased production of hydrochloric acid by the stomach, the pain is usually strong, with a decrease it is weak). The pain becomes worse when the stomach walls are stretched with copious amounts of food.

Helicobacter pylori gastritis is most often noted. Once in the stomach, bacteria multiply vigorously, damaging the gastric mucosa and altering the production of gastric juice. This leads to the occurrence of erosions and stomach ulcers.

Complications of Gestation

In 75% of women with chronic gastritis, the disease worsens during pregnancy. As a rule, pregnant women with chronic gastritis develop early toxicosis (vomiting), which often lasts up to 14–17 weeks and can be difficult.

Severe gastritis can lead to bleeding from the stomach and duodenum.

DIAGNOSTICS OF GASTRITIS DURING PREGNANCY

ANAMNESIS

In the anamnesis, as a rule, there is evidence of a previous acute gastritis or periodic exacerbations of chronic gastritis.

PHYSICAL STUDY

On palpation of the epigastric region, in most cases, patients do not notice pain.

LABORATORY RESEARCH

Laboratory diagnostics include:
· clinical blood test;
General urine analysis - when vomiting of pregnant women is attached, a positive reaction to acetone (+++ or ++++) is found in urine analysis, protein and cylinders are often detected. In blood tests, hypo- and dysproteinemia, hyperbilirubinemia, an increase in creatinine content are determined.

INSTRUMENTAL STUDIES

To diagnose chronic gastritis, carry out:

· Study of the secretory and motor function of the stomach.

Gastric secretion: basal up to 10 mmol / h, stimulated (after maximum histamine stimulation) - up to 35 mmol / h. Abundant gastric secretion is often observed at night. In chronic gastritis, the acid-forming function of the stomach may be normal or decreased; possible complete absence of hydrochloric acid in gastric juice (achlorhydria). In advanced cases, the production of pepsin (achilia) is also disrupted. · Endoscopic examination.

The fibroendoscopic method of research is diagnostically valuable, but quite burdensome for a pregnant woman; it should be used for diagnosis for special indications and in case of ineffectiveness of treatment. With superficial gastritis, gastroscopy reveals moderate swelling, sometimes slight vulnerability of the mucous membrane, focal hyperemia, increased mucus formation. Chronic gastritis with high acidity is often accompanied by erosive damage to the mucous membrane. Superficial erosions are presented as flat defects of the mucous membrane of various sizes and shapes, covered with fibrinous plaque or clean, their edges are usually low, the mucous membrane in the area of \u200b\u200berosion is hyperemic, edematous, often in the form of a small narrow rim, less often in the form of a wide oval. Hemorrhagic erosions are diverse not only in shape and size, but also in the depth of the lesion of the mucous membrane, and are also covered with hemorrhagic plaque. The mucous membrane around the erosion is pale, slightly swollen, often covered with a layer of scarlet blood or bloody mucus.

X-ray examination for the diagnosis of gastritis in pregnant women should not be used, since it is uninformative, and the harmful effect of X-rays on the fetus is undoubted. Ultrasound allows you to detect on an empty stomach an excess amount of mucus, hypersecretion, assess the condition (thickness) of the stomach wall, local pain under the sensor of the device.

DIFFERENTIAL DIAGNOSTICS

Differential diagnosis of the main forms of gastritis is carried out with functional disorders of the secretory function of the stomach ("irritated stomach", gastric or functional achilia). In this case, take into account the fact that chronic gastritis is characterized by more persistent and pronounced symptoms, as well as a picture of inflammatory changes in the mucous membrane according to gastrofibroscopy and biopsy data.

Gastritis with preserved or increased gastric secretion and antral gastritis, often manifested by pain, should be differentiated from peptic ulcer disease. With gastritis, there is no seasonality of exacerbations, at the height of exacerbation, ulceration of the gastric mucosa is not noted. Polyposis gastritis is differentiated from gastric polyposis (targeted biopsy data are of decisive importance).

For the differential diagnosis of antral and giant hypertrophic gastritis with a stomach tumor, gastrofibroscopy and targeted biopsy are of decisive importance.

INDICATIONS FOR CONSULTING OTHER SPECIALISTS

The consultation of a therapist and a gastroenterologist is shown.

EXAMPLE FORMULATING A DIAGNOSIS

Pregnancy 16 weeks Chronic gastritis B. Early toxicosis of pregnant women.

TREATMENT OF CHRONIC GASTRITIS DURING PREGNANCY

OBJECTIVES OF TREATMENT

Achieve disease remission.

NON-MEDICINAL TREATMENT

Treatment of chronic gastritis should be comprehensive, differentiated and strictly individual. With an exacerbation of the disease, a half-bed regime is shown, diet No. 1 according to Pevzner, fractional meals (5-6 times a day).

Pregnant women with preserved or increased secretory function of the stomach may (in the absence of edema, especially in the first half of pregnancy) the appointment of mineral waters Smirnovskaya, Jermuk 150-300 ml three times a day 1.5-2 hours after eating, because this reduces the time of action of hydrochloric acid on the gastric mucosa. In chronic gastritis with secretory insufficiency, water of the type Mirgorodskaya, Essentuki No. 4, No. 17 or Arzni is prescribed.

MEDICINAL TREATMENT OF GASTRITIS IN PREGNANT WOMEN

Treatment of pregnant women suffering from chronic gastritis with preserved or increased secretory function is carried out in the same way as for patients with peptic ulcer disease. Elimination of H. pylori infection during pregnancy is not carried out, since the main drugs used for this purpose (bismuth tripotassium dicitrate, tetracycline) are contraindicated. Oxacillin and furazolidone without bismuth tripotassium dicitrate are ineffective. With a pronounced exacerbation of chronic gastritis B, gastrofarm can be prescribed (2 tablets three times a day 30 minutes before meals), since it has an anti-inflammatory effect. Antisecretory agents (antacids and M-anticholinergics) are used as in peptic ulcer disease. Maalox, which has antacid, analgesic and cytoprotective properties, is prescribed in tablets or suspensions 1 hour after a meal. Attapulgite possesses adsorbing properties, establishes physiological balance in the stomach, does not lead to reactive formation of gastric acid; it is prescribed 3–5 times a day, one powder at a time, 1–2 hours after a meal and, if necessary, at night. Antispasmodic drugs (papaverine, drotaverine) eliminate pain syndrome. Metoclopramide regulates gastric motor function. For the treatment of chronic gastritis with normal or increased gastric secretion, infusions of medicinal plants are used that have anti-inflammatory, astringent, analgesic, enveloping, adsorbing properties: chamomile, mint, flax seed, oats, yarrow, cinquefoil, highlander bird, calamus rhizome, celandine, sedatives (valerian root, motherwort herb).

With severe secretory insufficiency, special attention is paid to replacement therapy (replenishment of the deficiency of hydrochloric acid and pepsin) - gastric juice (1 tablespoon per 1/2 glass of water), betaine-pepsin in usual therapeutic doses. For the same purpose, hyperbaric oxygenation is carried out (10 sessions with an oxygen pressure in the pressure chamber of 2 atm.). Patients with chronic gastritis with reduced secretory function are recommended such medicinal herbs that suppress the inflammatory process in the gastric mucosa and stimulate its secretory function: plantain leaves, wormwood, thyme, fennel, caraway seeds, parsley, mint, yarrow, etc. These herbs are used to prepare infusions ...

In patients with chronic gastritis A, exocrine pancreatic activity and intestinal digestion are often impaired. For the correction of these disorders, pancreatin 0.5-1 g before meals 3-4 times a day is useful. As with chronic gastritis B, abnormalities in gastric motor function are corrected with metoclopramide, and antispasmodics are prescribed for pain.

PREVENTION AND PREDICTION OF GESTION COMPLICATIONS

Compliance with the regime of work and rest, as well as diet. Treatment should be started immediately, because with the progression of toxicosis of pregnant women, vomiting becomes debilitating, and hunger and weight loss increase, liver and kidney functions suffer, and blood counts deteriorate.

FEATURES OF TREATMENT OF COMPLICATIONS OF GESTATION

Treatment of complications of gestation by trimester

Treatment of pregnant women with mild vomiting can be done on an outpatient basis. With vomiting of moderate and severe degree, treatment is carried out in a hospital. A properly organized therapeutic regimen and the elimination of negative emotions are important for the normalization of the central nervous system. Rational nutrition of pregnant women is of great importance in treatment. Food should be varied, easily digestible, contain a large amount of vitamins; it should be taken chilled, in small portions every 2-3 hours while lying down. Shown mineral non-carbonated alkaline water in small volumes 5-6 times a day.

When hospitalized, the patient must be placed in a separate ward. Taking into account the short period of pregnancy, in order to eliminate the negative effect on the ovum of drugs, it is advisable to start treatment with non-drug drugs. To normalize the functional state of the central nervous system and eliminate autonomic dysfunction, it is possible to use central electroanalgesia, acupuncture, psychotherapy and hypnotherapy. Using these non-drug methods alone may be sufficient to treat mild vomiting in pregnant women. Complex therapy continues until vomiting stops, general condition normalizes, and body weight gradually increases. Treatment of mild to moderate vomiting in pregnant women is almost always effective. The absence within three days of the effect of the treatment with excessive vomiting is an indication for termination of pregnancy.

Treatment is carried out strictly under the supervision of a physician.

Treatment of complications during childbirth and the puerperium

Treatment during childbirth and the postpartum period is carried out according to obstetric indications.

INDICATIONS FOR HOSPITALIZATION

Hospitalization is carried out with an exacerbation of the disease and for obstetric indications.

ASSESSMENT OF TREATMENT EFFICIENCY

To assess the effectiveness of treatment, repeated esophagogastroduodenoscopy is most often performed. After adequate treatment, superficial and hemorrhagic erosions quickly epithelize (within 10-14 days), leaving no significant macroscopic traces.

CHOICE OF TIME AND METHOD OF DELIVERY

Childbirth takes place on time through the natural birth canal. KS only for obstetric indications.

PATIENT INFORMATION

As a prophylaxis, a sanatorium-resort treatment of chronic gastritis is indicated without an exacerbation of the disease.

The article discusses gastritis during pregnancy. We will tell you about the causes and symptoms, what to do if there is an exacerbation of the pathology. You will learn about the necessary treatment with diet, medicines and folk remedies, as well as reviews from women and doctors.

Gastritis is an ailment of the gastrointestinal tract, characterized by inflammation of the mucous membrane of the inner walls of the stomach. This condition is accompanied by a malfunction in the production of gastric juice, which causes disturbances in the work of the digestive organ. Pathology has both a chronic and an acute form, it can proceed in different ways.

Gastritis in pregnant women causes discomfort and deterioration of health

The development of the disease during pregnancy does not threaten the health of the expectant mother or fetus, but at the same time causes severe discomfort. That is why it is advisable to start treating the pathology as early as possible, since if it flows into a chronic form, then this is fraught with the development of an ulcer or stomach tumor.

Causes

During pregnancy, the protective properties of the body of the expectant mother are slightly weakened. In the early stages, this is necessary for the successful attachment of a fertilized egg to the wall of the uterus and preventing its further rejection.

It is for this reason that most pregnant women during the period of bearing a child notice an exacerbation of chronic diseases or the appearance of new ailments, as well as a change in character. For example, if they were at first, and then suddenly became, then this is a reason for going to a doctor.

According to statistics, in 75% of cases, the main cause of gastritis during pregnancy is an exacerbation of a chronic ailment of the gastric mucosa, which was observed in a pregnant woman earlier.

There are 2 types of gastritis:

• Type A is a pathology that has arisen due to the progressive development of atrophic processes in the walls of the stomach.
• Type B - the disease begins to develop after the conditionally pathogenic bacterium Helicobacter pylori enters the stomach. A mom-to-be can become infected with this bacterium in a household way, both before and after conception. If before pregnancy the ailment did not manifest itself in any way, then during the carrying of a child due to hormonal changes, the course of gastritis is aggravated and aggravated. This type of ailment occurs most often and requires treatment.

A gastroenterologist will help you determine what type of gastritis you have. It is forbidden to diagnose yourself and prescribe treatment on your own, as this can lead to a deterioration in well-being or the loss of a child.

What affects the exacerbation of gastritis during pregnancy

The following are the main factors affecting the exacerbation of the disease in the 1st, 2nd and 3rd trimesters:

1. Genetic predisposition.
2. Unbalanced diet, abuse of foods containing preservatives and refined carbohydrates. Food is especially dangerous if it contains dyes, flavors, and stabilizers.
3. Lack of iron in the body.
4. Eating a large number of spicy and fatty foods. Also, too hot food affects the exacerbation of the disease.
5. Low intake of vitamins and proteins in the body.
6. Frequent stress and nervous tension, anxiety.
7. The presence of chronic infectious pathologies.
8. Inappropriate eating behavior, including snacks on the go, systematic overeating, poor chewing.

The main factors causing an exacerbation of the disease are associated precisely with improper food intake. Therefore, normalize food, if this does not help, then seek help from a specialist.

Symptoms

The signs of gastritis are varied. Sometimes they do not appear immediately, and in some cases they appear instantly. It all depends on the type and form of pathology. Experts distinguish chronic and acute forms of pathology. Below we will look at each of them.

Acute gastritis

The symptoms of this form of pathology are:

• sharp pain in the stomach;
• general deterioration of health, occasionally accompanied by vomiting, nausea, dizziness;
• discoloration of the tongue and covering it with a yellow or gray coating;
• with high acidity, severe heartburn occurs, aggravated by the use of sweet, sour foods. Belching and upset stools are also observed;
• the occurrence of discomfort in the stomach on an empty stomach. With a reduced production of gastric juice, the expectant mother experiences weakness, nausea, bad breath, flatulence.

An acute form of pathology can be caused by taking certain medications, prolonged nervous tension or eating foods that irritate the mucous membrane of the stomach walls.

Chronic gastritis

This type of gastritis is the most common. It is caused by the bacteria Helicobacter pylori. This microorganism negatively affects the inner walls of the stomach, damaging them, causing problems with the formation of gastric juice and provoking disturbances in the functioning of the organ.

During pregnancy, the chronic form of pathology has no characteristic signs, which makes it difficult to diagnose. Some symptoms of the disease can be mistaken for a manifestation of toxicosis, among them:

• nausea;
• bloating;
• heartburn;
• frequent fatigue;
• belching;
• discomfort, pain in the pancreas;
• excessive excitability;
• overwork arising from any physical exertion.

In the chronic form, it is important to establish the level of acidity of gastric juice, since the signs of the disease and methods of treatment depend on this.

Gastritis with high acidity is characterized by:

• Stool disorder.
• Recurrent painful sensations in the upper abdomen, right hypochondrium, epigastric region. They appear after eating a certain food, rarely occur on an empty stomach or at night.
• Eructations are sour.
• Heartburn.

With low acidity, the signs are as follows:

• nausea;
• vomiting;
• general deterioration in well-being;
• heaviness in the stomach;
• bloating;
• rumbling in the stomach.

Only specialists should treat and diagnose gastritis.

Diagnostics

If you suspect a disease and some symptoms, you need to visit a doctor as soon as possible. Unfortunately, gastritis has similar symptoms with other similar diseases of the gastrointestinal tract and toxicosis. Because of this, pregnant women are in no hurry to visit the doctor, but try to cope with the malaise on their own.

Diagnostic measures are as follows:

• Biochemical analysis of urine, feces, blood.
• Endoscopy - the procedure involves the collection of digestive fluid from the stomach through intubation. With the help of this technique, it is possible to establish the nature of acidity for the appointment of a suitable therapy.
• Palpation - with the help of it, the affected areas of the stomach are revealed.
• Ultrasound of the gastrointestinal tract to assess their condition.

How to treat

Treatment of gastritis is a lengthy process that requires compliance with all the recommendations of a specialist. To prevent an exacerbation of gastritis, you should minimize stressful situations, as well as pay attention to your diet and diet, excluding harmful foods from it. Before therapy, it is imperative to undergo all examinations that will help identify the exact form of the disease in order to prescribe a suitable treatment.

Endoscopy during pregnancy is rarely prescribed, since swallowing the probe causes discomfort that can negatively affect the well-being of the expectant mother.

Physiotherapy methods

In certain cases, physical therapy will help to cope with the malaise. Some pregnant women are sure that acupuncture is the most effective method, but this method cannot be considered the safest one during pregnancy.

The same can be said for electrophoresis, which transports the prescribed drug directly to the affected area. During pregnancy, this technique is used with caution, as there is no large-scale research on how it affects the baby in the womb. It is not recommended to use electrophoresis in late toxicosis, which is accompanied by severe vomiting and in chronic renal pathologies.

The safest is magnetotherapy, but it also has its own contraindications, which the specialist will acquaint you with.

Medication

Most of the drugs that effectively cope with gastritis are contraindicated for expectant mothers. That is why it is necessary to normalize nutrition in order to cope with the disease.

During childbearing, antibacterial medicines are prohibited, which neutralize the action of the Helicobacter pylori bacteria due to their negative effect on the fetus. Antisecretory drugs are also banned.

But the following medicines can be used for treatment:

• Dimethicone - has a regenerating effect.
• Raglan, Cerukal - cope with heartburn, nausea.
• Probiotics (Bifidum, Narine, Bifiform).
• Antispasmodics - relieve spasms and pain.
• Preparations with pancreatic and gastric enzymes are recommended for use with reduced secretory activity.

You should refrain from taking Almagel, Gastal, Maalox and Fosfalugel, as they contain aluminum, which is not recommended for use during childbearing.

Mineral water

Sometimes mineral water will help to cope with gastritis. But you can use it only after the permission of the doctor.

If a pregnant woman has low acidity, then you can drink "Essentuki" at numbers 4 and 17, "Mirgorodskaya". With increased acidity, “Borjomi” and “Jermuk” are allowed.

Drink healing mineral water 2 hours after eating.

The most effective treatment for gastritis is diet therapy.

Diet

With an exacerbation of gastritis in the early stages of pregnancy, especially if at this time the pregnant woman suffers from toxicosis, experts recommend adhering to a certain diet. With a general deterioration in health, weakness, bed rest and maximum rest are recommended.

rules

Basic rules of diet therapy for gastritis in pregnant women:

1. Fractional meals consisting of 6-8 meals a day.
2. Coarse food is prohibited, food must have the consistency of porridge and mashed potatoes or be semi-liquid.
3. You can not eat smoked, fried, sour and spicy products, as they increase the production of gastric juice.
4. It is recommended to reduce the amount of salt consumed.
5. Remove pickled foods and pickles from the diet.
6. The food should be varied and nutritious, and the daily diet should contain sufficient amounts of fats, vitamins, minerals and carbohydrates.
7. If possible, completely stop eating foods that contain fast carbohydrates.
8. It is forbidden to eat food that is too hot or cold, food must be warm.
9. To enrich the body with useful microelements, it is recommended to take multivitamins for expectant mothers.

Grocery list

Allowed Products:

• steamed cutlets;
• vegetables;
• scrambled eggs;
• greens;
• boiled river fish;
• boiled poultry meat;
• fresh fruits;
• dried white bread;
• milk;
• steamed vegetable stew;
• milk soups;
• meatballs;
• semi-liquid porridge.

Now let's take a closer look at the power supply scheme. In the early days, it is recommended to eat semi-liquid food that does not irritate the gastric mucosa. These products are:

• milk;
• cottage cheese;
• vegetable puree soups;
• cereals and soups with milk.

After a few days, you can add hard-boiled eggs, vegetable side dishes, fresh fruits and vegetables to your diet.

With the improvement of well-being, the pregnant woman can gradually return to normal nutrition, excluding from the diet:

• pickles;
• broths cooked in fish or meat;
• peas, beans;
• cabbage, onions, radishes;
• sweet and flour products;
• smoked meats;
• condiments, spices, spices;
• fried foods.

Folk remedies for gastritis

In certain cases, traditional medicine can cope with the pathology. They can be used for treatment only after consultation and permission from a doctor. Self-administration is prohibited, as it can negatively affect the course of pregnancy.

Important: some medicinal herbs for gastritis are prohibited in the first trimester. These herbs include sage, calamus, plantain, and thyme.

Herbal therapy

Herbal decoctions are capable of curing gastritis in pregnant women. Mint, St. John's wort, licorice naked, wormwood, yarrow, flowers, dried cress, calendula, licorice root, ivan tea and cinquefoil will help to eliminate pain and reduce inflammation.

To gently stimulate the inner walls of the stomach with low acidity, decoctions of caraway seeds, sea buckthorn, currants, rose hips, gooseberries, thyme and fennel are used.

You can make your own herbal preparations or buy them at the pharmacy. They are produced in the form of phyto-bags, which are brewed like tea. They drink this broth warm after eating.

The broth recipe is shown below.

Ingredients:

• herbal collection - 2-3 tbsp;
• water - 500 ml.

How to cook:

1. Pour boiling water over the herbs.
2. Let the broth brew for half an hour, then strain.
3. Drink after meals.

Flax seed

Flaxseed perfectly copes with diseases of the gastrointestinal tract and stomach, and from it helps to solve a number of problems faced by the future mother. What is the miraculous effect of a natural product? The brewed semen forms mucus that coats the walls of the stomach and has an anti-inflammatory effect.

Flax seed broths are safe for pregnant women and fetuses. Contraindications for use: pancreatitis, cholelithiasis.

Apples

Regular consumption of apples, especially green varieties, will not only enrich the body with vitamins or improve digestion, but also solve the problem with gastritis.

How to eat apples for gastritis? Grate 2 green apples daily. Eat the apple mixture half an hour after eating. Duration of admission is at least a month. After a month, eat 1 apple every other day.

Honey

If you are not allergic to honey, you can use it to treat gastritis. To do this, dilute 1 tablespoon of honey in 250 ml of warm water. With low acidity, drink a drink an hour before meals, with increased acidity, half an hour before meals. The duration of treatment is 30-60 days.

Honey eliminates inflammation and has a calming effect on the stomach lining.

- types, symptoms and treatment

One of the most common extragenital pathologies during pregnancy is gastritis. Like any inflammatory process, gastritis has a negative effect not only on the mother's body, but also on the body of the unborn child. According to statistics, about 70% of pregnant women suffer from gastritis, moreover, its chronic form occurs in 99 cases out of 100, and only 1% of cases are diagnosed with acute gastritis.

Acute gastritis

Acute gastritis is a sudden inflammation of the gastric mucosa caused by the negative effects of chemical, infectious and toxic factors. It develops rapidly, a couple of hours after the onset of the disease, acute pain in the stomach, cramps, vomiting appears, the tongue is coated with a gray bloom. It is observed, the skin is dry, pale, after a while diarrhea joins. This condition proceeds as an acute poisoning and requires immediate medical attention. The prognosis for pregnancy depends on the severity of the course and the etiological factor that caused the disease itself.

Chronic gastritis

Chronic gastritis is a sluggish disease caused by pathological changes in the gastric mucosa and impaired secretion of the gastric eye. Often proceeds with the involvement of neighboring organs in the process - the duodenum, gallbladder and ducts, liver and pancreas. It is manifested by the alternation of periods of remission and relapse of the disease. Unfortunately, chronic gastritis cannot be completely cured, but if you follow the recommendations of your attending gastroenterologist, you can significantly reduce the number of exacerbations and the negative impact of the disease.

Symptoms of chronic gastritis in pregnant women

Even if this disease reminded of itself for the last time in childhood or adolescence, then under the influence of a change in hormonal status, mechanical displacement of organs and other factors, an exacerbation of chronic gastritis in a pregnant woman occurs. There are no manifestations of its most diverse and specific symptoms characteristic of pregnant women.

The early manifestation and severe course of toxicosis in the first half of pregnancy should be alerted. Then dull pulling pains "under the spoon", belching with a "rotten egg", nausea and vomiting not only in the morning, but throughout the day, and stool disorders join. the body is subfebrile (37-38 ° C), the tongue is coated with a grayish bloom.

With gastritis with high acidity, severe "hungry" pains are characteristic, covering the upper abdomen. For low acidity, the most common complaints are heaviness in the stomach, constipation or diarrhea, and bad breath. Regardless of the disturbances in the secretion of gastric juice, unpleasant symptoms are aggravated by the intake of fatty, spicy, fried, salty, sour and sweet foods.

To confirm the diagnosis, it is enough to examine and study the history and complaints of the patient. Sometimes an analysis of gastric juice for acidity and FGS is carried out, and recently these two examinations are taking place simultaneously. Since gastroscopy is a rather unpleasant procedure, it is performed for pregnant women in special cases when treatment is ineffective or there are fears that it is developing. the abdominal organs helps to determine whether the pancreas, liver and gallbladder are involved in the process.

Treatment of chronic gastritis during pregnancy

Since the use of medications during pregnancy is limited for reasons of safety of the unborn child, diet becomes the basis of therapy. During an exacerbation, it is necessary to take food often and fractionally, in small portions. In the first week, it is necessary to use liquid and mashed food: slimy soups, mashed soups, liquid oatmeal cooked in water, mashed boiled lean meat. Carbonated drinks, sweets, broths and fresh vegetables and fruits are categorically excluded. After the acute period, you can gradually introduce milk soups and jelly into the menu, egg dishes - steam omelet, soft-boiled egg, steam cutlets and meatballs from meat and low-fat fish, porridge, non-acidic cottage cheese, stale white bread, biscuit biscuits, baked and boiled fruits and vegetables. Gradually, it is necessary to come to a balanced menu that is necessary for a pregnant woman and her unborn child, but with the exclusion of dishes and products that greatly irritate the gastric mucosa.

It should be remembered that medical treatment of chronic gastritis is prescribed only by a doctor after a thorough analysis of the relationship between the harm and benefits of treatment for the unborn child and taking into account the side effects. To protect the mucous membrane and relieve pain, Almagel or Maalox is recommended. The course of treatment is not more than 7 days. To improve digestion processes, enzyme preparations are prescribed - Pancreatin, Creon, Mezim. Such drugs as Gastrofarm, Hilak-forte and Laktovit help to stabilize the gastrointestinal microflora. The use of antibiotics, especially tetracyclines, was abandoned during pregnancy due to their teratogenic effect on the fetus. Antispasmodics - and platifillin, as well as an antiemetic drug, are prescribed only under the supervision of a doctor!

Decoctions of medicinal plants - chamomile, mint, flax seed decoction and oat jelly have a good effect on the stomach. You should not get involved in the treatment of mineral waters on your own - for high and low acidity, different mineral compositions are required, therefore, recommendations for each specific case can only be given by the attending gastroenterologist.

To treat or not treat gastritis during pregnancy

Chronic gastritis is not a contraindication for pregnancy. And, although the possibilities of therapy for this disease in pregnant women are somewhat limited, it must be treated.

If you leave the symptoms of the disease unattended, then over time, other digestive organs are involved in the local process, serious problems with the gallbladder and intestines appear. Lack of treatment for chronic gastritis can lead to the development of erosive gastritis, gastric ulcer and duodenal ulcer, and even to precancerous conditions. In pregnant women, a focus of constant pain leads to discomfort and deterioration of the psychological state, which can negatively affect the child. The constant disturbance of the digestive processes leads to the fact that the fetus does not receive enough substances necessary for its growth and development, especially in the early stages of embryonic development. Therefore, when planning a pregnancy, you must consult in advance with your gastroenterologist, if necessary, undergo full treatment and follow all recommendations for the prevention of recurrence of chronic gastritis while carrying a child.