A) The gastritis
The gastritis is an excess of heartburn or gastric acidity. It’s the inflammation of the gastric mucous (internal layer of stomach), inside the gastric camera (stomach) which becomes reddish and/or like subepithelial hemorrhages, affecting only one part of the stomach or the entire gastric camera or sphere. The gastritis can produce bleeding in the stomach walls, ulcers and erosion of the internal walls of the stomach. The main cause of the majority of gastritis is the presence of the bacterium Helicobacter Pylorus.

B)  Causas of gatritis
-    Abuse of intoxicate drinks and the tobacco.
-    Allergies to some foods.
-    Eat too much fast and without chewing well.
-    Consume very hot foods or too cold.
-    The erosion or weakness of the protector layer of the stomach covering.
-    Stomach infection with the bacterium Helicobacter pylorus.
-    Abuse of analgesics like Aspirin and anti-inflammatories (Piroxicam, Indomethacin).
About the use of Piroxicam, the Food and Drug Administration of USA (FDA) emitted a Guide, destinated to the public in general, where informs that the “non steroids anti-inflammatories”, between them the ibuprofen and Piroxicam “can increase the possibility of cardiac attacks or cerebrovascular accidents”, even, they can “cause gastrointestinal hemorrhages, which can come to death”. For such reasons, these medicaments “only have to be used in the lowest possible dose and for the briefest necessary lapse”. It’s good to consult your gastroenterologist about the use of the steroids anti-inflammatories.

1)  Common causes of Gastritis:
The less common causes of gastritis are:
-    Autoimmune disorders (like pernicious anemia).
-    Poisonings.
-    Reflux of bile to the stomach (bilious reflux).
-    Ingest or drink corrosive or caustic substances (like the toxic substances).
-    Excess of secretion of gastric acid (like the caused by stress).
-    Viral infection, especially in people with a weak immune system.

C)  Symptoms of gastritis
-    Abdominal pain (stomach).
-    Heartburn or gastric acidity (pyrosis).
-    Burning in the stomach.
-    Sensation of fullness (gastric fullness, easy satiety).
-    Persistent Anorexia.
-    Abdominal Indigestion.
-    Lost of appetite.
-    Nauseas, vomitings and burps.
-    Vomitings with blood or with aspect of coffee grains.

D)  Diagnosis of gastritis
The diagnosis of the gastroenterologist depends on the symptoms. When this is light; when you have abdominal pain, heartburn, burning in the stomach and/or sensation of fullness, it’s good to heal yourself with house-made recipes or medicinal plants: ASTOMACAL, fennel, camomile. If it’s more severe the gastritis, there’s presence of vomitings with blood, so you should go to the gastroenterologist immediately. A good diagnosis decided by a good gastroenterologist is helped with internal tests of the stomach like the endoscopy of the superior digestive apparatus. Also it helps the exam of the tissues (histopathologically) where it’s observed infiltration of polymorphonuclears (white corpuscles). Clinically there’s burning and pain in the epigastrium, accompanied by nauseas, sickness, etc. It’s frequent to find symptoms related to the gastroesophageal reflux, like heartburn. The burnings in the epigastrium give with the consumption of foods, above all milk. With the endoscopy we can determine if there’s hemorrhage and where it is, as well as the extension of the injury.

 

e)  Types of gastritis
From the point of view, also we can classify the gastritis, according the place of affectation in the interior of the stomach (cardia, body and antral). The gastritis can be classified histologically as acute or chronic, being based on the type of inflammatory cell. There isn’t any classification that agrees perfectly with the physiopathology.
The best and more practical classification; through endoscopy, which it divides in two main types: Erosive Gastritis and hemorrhagic; and, non erosive gastritis.

1) Erosive Gastritis and hemorrhagic: (Gastritis erosive hemorrhagic endoscopy)
The erosive gastritis is the second form of gastritis. It’s generated by the use of anti-inflammatory medicaments, non steroids, which habitually are used as analgesics, like the acetylsalicylic acid, fenoprofen, ibuprofen and naproxen. Also they are generated by the use and abuse of alcohol, of stress because of a surgery, of corrosive agents, or by injuries in stomach’s tissues from the ingestion of estrange bodies. The endoscopy shows that the superficial erosions which are observed, like some (acute erosive gastritis) or multiple (chronic erosive gastritis) punctiform injuries of the mucous which doesn’t penetrate in the deepest layers of the stomach. These injuries go accompanied frequently with some degree of hemorrhage, generally called submucous petequias.
The patients with erosive gastritis and hemorrhagic are critical sick and subdued to a great stress, like burned patients, patients in intensive therapy, neurological patients; and patients who ingest anti-inflammatory non steroids, by rheumatologic diseases like arthritis, alcoholic patients taking actively or as results of traumas located as the produced by the nasogastric tube. This type of patients requires prophylactic therapy. Less severe pictures are presented in patients under emotional tensions. The stress situation produces vascular constriction as an important mechanism in its development achieving the diminution of the blood flow in the gastric mucous and the inhibition of prostaglandins, which allows that the chlorhydric acid injures the gastric mucous. Generally they aren’t associated with abdominal pain on exception of when this is presented by the consumption of anti-inflammatories. Although it’s not the first cause of bleeding of high alimentary canal, when this is presented, it can be severe and requires surgery of emergency. The surgery of election is the superselective vagotomy, by laparoscopic via. The diagnosis of certainty is established by endoscopy and biopsy. As well as differencing of other causes of bleeding.
The erosive gastritis with bleeding demands an immediate treatment to stop the blood flow. The gastroenterologist must determine what action to take quickly. If it’s too abundant it can be introduced a tube in the stomach and goes through frozen water to contract the broken blood vessels. If the bleeding persists, you should realize an operation of emergency to remove the damaged part and in some cases the entire stomach.

2)  Non erosive Gastritis: (Gastritis non erosive bacterium helicobacter pylorus)
The non erosive Gastritis is an infection caused by the presence of the bacterium helicobacter pylorus which is found in the 90% of the patients with chronic gastritis. The bacterium Helicobacter pylorus has an external layer which is resistant to the normal effects of heartburn, very different to the other bacteria that die destroyed by the effect of heartburn. This capacity of resisting the heartburn allows you to stay months and even years, generating in the stomach, gastritis and if the bacterium helicobacter pylorus is not destroyed, it can generate stomach ulcers. This infection generates an inflammation of the gastric mucous, which in its turn alters the gastric secretor physiology, making that the mucous will be more susceptible to the injuries by the acid. The maximum concentrations of Helicobacter pylorus are detected in the antral gastric, where the confined infection increases considerably the risk of prepyloric and duodenal ulcer. In some patients the infection affects the entire stomach and seems to be associated with the subsequent development of gastric ulcers and of gastric adenocarcinoma.
This type of gastritis is a chronic process, very frequent in the entire world. In underdeveloped countries, the infection is acquired in the childhood; on the other hand, in developed countries it’s rare, but it increases with the age. However, only the 20% of people are infected with helicobacter pylorus and have non erosive gastritis, or gastric ulcers; and an 80% are carriers of the helicobacter pylorus in an asymptomatic way; this means, it doesn’t generate gastric symptoms. These asymptomatic cases can become symptomatic and generate gastritis when they appear other factors like the use of anti-inflammatory non steroids medicaments (piroxicam, indomethacin).
The main cause of non erosive gastritis is the infection by the bacterium helicobacter pylorus, which happens in the childhood, in most of the cases. The most frequent symptoms of non erosive gastritis are: abdominal pain and reduction of the acid secretion of the stomach; as well as, pyrosis, intolerance to the irritatings, spicies and citrics, meteorism and flatulence. To who develop atrophic gastritis, they include lost of weight, among other symptoms. If it doesn’t diagnose or treat on time, or advance as a silent infection, it can derivate in gastric cancer. It has been verified the association of the gastric cancer and the bacteria helicobacter pylorus.
The form of diagnose the presence of the bacterium helicobacter pylorus, is through an exam of urea in the exhaled air, that it detects with a range of accuracy of 90%. Another way of diagnose is through the endoscopy and biopsy; in general, this type of non erosive gastritis doesn’t present symptoms, it’s asymptomatic. Once detected the bacterium helicobacter pylorus, it should be occurred a therapy of eradication; sometimes there can be recurrence of the infection, transmitted by the saliva and the non purified water, the main reservoir are teeth, it’s important to treat the family’s members of the patients with the bacterium helicobacter pylorus and to insist in the decay’s therapy and dental brush. The treatment of the non erosive gastritis is oriented to eradicate the Helicobacter pylorus. In negative patients to the bacterium helicobacter pylorus, the treatment goes to the symptoms, using suppressive medicaments of acid (for example H2 blockers, inhibitors of the protons bomb) or antiacids.

3)  Other Types of Gastritis: 
Also there are two types of gastritis of importance, which we mentioned hereunder:

a)  Acute Gastritis by Stress:
Acute gastritis by stress is the most severe form. It used to be presented in critical patients, like those who are in the unity of intensive care. The erosions by stress can appear abruptly as result of a serious traumatism or aggressions on the interior cover of the stomach.

b)  Atrophic Gastritis:
It’s characterized by an atrophy or diminution of the size of the layer which recovers the stomach. It’s the disappearance of the folds, being observed the blood vessels of the mucous and the mucous wall has been lost in pieces or entirely. The atrophic gastritis is the final stage of a chronic gastritis and can be a precursor of the gastric cancer. It can be diagnosed by means of the endoscopy and biopsy.