Chronic gastroduodenitis code ICD. Chronic erosive gastritis: signs of this disease and its treatment Chronic erosive gastritis ICD code 10

According to the etiological mechanism of occurrence, acute endogenous and exogenous gastritis are distinguished.
The development of acute endogenous gastritis is associated with an infection present in the body. The most common etiological agent is the spiral-shaped bacterium Helicobacter pylori, which is detected in 80% of patients with acute gastritis. Helicobacter bacteria secrete various toxins and enzymes (urease, etc.), under the influence of which inflammatory reactions develop in the gastric mucosa. Helicobacter pylori infection also contributes to the development of gastric ulcers.
Less commonly, the causative agents of endogenous acute gastritis are streptococci, Proteus, staphylococci, E. coli, cytomegalovirus, pathogens of fungal infections (candidiasis, histoplasmosis, etc.), etc. Morphological and functional prerequisites for the development of acute gastritis occur with influenza, scarlet fever, measles, diphtheria, viral hepatitis, pneumonia. In rare cases, secondary acute gastritis develops with disseminated tuberculosis and secondary syphilis.
The etiological factors of acute exogenous gastritis are, first of all, food agents - thermal, mechanical, chemical. Irritation of the gastric mucosa by too hot, spicy or rough foods can cause the development of acute gastritis. Smoking, alcohol, and drinking strong coffee have an unfavorable damaging effect on the gastric mucosa.
Exogenous causes of acute gastritis also often include food poisoning caused by eating food contaminated with Salmonella, Shigella, Yersinia, and Klebsiella. In addition, irritation and damage to the gastric mucosa can be caused by long-term use of certain pharmacological drugs - salicylates, glucocorticoids, bromides, iron preparations, sulfonamides, antibiotics. Acute gastritis can develop during radiation therapy for stomach cancer (radiation gastritis), intentional or accidental ingestion of chemicals into the stomach (acetic, nitric, hydrochloric, sulfuric, acids; sublimate, ammonia, caustic soda, ethylene glycol, methyl alcohol; compounds iodine, arsenic, acetone, phosphorus, etc.). At high concentrations or a significant amount of toxic substances consumed, a burn or perforation of the wall of the stomach and esophagus may occur.
Acute allergic gastritis develops with individual intolerance to certain foods and is usually accompanied by other allergic manifestations - urticaria, angioedema, an attack of bronchial asthma, etc.

Today, more and more attention is paid to early and non-invasive diagnosis of atrophic gastritis. For this purpose, gastroenterologists have developed a special diagnostic panel. When performing conventional gastroscopy, it is not possible to identify foci of epithelial dysplasia, much less determine their area. Because of this, errors often arise associated with both overdiagnosis and underdiagnosis: the area of hyperplasia may be incorrectly assessed, and inflammatory changes may be mistaken for epithelial metaplasia. In order to correctly assess the area of the altered epithelium and take a biopsy from all altered areas, during gastroscopy the mucous membrane is stained (most often with methylene blue) - the dye is well perceived by areas with intestinal metaplasia.
The special Biohit hematology panel allows you to quickly and effectively determine the degree of epithelial metaplasia, atrophy of the mucosa and parietal glands, and avoid diagnostic errors. This panel examines the level of serum pepsinogen, determines the ratio of pepsinogen 1 to pepsinogen 2, histamine 17. A decrease in these indicators indicates pronounced atrophy of glandular epithelial cells, and a low level of gastrin 17 indicates the death of G-cells of the gastric glands.
At the same time, increased levels of gastrin 17 and pepsinogen 1 are often associated with Helicobacter pylori infection. A significant increase in the level of gastrin 17 is most often associated with autoimmune gastritis, in which achlorhydria or hypochlorhydria is observed, the function of the antrum of the stomach is preserved. If there are also foci of atrophy in the antrum (multifocal atrophy), then the levels of all these indicators will be low. This panel has at least 80% reliability, is used at the initial stages of the examination and allows you to determine the type of gastritis, its location and cause, identify a precancerous condition and determine the correct treatment tactics.
In comparison with a hematological panel and endoscopic examination with biopsy sampling, other methods for diagnosing atrophic gastritis are less informative. Thus, during gastrography, smoothness of the folds of the mucous membrane and slowing of gastric peristalsis are noted, its size is reduced. The same picture is found during an ultrasound of the stomach. Intragastric pH-metry detects a decrease in the acidity of gastric juice. To clarify the diagnosis, it is advisable to carry out daily acidity measurements. If malignancy is suspected, it is necessary to perform an MSCT of the abdominal organs to exclude a tumor process. It is also necessary to carry out all the necessary studies to detect infection with H. Pylori: PCR diagnostics of Helicobacter, a breath test, detection of antibodies to Helicobacter in the blood.

In the system of statistical recording of all nosological units, the code of chronic gastritis according to ICD 10 is of great importance.

This classification, which is revised every 10 years with the introduction of certain additions, allows for the following actions on a global and local scale:

Thanks to the international classification of diseases, doctors around the world can use the same data and share their own.

What is chronic gastritis

Acute gastritis in the urolithiasis is an inflammatory process involving the gastric mucosa, digestive disorders and damage to important layers of the gastric wall.

However, gastritis most often has a chronic course with exacerbations. Moreover, according to theories about the pathogenesis of the disease, inflammation is immediately long-lasting, which makes it possible to distinguish it as a separate nosology even in the ICD. There are three main types of the inflammatory process: A, B and C. The clinical picture of the morphological forms will be the same, but the treatment will be radically different.

Gastritis often occurs in combination with a pathology such as duodenitis, that is, inflammation of the duodenum. Even in the ICD, these pathologies are located in the same section next to each other. Combined the inflammatory process is isolated as a separate pathology– gastroduodenitis. The ICD 10 code for chronic gastroduodenitis is represented by the following symbols: K29.9, which is one of the items in the extensive section on inflammation of the stomach.

Position of the disease in the ICD system

Diseases in the international classification of diseases are in most cases divided into subsections according to etiology.

Thanks to this coding, it is possible to develop and use the latest types of pathology treatment.

For example, different types of gastritis require fundamentally different therapy. If the patient experiences a significant increase in secretion, then proton pump inhibitors must be used. If acidity is reduced, then the use of these drugs is unacceptable.

The first division in the ICD is in accordance with the lesion system. Gastritis belongs to the class of diseases of the digestive organs. The gastritis code in ICD 10 is presented as follows: K29. However, this section has 9 more subparagraphs, each of which is a separate nosological unit.

That is, K29 indicates that the patient has gastritis or duodenitis, but this is not enough to make a correct, complete diagnosis. The doctor finds out the etiology and understands the pathogenesis of the disease as much as possible, after which the final coding is carried out.

Options for the location of gastric inflammation in the ICD system:

K29.0 - is an acute inflammatory process with the obligatory presence of bleeding (in its absence, code K25 is set, that is, ordinary erosion);
K29.1 - this is how any acute gastritis is coded, except for the above;
K29.2 – inflammation of the stomach caused by alcohol consumption is isolated separately;
K29.3 - in ICD 10, erosive gastritis or superficial chronic gastritis is coded as follows;
K29.4 – this is how chronic inflammation of an atrophic nature is written;
K29.5 - represents a whole group of chronic nosologies, when it is not possible to clarify the etiology or type;
K29.6 – this includes a giant hypertrophic inflammatory process or a granulomatous lesion;
K29.7 - simply unspecified inflammation of the gastric membranes;
K29.8 – inflammation of the mucous membrane of the duodenum or duodenitis;
K29.9 – combined pathology in the form of gastroduodenitis.

In addition to the listed nosological units in the International Classification of Diseases, 10th revision, there are two exceptions that are in the same class, but in different sections.

These include: eosinophilic gastroenteritis and Zollinger-Ellison disease. This disease belongs to the pathologies of the pancreas and is an oncological process.

However, due to specific damage to the cells of the organ, increased production of gastrin occurs, which increases the secretion of hydrochloric acid by the stomach. Thus, the patient has all the signs of gastritis, but the etiology of the clinical picture has nothing to do with the stomach.

Mucosal atrophy

Chronic gastritis:

antral
fundamental

Giant hypertrophic gastritis

Excluded:

with gastroesophageal (gastroesophageal) reflux (K21.-)
chronic gastritis caused by Helicobacter pylori (K29.5)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

ICD code 10 chronic erosive gastritis

Erosive gastritis, ICD code 10

Are you still suffering from GASTRITIS? It is necessary to treat not the effect, but the cause, says Olga Kirovtseva.

The healthcare system uses the international classification of diseases ICD-10. But the average person does not always understand how this phrase is related to the disease.

Everything is very simple. This classification is intended to provide statistics on all existing diseases and health-related problems. And the number 10 in this phrase indicates the frequency with which this statistical information is collected (10 years).

Very often among the types of gastrointestinal tract there is erosive (hemorrhagic) gastritis or bulbitis. This disease is not only unpleasant, but also dangerous. Indeed, with its development, the entire gastric mucosa is affected by small, but quite numerous erosions, which not only cause pain, but also bleed quite often.

According to the ICD, the code for chronic gastritis is K-29.0. For the average person, this is an ordinary set of letters and numbers, but for a doctor it says a lot. Just seeing it in a medical document, a gastroenterologist will immediately say that it is acute erosive gastritis, complicated by bleeding.

It is dangerous because it is a precursor to ulcers. and if treatment is ignored, it quickly develops into it. Its development is accompanied by inflammation in certain areas of the stomach and focal lesions appearing there, which have very thin, often bleeding, vessel walls.

With a gastrointestinal disease such as bulbitis, the ICD code can tell the doctor not only about the symptoms of the disease, but also allows him to make an assumption about its possible preconditions, and, therefore, eliminate factors that will interfere with treatment. And the causes of chronic erosive gastritis are different. Among the main ones are the following:

Poor nutrition, constant snacking, eating fast food and sweet soda;
Alcohol abuse and smoking;
Constant stress, unfavorable living or working conditions.

Before starting treatment for erosive gastritis. the cause that provoked it should be removed, otherwise no medications or procedures will give a positive result.

If a sick person sees the ICD-10 code, erosive gastritis, in his medical documents, a description of it, if desired, can be found in a reference book containing information about various diseases.

But it is worth firmly remembering that any self-medication for this disease is fraught with serious complications. All medical prescriptions are the prerogative of the doctor! And the ICD was created only for medical specialists.

It is needed in order to have optimal conditions for processing and analyzing all statistical data obtained from different regions and countries on morbidity and mortality. In ICD-10, verbal diagnoses are converted into an alphanumeric code, which greatly facilitates not only analysis, but also storage and retrieval of data.

By secret

Are you tired of stomach pain, nausea and vomiting...
And this constant heartburn...
Not to mention bowel disorders, alternating with constipation...
It’s sickening to remember the good mood from all this...

Elena Malysheva: Gastrointestinal diseases go away instantly! An amazing discovery in the treatment of ulcers, gastritis, pancreatitis, colitis, dysbacteriosis, intestinal infections and many other diseases. .

Hello, my dear!

For many years now I have been appearing on your TV screens every day and more than once we have talked about problems of the gastrointestinal tract. A lot has been said about methods of treating stomach diseases! In our program, we often talk about surgery and medicinal procedures, but we very rarely touch upon traditional methods. And not just recipes from grandmothers, but what was recognized in the scientific community, and of course, recognized by our TV viewers. Today we will talk about the healing effects of teas.

Surely you are now at a loss about what other healing teas we can talk about in the treatment of the gastrointestinal tract? Indeed, ordinary tea can help in the treatment of such serious diseases as ulcers, gastritis, pancreatitis, etc. If you remember, several issues ago I talked about the possibility of triggering the regeneration of the body by influencing certain receptors of the cells of our body. So, to heal the gastrointestinal tract and more, you need to start the return process, that is, return the cells to their original state. After all, medicine, for the most part, is a struggle with the investigation. But it is necessary to eliminate exactly the cause and return the body to its original state. That is why, after taking the correct dosage of certain substances contained in the Monastic Tea drink. Almost all patients feel light, as if they were born again. Men, in turn, felt a surge of strength, lasting potency, a powerful surge of energy, and began to get better sleep.

Tea therapy helps to cope with such terrible diseases as ulcers, gastritis, colitis, pancreatitis, dysbacteriosis, stool problems, etc. When we have problems, gastrointestinal diseases destroy the body, and when everything is fine, the body comes into tone. That is, the entire system directly affects the state of the body. And this connection helps fight the disease as effectively as possible.

And how does it work, you ask? Will explain. Tea therapy, with the help of specific substances and antioxidants, affects certain receptors that are responsible for its regeneration and performance. Information about diseased cells is rewritten to healthy ones. As a result, the body begins the healing process, namely, it returns, as we say, to the point of health.

At the moment, there is only one center that collects and sells this Monastic Tea - this is a small monastery in Belarus. They talk about him a lot both on our channel and on others. And not in vain, I tell you! This is not just any ordinary tea, but a unique mixture of the rarest and most powerful natural healing substances. This tea has proven its effectiveness not only to patients, but also to science, which has recognized it as an effective drug. Diseases of the gastrointestinal tract go backwards, as studies have shown. The main thing is to strictly follow the instructions in the method!

We invited Igor Krylov to the studio, one of the thousands of patients who were helped by Monastic Tea:

Igor Krylov: Every day I felt improvement. The ulcer was receding by leaps and bounds! In addition, there was a general improvement in the body: pancreatitis stopped bothering me, I could afford to eat almost whatever I wanted. I believed it! I realized that this is the only way out for me! Then it was all over, the headaches went away. At the end of the course I became absolutely healthy! Fully. The main thing in tea therapy is its complex effect. Classic treatment does NOT remove the ROOT CAUSE of the disease, but only fights its external manifestations. And Monastic Tea RESTORES THE WHOLE BODY, while our doctors are always bombarded with complex, incomprehensible terms and are always trying to sell expensive drugs that are of no use... As I already said, I tried all this on myself personally

Elena Malysheva: Igor, tell us more about the treatment process!

Igor Krylov: I couldn’t go to the Belarusian monastery itself, so I ordered Monastic Tea on this website. To receive it, fill out your details on the website, leave your working phone number so that they can contact you and discuss the details. I received the tea 4 days later, it came in a closed envelope, without identification marks. The product costs a penny compared to the price I spent on treatment and would have spent even more if I had not ordered this tea! There are instructions, so the technique can be easily understood. Already after the first dose, improvement is felt. Try it yourself and you will understand me.

Elena Malysheva: Thank you Igor, our operators will post a link to the website of the Belarusian Monastery so that you can place an order.

As you can see, the path to health is not so difficult. You can order monastery tea here. This is the official website.

Original Monastic Tea can only be ordered on the official website, which is published below. This product has all the necessary certificates and is tested for effectiveness. There are a lot of fakes in the CIS countries, ordering which you will not get the effect.

Comments for July:(47/47)

How I cured a stomach and duodenal ulcer in 1 week

I never thought that I would write public appeals, but I can’t help but brag about my discovery. Let me get ahead a little and say that I finally found a really working method that saved me from stomach and duodenal ulcers!

Therefore, my dears, let us arm ourselves with patience and take into account what has been said. I am sure that you, like me, are tired of wasting money and time on useless medications that bring absolutely no benefit, but only flush money, sorry, down the toilet. Right now, take all the pills and throw them in the trash. because you won't need all this anymore! Never! All ulcers, gastritis, and any disease of the digestive organs will disappear forever!

Threw it away? Then let's get started!

I was diagnosed with a stomach and duodenal ulcer 4 years ago. Presence of Helicobacter pylori and weak mucous membrane. As I already said, I have experienced everything that is available today. I periodically felt better, and I believed that the disease had receded. However, everything came back again. And the further it goes, the worse and worse it gets.

And the worst thing is constant “probes” (EGD), abdominal pain, diets, hospitals. Increased secretions of gastric juice and bile at any time of the day - the stomach and duodenum were destroying themselves! There was bleeding several times, I was even afraid that it might lead to surgery or worse. Against the backdrop of all this, the immune system has weakened. I felt completely overwhelmed, weak, tired quickly, and was constantly drowsy. I just didn't want to live.

Doctors shrugged their shoulders and prescribed more and more new medications, which became more and more expensive. It feels like they were deliberately siphoning off money!

But to hell with the money, if it helped! But there was no effect! There were only temporary improvements and a lot of side effects.

Faith in traditional medicine is lost! Go ahead.

When faith in traditional medicine was lost, I began searching for all possible non-traditional methods of treatment that exist.

I went to the grandmothers, listened to all sorts of whispers and all that - it’s useless!

I dug up all sorts of ancient recipes, collected herbs with my own hands, dried them, mixed them and brewed them to take infusions - it didn’t help!

I signed up for sessions with hereditary magicians and sorcerers, and also visited all sorts of psychics - this is just pumping out money! Imagine, they sometimes confused which disease I wanted to be cured of!

God's Reward for Patience

Despite all the failures, I did not give up. I continued to search and try new methods.

Despite the futility of my efforts, I did not lose hope. Although I had no strength left, to be honest.

And I swore to myself that if I found a way to recover, I would do everything possible to tell as many people as possible about it. suffering from ULCERS! And also from other diseases of the digestive organs!

Probably, God rewarded me for my patience and sent me help from above in treating the ulcer.

Has a cure for ulcers been found?!

In general, purely by chance, I came across some blog on the Internet, where my friend in misfortune talked about how she solved a similar problem and referred to the site where she acquired this invaluable information.

I went to this site. Stomach tea is a rare type of tea prepared according to a monastery recipe, which heals with the help of its unusual properties.

This tea is collected and produced in a Belarusian monastery, and most importantly, it cures the body of any disease of the gastrointestinal tract - this is a natural process.

I was especially struck by the fact that on that website it was written that this tea heals completely. and not somehow partially. That is, a recovery mechanism is launched, as it were. All diseased cells and infection disappear. and it doesn’t matter whether you know about them or not! You're just getting better!

At first I thought (as you are probably thinking now) - what nonsense! Another money grab. However, I decided to thoroughly familiarize myself with Stomach Tea according to the monastery recipe.

In addition, it turned out that the price of tea is so ridiculous that it is very, very difficult to call it a money grab.

But it wasn’t the money that worried me at all - I had already spent 30 times more on other methods. I was worried about something completely different! Namely, will there be a result?

Having visited the official website of Stomach Tea, I placed an order!

Results. Have the stomach and duodenal ulcers gone away?

It sounds like a fairy tale, but I felt better already on the second day of drinking the tea. This was not a cure yet, of course, but I felt a surge of strength and energy. It became easier to breathe, move, the discomfort in the abdominal area almost disappeared. For some reason I wanted to smile and sing.

On the 4th day of use, I began to feel light after eating, the feeling of drowsiness and fatigue went away, I became cheerful, I had the strength to talk and walk down the street.

After another 3 weeks, I felt that I didn’t need diets and pills. All symptoms of stomach and duodenal ulcers are gone. THE ULCER IS CURED. I didn't need tests. I just knew it! But my son finally dragged me to get tested for a “probe” (EGD). Absolutely healthy stomach and intestines, no bacteria! We waited a month, did tests and a probe again. Everything is okay! That's it, goodbye ULCER. All diagnoses have been removed and points have been drawn.

Moreover, I am not bothered by a bunch of concomitant ailments that were the result of medical treatment!

I feel like I’m 10 years younger. And people around me say that now I feel like I’m flying. But I really fly - I finally began to live a full life as a truly healthy person WITHOUT AN ULCER!

So, the official website of Stomach Tea is located at this link. order tea only on this site, because on others there is a chance of running into unlicensed products. The price of tea is a pittance, and is equal to 3 packs of tablets that I was treated with, which are essentially of no use. The choice is yours.

Thank you all for your attention! Friends, who knows about this Stomach Tea - write your reviews. It would be very interesting to know who else it helped.

A positive result from drinking stomach tea was recorded in 97% of patients.

Erosive gastritis

Erosive gastritis is erosion of the gastric mucosa caused by damage to the protective factor of the mucous membrane. This disease of the gastrointestinal tract is usually acute, complicated by bleeding, but can be subacute or chronic with mild symptoms or the absence of any signs. The diagnosis is made by endoscopy. Treatment of erosive gastritis is aimed at eliminating the cause of inflammation.

For some ICU patients (eg, mechanical ventilation, head trauma, burn injury, combined trauma), it is advisable to prescribe acid-suppressing drugs to prevent erosions.

ICD-10 code

What causes erosive gastritis?

Causes of erosive gastritis include nonsteroidal anti-inflammatory drugs, alcohol, stress and, less commonly, radiation, viral infection (eg, cytomegalovirus), vascular disorders, and direct mucosal trauma (eg, nasogastric intubation).

Erosive gastritis is characterized by superficial erosions and pinpoint damage to the mucous membrane. They can develop 12 hours after the initial injury. Deep erosions, ulcers and sometimes perforation can occur in severe cases of the disease or when left untreated. Damage is usually localized in the body of the stomach, but the antrapium may also be involved in the process.

Acute stress gastritis, a form of erosive gastritis, develops in approximately 5% of critically ill patients. The likelihood of developing this form of gastritis increases with the length of the patient's stay in the ICU and depends on the length of time the patient does not receive enteral nutrition. The pathogenesis likely involves hypoperfusion of the gastrointestinal mucosa, leading to the destruction of the mucosal protective factor. In patients with traumatic brain injuries or burns, there may also be an increase in acid production.

Symptoms of erosive gastritis

Moderate erosive gastritis is often asymptomatic, although some patients complain of dyspepsia, nausea or vomiting. Often the first manifestation may be hematomesis, melena or blood on nasogastric intubation, usually within 2-5 days after exposure to the etiological factor. Bleeding is usually moderate, although it can be massive in cases of deep ulceration, especially in acute gastritis as a result of stress.

Where does it hurt?

Diagnosis of erosive gastritis

Acute and chronic erosive gastritis are diagnosed by endoscopy.

What needs to be examined?

Who to contact?

Treatment of erosive gastritis

In severe gastritis, bleeding therapy requires intravenous transfusion of fluids and, if indicated, blood. Endoscopic hemostasis should be performed; surgical treatment (total gastrectomy) is indicated only as a last resort. Angiography is unlikely to be effective in stopping severe gastric bleeding due to the multiple gastric collaterals. Acid suppression should be started immediately if the patient has not received this treatment.

With moderate gastritis, excluding the etiological factor and using medications that reduce gastric acidity may be sufficient.

Medicines

How to prevent erosive gastritis?

Prevention of erosive gastritis can neutralize the effect of stress on the development of acute gastritis. However, this primarily concerns patients at high risk and requiring intensive care, including patients with severe burns, CNS injuries, coagulopathy, sepsis, shock, polytrauma, mechanical ventilation for more than 48 hours, hepatic or renal failure, multiple organ dysfunction, and peptic ulcer or gastrointestinal tract. - history of intestinal bleeding.

Erosive gastritis can be prevented by following preventive measures that are aimed at increasing the pH of the stomach above 4.0 and consists of intravenous administration of H 2 blockers, proton pump inhibitors and oral antacids. Repeated pH measurements and changes in prescribed therapy are not required. Timely enteral nutrition can also reduce the likelihood of bleeding.

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University named after. A.A. Bogomolets, specialty - “General Medicine”

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ATTENTION! SELF-MEDICATION CAN BE HARMFUL FOR YOUR HEALTH!

Be sure to consult with a qualified specialist so as not to harm your health!

Erosive gastritis of the stomach

Erosive gastritis of the stomach is an inflammatory process accompanied by destruction (erosion) of areas of the gastric mucosa. Inflammatory processes that occur in the human stomach are generally called gastritis. Erosive gastritis is considered a more severe form of the disease than ordinary gastritis and, due to its specificity, is much more difficult to treat. It is impossible not to treat erosive gastritis, as this can lead to severe bleeding throughout the entire eroded surface. Such bleeding is extremely dangerous to human health.

Symptoms of erosive gastritis of the stomach

It is very difficult to diagnose erosive gastritis based on its symptoms, since its symptoms are no different from the symptoms of other types of gastritis. The only exceptions are those cases in which gastric bleeding is observed. In this case, with the diagnosis everything becomes simpler and obvious.

In general, the symptoms of erosive gastritis can be described as follows:

Pain in the gastric projection (upper abdomen). As a rule, this pain is not severe. However, if the processes have gone far, it is possible to eliminate pain from erosive gastritis only with the help of strong analgesics;
Heartburn. Gastritis is almost always accompanied by this symptom, the appearance of which is associated with reflux of stomach contents into the lower parts of the esophagus. Since gastric juice contains hydrochloric acid, the patient experiences a burning sensation;
Very often, erosive gastritis is accompanied by dyspeptic disorders in the form of belching (rotten, sour or bitter), as well as diarrhea;
The patient may experience severe pain in the morning when he eats his first meal of the day. At this time, gastric juice irritates the receptors at the bottom of the erosions, which leads to pain.

Erosive-hemorrhagic gastritis

Often, erosive gastritis develops into another form of gastritis - erosive-hemorrhagic gastritis. This disease is considered to be a complication of erosive gastritis. With this form of the disease, bleeding is possible. The strength of these bleeding depends on the depth of the erosion and its location.

The most dangerous areas for erosion are areas located on the field of lesser curvature, where there are a large number of large blood vessels with high blood flow intensity.

This form of gastritis is characterized by the following symptoms:

Reduction of pain, and the intensity of pain decreases in proportion to the severity of bleeding; the stronger the bleeding, the less pain. This is easily explained by the fact that in the patient, in places of erosion, tissue areas are destroyed along with receptors capable of perceiving pain;

Vomit. This sign is always present. The stronger the lesion, the more intense the vomiting. A characteristic feature of vomit in hemorrhagic gastritis is its brown color due to the blood trapped in these masses;
Characteristic signs are also signs of anemia (pale skin, rapid pulse, low blood pressure, dizziness);

Dark feces Its color is due to stool entering the stool. In most cases, dark stool is the first sign of the disease, since vomiting usually occurs later.

Causes of erosive gastritis

There are many causes of the disease, however, the most common causes of erosive gastritis are:

Getting bad, low-quality food into the stomach cavity;
Ingestion of toxic compounds (including alcohol);

Violation of the secretory-motor functions of the stomach;
Helicobacter infection;
Side effects of medications.
Secondary causes of erosive gastritis include:
Diabetes;
Hyperfunction of the parathyroid gland;
Hormonal status problems;
Crohn's disease;
Problems in the functioning of the cardiovascular system;
Stomach cancer.

Erosive gastritis code according to ICD 10

According to the International Classification of Diseases, Tenth Revision (IBC10), erosive gastritis with bleeding (hemorrhagic gastritis) has code K29.0.

Diagnostics

Timely diagnosis of erosive gastritis is the key to its correct and effective treatment.

It is believed that the most effective way to diagnose this disease is endoscopy and biopsy of the surface of the mucous membrane. The endoscopy procedure begins with preparing the patient by treating the mouth and oropharynx with a special anesthetic, and, if necessary, administering sedatives to the patient. After this procedure, an endoscope (a camera with a light source) is inserted into the stomach through the mouth through a long and thin tube. If necessary, a small area of the mucosa can be taken for analysis.

In addition to endoscopy and biopsy, doctors can resort to other diagnostic methods:

X-ray examination, which is carried out using barium salts. By drinking a drug containing barium salts, the patient gets relief
examines the surface of the mucosa for the presence of erosions, ulcers and neoplasms;
Analysis of stool for the presence of occult blood;
Analysis of blood and exhaled air for the bacteria Hilicobacter pylari;
General blood analysis.

Treatment of erosive gastritis

After the cause of gastritis is determined, the attending physician decides on a treatment strategy.

Depending on the circumstances, treatment options may include:

Correction of gastric juice secretion. For this purpose, drugs that block histamine receptors or proton pumps are used. The first include Famotidine, Quamatel and Ranitidine. The second group includes Controloc, Omez, Proxium, Lansoprazole;
Neutralization of hydrochloric acid produced in the stomach itself. For this, Venter, Maalox, Rennie, Almagel, and Phosphalugel are most often used. The advantages of these drugs include their ability to form a protective film, under which tissue restoration processes proceed faster;
Facilitation of digestion is achieved by using the drugs Mezim, Creon, Pangrol, Festal, Panzinorm;
Restoration of normal motility of the stomach and duodenum. To achieve this, the drugs Motilium, Cerucal, Domperidone, Metoclopramide are used;
In severe cases with bleeding, drugs to stop bleeding are used. These are Dicynone, Thioctic acid, Etamsylate, Vikasol;
If the cause is the bacterium Hilicobacter Pilari, then Metronidazole, De-Nol, Clarithromycin, Ornidazole, Pilobact Neo, Amoxicillin, Clatinol are used;
Good results are obtained from sanatorium-resort treatment using mineral water.

Diet for erosive gastritis

Doctors rightly believe that it is impossible to cure erosive gastritis without a special diet. In the acute phase of the disease, the so-called “Table” is used in medical practice. With improvement, the patient is gradually transferred to the “Table No. 5” diet.

These diets are based on the following principles:

A ban on foods and dishes that stimulate increased gastric secretion and, accordingly, cause irritation of the mucous membrane. It is fried, fatty, peppery, salty;
All products must be absolutely fresh, and their heat treatment must be steamed or cooked;
Meals should be frequent, fractional, very small portions;

You should only eat warm foods, preferably in a liquid or “mushy” state. You should also not eat cold food; it is just as dangerous for erosive gastritis as hot food;
The ban includes buns, fresh bread, muffins, chocolate, cookies, lard, sausages, as well as other products containing animal fat;
Stale bread, both black and white, porridge (except wheat and barley), mashed potatoes, soups, dietary meat (rabbit, chicken, young beef), and fish are allowed.

A sample menu for the day might look like this:

First breakfast. Cheese casserole. Cocoa;
Lunch. Tea without sugar, a piece of bread with butter;
Dinner. Soup based on meat (preferably chicken) broth. Steamed vegetables with a piece of fish (also steamed);
Afternoon snack. Crackers with a glass of jelly;
Dinner. Baked vegetables. Dried fruits compote.
Second dinner. A glass of yogurt, kefir or fermented baked milk.

Prevention

Prevention of the occurrence and development of erosive gastritis is associated, first of all, with the elimination of factors contributing to the occurrence of the disease. According to doctors, the primary issue in this regard is the issue of organizing a balanced diet. It is very important that the body receives the required amount of proteins, fats and carbohydrates without bias towards one of these groups of organic substances.

In addition to the quantity and quality of food, a very important factor in prevention is the time at which food is consumed. The timing must be strictly defined, and maintaining a diet is also a key factor in the prevention process.

One of the prohibitions that should be observed is the prohibition of overeating, as well as eating immediately before bed. You should also avoid on-the-go snacks, dry meals and long breaks between meals. It is very important to avoid foods that are too hot or cold.

It should also be remembered that alcohol (in any form) provokes the disease. Nutritionists believe that food hygiene is an important factor in preventing the development of gastritis. Indeed, with gastritis, special attention is paid to the quality of products and the rules of their storage.

One of the most important requirements in the prevention of gastritis is preparing food for one day, without long-term storage. This is the rule that is most difficult for many people to follow. You should not include in your diet foods that can cause dyspeptic disorders.

Another important component of the prevention of gastritis is maintaining hygiene and timely treatment of the oral cavity, and more precisely the teeth. This is especially true for caries, as well as timely removal and prosthetics. The presence of infections in the mouth and nasopharynx (sinusitis, tonsillitis) has an extremely negative effect on the course of erosive gastritis.

As with other diseases of the gastrointestinal tract, stress and exercise aggravate the course of the disease. Creating a physical and psycho-emotional comfortable state for the patient is a primary task for effective prevention and treatment of the disease.

Folk remedies in the fight against erosive gastritis

Erosive gastritis is a common disease, which means that traditional medicine has a huge arsenal of means to combat this disease. You should not think that traditional medicine is an alternative to drug treatment, it is not. Traditional medicine can contribute to treatment, significantly shorten the time of treatment and rehabilitation, but in no way replace treatment with a doctor.

Among the most popular ways to combat the disease are the following recipes:

Treatment with sea buckthorn oil. It is well known that sea buckthorn oil is very effective in treating wounds and erosions. To treat erosive gastritis, you can use sea buckthorn oil, either home-made or oil purchased at a pharmacy. Take sea buckthorn oil every morning on an empty stomach, a teaspoon for two to three weeks;
Treatment with propolis. For gastritis accompanied by severe pain, the use of propolis tincture has a good effect. It is recommended to take an alcohol tincture of this beekeeping product right before meals, 20 drops diluted in a glass of warm water. Practice shows that after the first day of use, pain subsides. It is recommended to continue the course of treatment with propolis tincture for 21 days;

Treatment with wheat sprouts. It is recommended to rinse several handfuls of wheat grains with warm water and then place them in an even thin layer on gauze. After this, you need to cover the grains with another layer of gauze and leave for three days, moistening the top layer of gauze with water every day. After three days it will become noticeable that the wheat has sprouted; it is the wheat sprouts that are collected and crushed. Six tablespoons of crushed wheat germ are mixed with two tablespoons of olive oil and placed in a glass container. Take the mixture for five days exactly one hour before breakfast. A single portion of the mixture for administration is a teaspoon.
Treatment with honey and aloe. To prepare the medicine, you need to take five large aloe leaves (the plant does not need to be watered for two weeks beforehand, and the plant must be at least three years old) and five tablespoons of honey. The leaves are placed in the freezer for a day and only after that are ground in a meat grinder. After squeezing the resulting juice, mix it with honey. It is believed that honey relieves the manifestations of the inflammatory process, and aloe heals erosions well. Take a teaspoon of the mixture on an empty stomach immediately after the person wakes up. Treatment takes at least three weeks;

Treatment with mummy. If erosive gastritis cannot be treated with other methods, you can try a potent drug - mumiyo. To do this, dissolve one pea (the size of a match head) of mumiyo in a glass of warm milk. Add a tablespoon of honey to the mixture and mix everything thoroughly. The resulting mixture is drunk. The course of treatment is two weeks. You should drink two glasses of the mixture per day, in the morning on an empty stomach and in the evening before bed. After two weeks of taking the drug, a break is taken for five days. Then the course should be repeated. A total of three courses of treatment are allowed;

Treatment with milk and chamomile. Five spoons of dried chamomile flowers are placed in an enamel pan. Then it is poured with one glass of milk and brought to a boil. After everything has cooled, the broth is filtered through cheesecloth. The decoction should be taken for five days, drinking a glass of decoction on an empty stomach early in the morning;
Treatment of erosive gastritis with herbal tea for low acidity. In this case, it is recommended to take 50 grams of chamomile flowers, licorice rhizomes and marshmallow root, as well as fennel fruits. All ingredients should be crushed. After this, a tablespoon of the collection is brewed with a glass of boiling water and filtered. You should drink half a glass of the decoction four times a day before meals. The course of treatment is three weeks;
Treatment of erosive gastritis with herbal remedies for high acidity. To prepare the decoction, take 20 grams of the herb marshweed, chamomile and calendula. The ingredients are crushed. A tablespoon of the resulting mixture is poured with 300 milliliters of boiling water and left for 12 hours. After this, the broth must be filtered. Take one tablespoon of decoction before meals three times a day. The course of treatment is three weeks.

Before starting treatment with one or another traditional medicine, you should seek advice from your doctor in order to avoid unpleasant incidents.

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Diseases of the gastrointestinal tract

ICD 10 chronic erosive gastritis

ICD-10 code, erosive gastritis: symptoms and treatment

Stomach diseases are unpleasant and painful ailments that affect appetite, good mood and active performance. They cause inconvenience in everyday life and cause severe and painful complications.

One of these types of gastrointestinal disease is erosive gastritis (classification and code according to ICD-10 will be discussed in this article). You will also find answers to important and interesting questions. What are the causes of the disease? What symptoms accompany the disease? And what methods of treatment exist?

However, before learning more about the disease, let's get acquainted with the International Classification of Diseases and determine what code is assigned to erosive gastritis (according to ICD-10).

Worldwide systematization

The International Classification of Diseases is a normative document that ensures worldwide uniformity of methods and materials. In the Russian Federation, the healthcare system made the transition to the international classification back in 1999.

Is there an ICD-10 code for erosive gastritis? Let's find out.

Classification of gastritis

According to this systematization, recognized both in our homeland and throughout the world, ailments of the digestive organs are classified according to the following designations: K00–K93 (ICD-10 code). Erosive gastritis is listed under the code K29.0 and is diagnosed as an acute hemorrhagic form.

There are other forms of this disease, and here are the designations assigned to them:

K29.0 (ICD-10 code) – erosive gastritis (another name is acute hemorrhagic);
K29.1 – other acute forms of the disease;
K29.2 – alcoholic (provoked by alcohol abuse);
K29.3 - superficial gastritis in chronic manifestations;
K29.4 – atrophic in chronic course;
K29.5 – chronic course of antral and fundal gastritis;
K29.6 – other chronic diseases of gastritis;
K29.7 – unspecified pathology.

The above classification indicates that each type of disease is assigned its own ICD-10 code. Erosive gastritis is also included in this list of international ailments.

What kind of disease is this and what are the causes of its occurrence?

Briefly about the main disease

As mentioned above, erosive gastritis of the stomach (ICD-10 code: K29.0) is a fairly common disease of the gastrointestinal tract, characterized by the appearance of a large number of erosions (red round formations) on the mucous membrane.

This pathology most often manifests itself in an acute form and is complicated by internal bleeding. However, chronic erosive gastritis is also diagnosed (ICD-10 code: K29.0), which can manifest itself in a sluggish form of the disease or not be accompanied by symptoms at all.

This type of gastrointestinal ailment is considered the longest, considering the time spent on treatment. It is most often observed in adult patients, especially men.

What are the reasons for its origin?

Disease provocateurs

According to medical research, erosive gastritis (ICD-10 code: K29.0) may be a consequence of factors such as:

the influence of bacteria (for example, Helicobacter pylori) or viruses;
long-term use of certain medications, including nonsteroidal anti-inflammatory drugs;
long-term alcohol or drug abuse;
prolonged stress;
diabetes;
pathological changes in the thyroid gland;
chronic diseases of the heart, respiratory system, blood vessels, kidneys, liver;
unhealthy diet, irregularities;
harmful working conditions or places of residence;
gastric oncology;
impaired blood circulation in this organ;
hormonal disbalance;
mucosal injuries.

Classification of the disease

Depending on what causes the disease, erosive gastritis (ICD-10 code: K29.0) is divided into:

primary, occurring in practically healthy people;
secondary, resulting from serious chronic diseases.

The following are the forms of this disease:

Acute ulcerative. May occur due to injuries and burns to the stomach. Manifests itself in bloody impurities in vomit and feces.
Chronic erosive gastritis (ICD-10 code: K29.0) is characterized by alternating exacerbations and remissions of the disease. Erosive tumors reach five to seven millimeters.
Antral. Affects the lower part of the stomach. Caused by bacteria and pathogens.
Reflux. A very severe form of the disease, accompanied by the release of exfoliated organ tissue through vomiting. Ulcers can reach one centimeter.
Erosive-hemorrhagic. Complicated by severe and profuse bleeding, leading to probable death.

How does the underlying disease manifest itself?

Symptoms of the disease

In order to seek qualified medical help in time, it is very important to recognize the first symptoms of erosive gastritis as early as possible (ICD-10 code: K29.0). The main signs of this disease are listed below:

Acute spasmodic pain in the stomach, worsening as new ulcers form.
Severe heartburn (or burning in the chest area), not associated with meals.
Constant feeling of heaviness in the stomach.
Sudden and severe weight loss.
Intestinal disorder (alternating constipation with diarrhea, blood in stool, black feces - indicates gastric bleeding).
Belching.
Bitter taste in the mouth.
Lack of appetite.

These manifestations are characteristic of acute erosive gastritis (ICD-10 code: K29.0). If you experience several of the signs mentioned above, even the most insignificant ones, then you should immediately contact a medical facility.

However, it must be remembered that chronic (chronic) erosive gastritis (ICD-10 code: K29.0) is practically asymptomatic. Its first visible manifestations may be bloody discharge during vomiting and bowel movements.

How is the disease diagnosed?

Definition of illness

The symptoms of erosive gastritis are in many ways similar to the manifestations of diseases such as oncology, stomach ulcers, and varicose veins in this organ.

Therefore, it is very important to carry out a correct diagnosis of the disease in order to establish the real diagnosis as accurately as possible. What will the medical examinations include?

A possible next stage of diagnosis would be an x-ray of the abdominal organs. This examination is performed in several projections, taking into account the different positions of the patient’s body (standing and lying). Half an hour before the procedure, the patient will need to put several Aeron tablets under the tongue to relax the organ being studied.

You may also need to conduct an ultrasound examination of the gastrointestinal tract, carried out in two stages on an empty stomach. First, an examination of the internal organs will be performed at rest. The patient will then be asked to drink a little more than half a liter of water, and the ultrasound will continue.

All of the above manipulations are very important. However, the most effective diagnostic method is endoscopy.

Gastroscopy

The essence of this procedure is as follows: an endoscope is lowered inside, through the mouth opening - a flexible tube, at the ends of which a camera and an eyepiece are located.

Thanks to what he sees, the specialist will be able to assess the full picture of the disease, recognize all the subtleties of the disease and prescribe the only correct treatment.

What will it consist of?

Drug therapy

Treatment of erosive gastritis (ICD-10 code: K29.0) is based on the following basic principles:

destruction of the causative bacteria (“Clarithromycin”, “Pilobact Neo”, “Metronidazole”, “Amoxicillin”);
reducing the aggression of hydrochloric acid (“Almagel”, “Maalox”, “Rennie”);
promoting proper digestive processes (“Mezim”, “Pangrol”, “Festal”);
normalization of acidity (“Famotidine”, “Omez”, “Controloc”);
stopping bleeding (“Etamzilat”, “Vikasol”);
use of antibiotics;
relieving painful spasms and sensations.

These drugs are also used for exacerbation of erosive gastritis (ICD-10 code: K29.0). The attending physician will prescribe individual therapy, which will need to be used in accordance with the prescribed dosage and schedule of taking the medications.

However, any drug treatment will be ineffective if you do not monitor proper nutrition.

Diet

Here are the basic principles of the diet for patients with gastritis:

do not eat fatty, fried and smoked foods;
It is forbidden to consume flour, sweets, spices;
balanced use of vitamins;

It is recommended to prepare dishes by steaming;
meals should be frequent (about six times a day);
portions should be small;
dishes should be consumed warm and mushy;
cook food with water, not broth.

Is it possible to use traditional medicine as a treatment for erosive gastritis?

Folk recipes

There are effective and efficient traditional medicine recipes that will help not only alleviate symptoms, but also cure the disease. They can be used as part of complex therapy, after consultation with your doctor.

What kind of means are these?

First of all, calendula infusion. It can be prepared like this: pour one tablespoon of flowers with a glass of boiling water, leave for an hour, strain and drink a tablespoon three times a day. This medicine will reduce the inflammatory process, reduce acidity and neutralize bacteria.

An infusion of several herbs, taken in two tablespoons each (St. John's wort, yarrow, chamomile) and celandine (one tablespoon), will also be very effective. Pour the mixture into seven glasses of boiling water and leave for half an hour. Drink half a glass four times a day.

An effective treatment for erosive gastritis can be freshly squeezed juices of beets, cabbage, carrots or potatoes, which can be drunk one hundred milliliters four times a day half an hour before meals.

An interesting traditional medicine recipe is aloe mixed with honey. To do this, take ten leaves of the plant (after keeping them in the refrigerator overnight), grind them in a blender and cook in a water bath for ten minutes. Then add honey (in a one to one ratio) and boil for another minute. Take one tablespoon on an empty stomach. The mixture should be stored in the refrigerator.

Here’s another effective remedy: mix half a kilogram of honey with fifty grams of lard and thirty grams of propolis, grind, melt and cook over low heat until everything dissolves. Take one tablespoon half an hour before meals.

And finally

As you can see, erosive gastritis is a very serious disease, accompanied by unpleasant symptoms and manifestations. To recover from the disease, it is important to consult a doctor in time and strictly adhere to the prescribed treatment.

Good health to you!

Erosive gastritis

Erosive damage to the stomach (erosive gastritis) is a fairly common disease of the digestive system. Erosive gastritis can be acute or chronic.

Acute erosive gastritis is a superficial lesion of the gastric mucosa. It develops very quickly, especially when provoked by various stresses.

Chronic erosive gastritis is characterized by multiple erosions of the gastric mucosa at different stages of healing.

Among the many diseases of the upper gastrointestinal tract (GIT), gastroduodenal erosions are among the most common and least studied.

Gastroduodenal erosions are superficial defects of the mucous membrane of the stomach and duodenum, not extending beyond its own muscular plate, which form in foci of superficial necrosis and heal without the formation of a connective tissue scar.

Erosion of the mucous membrane of the stomach and duodenum was first described by the Italian anatomist Morgagni back in 1761 in his work “On the location and causes of diseases identified by the anatomist,” based on the study of extensive sectional material. Subsequently, the study of the process of erosion of the mucous membrane of the gastroduodenal zone, mainly as a pre-ulcerative condition, was reflected in the works of K. Rokitansky (1842).

As suggested by K. Kawai et al. 30 years ago they began to distinguish between acute (superficial, flat) and chronic (complete, raised, smallpox-like - varioliform) erosions. Acute erosions are superficial defects of the gastric mucosa, mainly in its distal section, the diameter of which does not exceed 1–2 mm. Chronic erosions are raised (raised) areas of the gastric mucosa with a diameter of 3–7 mm, having a rounded shape, resembling a papule with an umbilical depression in the center, often with a small ulceration at their top (“mature” complete erosions).

Etiology and pathogenesis

Among the main causes of acute erosions, the following play an important role: 1) taking medications, including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, digitalis preparations, nitrofurans, tolbutamide, veroshpirone, ethacrynic acid; 2) alcohol intoxication; 3) stressful effects (burns and frostbite, shock, wounds, polytrauma, psycho-emotional stress); 4) severe somatic pathology (decompensated circulatory failure, chronic renal and hepatocellular failure, blood diseases, chronic nonspecific lung diseases);

5) diseases of the endocrine system (hyperparathyroidism, diabetes mellitus, sepsis).

According to etiology, chronic erosions are divided into primary and secondary. Primary ones arise, as a rule, in practically healthy young people without concomitant diseases under the influence of unfavorable socio-climatic or psychotraumatic factors and are capable of undergoing involution as the influence of the latter is eliminated.

Secondary chronic erosions arise as the equivalent of a syndrome of generalized circulatory-hypoxic disorders, altered immune reactivity and metabolic processes against the background of diseases of the cardiovascular system and liver, associated with complete erosions with a frequency of up to 75%.

According to L.I. Aruina, in 19.1% of patients, erosions occur against the background of chronic gastritis, in the rest they are combined with other diseases of the digestive system, primarily with duodenal ulcer (51%) and chronic cholecystitis (13%).

Among the factors that are important in the development of erosions, the role of Helicobacter pylori (Hp), duodenogastric reflux, hydrochloric acid, a decrease in the cytoprotective properties of the gastric mucosa gel, microcirculatory disorders in the gastric mucosa, immune disorders, and some hormones is being studied.

Risk factors for erosion of the gastric mucosa

1. HP infection. According to the results of modern studies, contamination of the mucous membrane with Hp is 66–85% when erosions are localized in the stomach. Some authors believe that the important role of HP in the occurrence of erosions is confirmed not so much by the high level of contamination of the gastric mucosa, but by the pronounced effect of eradication therapy, which clearly correlates with the frequency of elimination of erosive lesions.

2. Most researchers attach great importance to microcirculation disorders in the pathogenesis of erosions of the gastric mucosa. With recurrent erosive gastritis in the remission phase, disturbances of local and general microcirculation are observed in 62 and 40% of cases, respectively, compared to 38 and 24% in patients with chronic gastritis without erosion, and especially pronounced changes were revealed when studying terminal blood flow.

3. Duodenogastric reflux is of great importance in the formation of acute and chronic erosions. According to various authors, gastric erosions are combined with the latter in 22.9–85% of cases. Components of duodenal contents, primarily salts of deconjugated bile acids and lysolecithin, in high concentrations have a damaging effect on the gastric mucosa.

4. Many researchers provide data on disturbances in the motor function of the stomach and an increase in intracavitary pressure, which first causes functional and then organic damage to the organ with the formation of a clinical picture of the disease. Thus, in the work of E.V. Nikishina identified intragastric and intraduodenal hypertension in 78% of patients with erosive gastritis, and also noted the predominance of the hyperkinetic type of gastric motor disorders.

5. In some cases, an increase in the blood levels of cortisol, gastrin, thyroid-stimulating hormone and insulin in patients with erosions is shown. Using correlation analysis, the authors established a direct relationship between the level of intragastric and intraduodenal pressure and the content of gastrin, insulin and thyroid-stimulating hormone.

6. Recently, more and more works have appeared indicating the importance of immunity disorders in the development of chronic gastric erosions.

7. The significance of the acid-peptic factor in the development of chronic gastric erosions has not been clearly defined. I.V. Maev et al. (1998) report that chronic erosions are more common against the background of high levels of gastric secretion.

8. Non-steroidal anti-inflammatory drugs occupy a special place among the causes of the development of gastroduodenal erosions. Gastroduodenal ulcers occur in 20–25% of patients taking these drugs for a long time, and erosions of the mucous membrane of the stomach and duodenum occur in more than 50% of patients, and the risk of developing such lesions persists for several months after stopping treatment.

Clinical picture

Acute erosions have a clearly defined clinical symptom complex; clinical signs of underlying diseases come to the fore. In 30–90% of young people with unchanged mucous membrane, acute erosions can be asymptomatic or the clinical manifestations are quite scanty and nonspecific. More often, heartburn and sour belching occur; very rarely, low-intensity fasting and “hungry” pain in the epigastrium occurs. Acute gastric erosions are characterized by relatively frequent (up to 4.5%) development of hemorrhagic complications.

For chronic erosions, the manifestations of dyspeptic and abdominal pain syndromes are quite pronounced and specific. Belching and heartburn are observed in 75% of patients with chronic erosions, often combined with a feeling of heaviness in the right hypochondrium and flatulence. Periodic fasting and “hungry” pain in the epigastrium, observed in most patients with chronic erosions, often radiates to the spine. Moreover, if in young patients aching and dull pain predominate, then in the older age group the pain against the background of an increasing feeling of heaviness in the epigastrium is predominantly cramping in nature with the development at their height of nausea, unstable stool with a predominance of constipation.

Thus, the clinical picture of chronic erosions reveals a certain similarity with the symptoms of duodenal localization of an ulcerative defect. Quite frequent formation of pronounced symptoms of underlying diseases was also noted. These include diseases of the cardiovascular system (arterial hypertension, coronary heart disease) and liver (chronic hepatitis and cirrhosis).

At the same time, there are studies indicating the nonspecificity of the clinical picture, which consists of pain and dyspeptic syndromes of varying severity. I'M WITH. Zimmerman et al. They also believe that it is impossible to use clinical manifestations for diagnostic purposes in relation to erosive gastritis.

Diagnosis of two types of erosions is carried out using fibrogastroduodenoscopic examination. However, a full judgment about the nature of erosions can be made only on the basis of a histological examination. The development of acute erosions is usually preceded by subepithelial hemorrhages of the petechial type, but without compromising the integrity of the gastric mucosa, and therefore they are often described as hemorrhagic erosions. On histological examination, the defect in the mucous membrane of the stomach or duodenum is usually shallow, but occupies several ridges. The period of epithelization of acute erosions does not exceed 2–7 days.

Chronic erosions are located in the antrum of the stomach in the form of chains going towards the pylorus, in quantities from 1 to 15. The depth of the mucosal defect in chronic erosions is almost the same as in acute erosion; their bottom is usually formed by glands, less often by a muscular plate mucous membrane. Morphologically, chronic erosions are characterized by the presence of coagulative necrosis, which resembles fibrinoid necrosis in acute erosion, but without the typical fibrosis of the edges. Hyperplasia of the pyloric glands in the zone of chronic erosion is the cause of the formation of those elevations that serve as an endoscopic criterion. In the area of the bottom of complete erosions, granulation tissue is detected, and in the marginal sections - dystrophic and atrophic changes in the epithelium of the glands. Chronic erosions exist for a long time - from 4 weeks to several years. According to a number of authors, this type of erosion can be divided into “immature” and “mature” based on the nature of histological changes. In the first case, erosion goes through all stages of development and epithelializes, then swelling of the mucous membrane at the site of its bulging remains permanently as a result of developing tissue fibrosis and pronounced productive inflammation.

Treatment

One of the most important and difficult problems is the treatment of chronic gastric erosions. Considering the versatility of the pathogenesis, most authors recommend complex treatment of erosions with an impact on various parts of their pathogenesis.

Therapy of both acute and chronic erosive lesions of the stomach involves, first of all, eliminating the influence of unfavorable factors of an exogenous and endogenous nature, that is, eliminating stressful influences, normalizing the diet and quality of nutrition, quitting smoking and drinking alcohol, and taking drugs with ulcerogenic properties.

Antisecretory drugs are intended for the treatment of gastroduodenal erosions, especially those occurring with ulcer-like manifestations and severe hyperacidity. Proton pump inhibitors (PPIs) are used - omeprazole 40 mg per day. It is possible to use H2 receptor blockers (famotidine 40 mg per day for 4–6 weeks with gradual withdrawal).

Considering the frequent detection of HP in the erosion zone, it is recommended to treat with anti-Helicobacter drugs as part of triple or quadruple therapy using mainly de-nol, which not only promotes the elimination of HP, but also has an anti-inflammatory and cytoprotective effect.

The II Maastricht Consensus recommendations for first-line treatment included the following triple treatment regimens: PPI at a standard dose 2 times a day (or ranitidine bismuth citrate) + clarithromycin 500 mg 2 times a day + amoxicillin 1000 mg (or metronidazole 500 mg) 2 times a day for 7 days.

Quadruple therapy was used as second-line therapy: PPI in a standard dose 2 times a day + bismuth subcitrate 120 mg 4 times a day + tetracycline 500 mg 4 times a day + metronidazole 500 mg 3 times a day.

The III Maastricht consensus made the following changes to the treatment of Helicobacter pylori infection: - first-line therapy: PPI + clarithromycin + amoxicillin (metronidazole can be used if primary resistance to clarithromycin in a given region is over 15–20%); - PPI + amoxicillin + metronidazole regimen (can be used if resistance to metronidazole in the region is less than 40%); - 14-day prescription of eradication therapy increases the frequency of HP eradication by 9–12% compared to a 7-day course; - quadruple therapy with colloidal bismuth can be used as an alternative to first-line therapy;

As a second-line eradication regimen, bismuth-based quadruple therapy has retained its importance as the most optimal.

In case of ineffectiveness of first- and second-line eradication regimens, the III Maastricht Consensus offers the practitioner several acceptable options for further therapy. It is possible to prescribe high doses of amoxicillin (0.75 g 4 times a day for 14 days) in combination with high (4-fold) doses of PPIs. Another option may be to replace metronidazole in the quadruple therapy regimen with furazolidone (100–200 mg 2 times a day). An alternative is the use of a combination of PPIs with amoxicillin and rifabutin (300 mg per day) or levofloxacin (500 mg per day). The optimal way to overcome Hp resistance remains the selection of antibiotics, taking into account the individual sensitivity of a given Hp strain.

With NSAID gastropathy, according to the III Maastricht consensus, the risk of developing erosions and ulcers of the stomach and duodenum in Hp-positive patients is higher than in Hp-negative patients. Carrying out eradication therapy reduces the risk of developing ulcers and erosions in patients, and therefore, before starting to take these drugs, it is necessary to conduct a study of Hp infection and, if confirmed, prescribe eradication therapy. However, eradication therapy alone is not enough to prevent the development of NSAID gastropathy.

Antacids, especially Maalox, are effective means of combating duodenogastric reflux. Of course, in classic gastroesophageal reflux disease, the anti-acid activity of antacids cannot be compared with that of PPIs. But in the presence of biliary reflux, the purpose of their use is not only the neutralization of hydrochloric acid, but also the adsorption of bile acids and lysolecithin, as well as increasing the resistance of the mucous membrane to the action of aggressive factors (cytoprotection).

Cytoprotectors. It is known that the mucous protective barrier of the stomach has two lines of defense. The first line includes mucus, gastric and duodenal secretion of bicarbonates, the hydrophobic surface of the mucous membrane of the stomach and duodenum. The second line of defense is formed by the epithelial barrier. The apical surface of the gastric epithelium and intercellular junctions are extremely resistant to reverse diffusion of H+ ions due to the presence on their basolateral surfaces of two transport systems that remove H+ ions from the gastric mucosa. The integrity of this barrier is regulated by gastric growth factors, one of which is transforming growth factor. This barrier includes tissue substances containing sulfhydryl groups (glutathione- and thiol-containing proteins), which are powerful natural antioxidants, as well as traps for free radicals of hydrogen and oxygen. The third line of defense includes normal blood flow, which promotes the elimination of H+ ions, provides energy for metabolic processes, supports the first and second lines of defense, and also regulates reparative processes in the gastric mucosa.

A significant clinical effect was obtained in the treatment of gastroduodenal erosions when prescribing 800 mg per day for 2–4 weeks of synthetic PGs enprostil and misoprostol, which improve regional blood flow and microcirculation, stimulate the formation of a mucous-bicarbonate barrier. In addition to prostaglandins, bismuth preparations (mainly bismuth tripotassium dicitrate - de-nol), sucralfate, and pentoxifylline also have a cytoprotective effect.

Drugs that improve microcirculation. Trental is most effective, improving microcirculation, rheological properties of blood and oxygen supply to tissues. In isolated works one can find recommendations for the inclusion of immunocorrectors in the treatment regimens of patients with chronic gastric erosions - T-activin 100 mg per day for 5-10 days, B-leukin (human recombinant interleukin), Galavit 200 mg per day for 5–10 days. There are reports of the effectiveness of the use of opioid peptides - dalargin and solcoseryl - for chronic gastric erosions, especially in combination with antisecretory drugs.

Thus, chronic gastric erosions are characterized by a recurrent course and, despite the large number of medications and regimens for their use, are often resistant to therapy. Often, the effectiveness of treatment for patients with chronic erosions remains low; in 24–25% of cases, clinical and endoscopic remission cannot be achieved, which can lead to the development of serious complications.

All this indicates the need to conduct more in-depth studies of the etiology and pathogenesis of chronic gastric erosions in compliance with the principle of complexity. This will allow you to choose the optimal treatment regimen for patients and significantly reduce the time for epithelization of chronic gastric erosions. Further dynamic observation makes it possible to reduce the frequency of recurrence of chronic erosions and improve the quality of life of patients.

All diseases are collected and distributed according to codes in the ICD (international classification of diseases).

Gastritis according to ICD 10 has code 29, and its varieties are indicated using additional numbers:

acute hemorrhagic form – K 29.0;
acute form of other gastritis - K 29.1;
alcoholic form – K 29.2;
chronic form of superficial gastritis – K 29.3;
chronic form of atrophic gastritis – K 29.4;
chronic form of antral and fundal gastritis – K 29.5;
other chronic forms – K 29.6;
unspecified gastritis - K 29.7.

In accordance with the classification, acute gastritis has a code in ICD 10 - K 29.0 and K 29.1 and is divided into:

hemorrhagic (K 29.0);
alcoholic (K 29.2);
hypertrophic and granulomatous (K 29.6);
unspecified (29.7).

Each type has its own symptoms and treatment features. The reasons for all types of acute forms are similar.

Reasons for the development of the acute form

There are many reasons for inflammation of the epithelium of the gastric mucosa:

violation of diet and diet;
food allergies;
abuse of strong instant coffee, alcohol and carbonated drinks;
consumption of products containing chemicals and dyes;
long-term drug therapy and drug overdose;
oncology of the digestive organs, trauma and surgery;
infectious diseases of the digestive system;
metabolic disorders;
increased radioactive background.

The disease often occurs due to eating on the go or poor chewing of food.

Symptoms of the development of acute gastritis

Symptoms of stomach inflammation depend on the type of disease. The first sign of the erosive type is nausea, stomach pain and internal bleeding. There are cases when other signs are absent, and only bleeding is detected. In this case, the disease is classified as acute hemorrhagic gastritis code according to ICD 10 - K 29.0.

The catarrhal type of the disease usually develops against the background of emotional stress, poor diet, overeating or prolonged fasting. This is the simplest form of inflammation of the stomach, otherwise called acute alimentary gastritis and has an ICD code of 10 K 29.1. Treatment is carried out with medications, and traditional medicine can also be used.

The ulcerative appearance is directly related to functional stomach disorders, often manifests itself with bleeding, and can provoke the development of a perforated gastric ulcer. The cause may be infectious bacterial diseases: diphtheria, pneumonia, hepatitis, typhus.

The antral type of inflammation differs from other forms by the increased acidity of gastric secretions. The cause may be a bacterial infection, the main symptom being heartburn. It is with antral gastritis that gastric reflux can develop with the reflux of gastric secretions into the esophagus.

An attack of the acute form of the disease is not difficult to determine; the symptoms are pronounced:

flatulence with stool disturbance;
sour heartburn and belching;
severe pain in the epigastric region;
nausea and vomiting that does not bring relief;
temperature can rise to 39 0 C;
a gray coating appears on the tongue.

Typically, an attack develops 4 to 5 hours after the irritant.

Classification of chronic form

This disease is also classified according to international standards. The ICD 10 code for chronic gastritis has several classes:

chronic superficial gastritis – K 29.3;
chronic atrophic form – K 29.4;
chronic antral and fundamental gastritis – K 29.5;
rare chronic species - K 29.6;
other unspecified forms - K 29.7;
duodenitis – K 29.8;
gastroduodenitis - By 29.9.

Symptoms of chronic gastritis

The chronic form of the disease is the most common, symptoms are usually mild, and the disease can progress over years. As a result, without treatment, the disease can develop into more serious pathologies or provoke complications.

Superficial gastritis is the most harmless; it affects only the upper layer of the mucous membrane of the stomach walls. According to ICD 10, the chronic form is also listed in the class of infectious diseases of the digestive system and in the class of oncological and autoimmune diseases.

Pain and discomfort in the upper abdomen are the most characteristic symptom of chronic inflammation of the stomach. Usually the pain is aching and localized in the upper part of the epigastric zone. Pain syndrome can be provoked by poor nutrition, poisoning with poor-quality food, constant overeating or long-term fasting.

If the disease is associated with a person’s poor diet, the chronic form usually worsens in spring or autumn.

If these exacerbations go away without appropriate treatment, a complication may develop in the form of erosive gastritis, which is not far from a peptic ulcer.

Features of the chronic form

The chronic form of atrophic gastritis is an independent disease with a specific clinical picture:

always low acidity;
the walls of the stomach become thinner and stretched;
degeneration of glandular cells develops;
the epithelium thickens;
folds in the gastric mucosa are smoothed out.

Unspecified gastritis according to ICD 10 is coded K 29.7. This code is usually used if the diagnosis includes only gastritis without additional specifications.

Special forms are considered:

Atrophic appearance may have other names and be classified according to ICD 10 as K 31.7 - gastric polyps or D 13.1 - benign neoplasms of the stomach.
Ménétrier's disease– hypertrophic gastritis, classified according to ICD 10 as K 29.6, characterized by hypertrophy of the folds of the epithelium of the gastric mucosa.
Lymphocytic gastritis is also coded, a distinctive feature of which is the accumulation of lymphocytes in the epithelium of the mucous membrane.

Some forms and types of stomach inflammation can occur against the background of infectious diseases, in which case they will be classified according to the section on infectious diseases.