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Acute or chronic inflammation of the gastric mucosa occurs in more than half of the world's population. And if a common person can start drug therapy to alleviate the condition, then in the case of pregnancy, this process has a certain complexity. Like any inflammation, gastritis can disrupt the usual way of life and have a negative impact on the development of the fetus.

According to statistics, inflammatory-dystrophic pathologies affect about 70% of women in the position, and most of them have an exacerbation of a chronic disease.

Causes of gastritis during pregnancy

With diagnosis and a thorough examination, one of the types of gastritis can be detected in pregnant women:

• A - manifested by the development of atrophy of the gastric wall mucosa.
• B - inflammation occurred due to infection with the gram-negative microorganism Helicobacter pylori.

It is worth noting that this bacterium is easily transmitted through household contact, and is present in more than half of humanity. However, not every person has a bacterium manifested by diseases of the gastrointestinal tract, often the microorganism “sleeps”, and is activated only with a decrease in immunity.

Quite often, women are faced with an acute form of gastritis, which is associated with poor nutrition, and specific taste preferences that manifest themselves when carrying a child. Such moments can lead to an exacerbation of gastritis:

• Stressful situations and nervousness.
• Undernutrition, long breaks, starvation.
• Abuse of refined carbohydrates, preservatives, flavors and dyes.
• Inheritance passed down from one of the close relatives.
• Infectious diseases.
• Lack of vitamins and nutrients.

There are plenty of factors that can exacerbate a chronic course or cause an acute one. In addition, against the background of the fact that all the defenses of the woman's body are thrown to protect the fetus, the pregnant woman herself begins to undergo numerous ailments and infections.

Symptoms of gastritis during pregnancy

The symptoms of dyspepsia are quite pronounced, and they cannot be ignored. The disease manifests itself both locally and common symptoms, and can disturb the expectant mother at any stage of pregnancy.

General disorders are manifested by nervousness, weakness throughout the body, pallor of the skin, stool disorder, hyperacidity, night sweats, evening fever.

Local disorders can be recognized by belching with reflux of gastric juice, frequent heartburn, heaviness after eating, rapid satiety, frequent hunger, pain in the right side.

information All these factors will help to suspect the presence of an exacerbation of gastritis, and especially the painful and exhausting toxicosis that accompanies all nine months. Of course, these symptoms are quite extensive, and may indicate various diseases, therefore, at the slightest discomfort, a woman needs to contact a gynecologist and gastroenterologist for a diagnosis.

Diagnosis of gastritis during pregnancy

To make a diagnosis, the specialist carefully listens to the patient's complaints, prescribes a list of tests that will help confirm or refute the presence of gastritis, determine its type, and only then prescribes therapy. Mandatory procedures include:

• A blood test for biochemical analysis, which will show the level of bilirubin, the content and level of gastrin, the presence of anemia and antibodies.
• Fractional sounding has contraindications during pregnancy, but may be allowed by the doctor in especially severe cases.
• A biopsy of gastric tissues is also a painful procedure, therefore it is performed in extreme cases.
• Carrying out a HELIK test, which will show the presence of a pathogen in the stomach. The test is respiratory, so it does not cause any discomfort.

information It is worth saying that each type of gastritis has a characteristic clinical picture, which indicates to the specialist the form of the disease. Therefore, drug therapy should be carried out as early as possible to avoid unpleasant complications.

Complications (exacerbations) of gastritis in pregnant women

By itself, gastritis is not particularly terrible, and with the normalization of nutrition, the disease proceeds calmly, without exacerbations. But if abused simple rules, which are recommended to patients, you can get serious consequences:

• An ulcer is a serious inflammation that affects not only the mucous membrane, but also muscle tissue. Treatment of ulcers during pregnancy is complex and lengthy. The disease is manifested by severe pain, vomiting, constant heartburn.
• Bleeding occurs with severe attacks of gastritis, against the background of exacerbation. At the first sign of vomiting with blood, you should seek medical help.
• Cancer is the most serious complication that develops after an untreated ulcer. It is quite easy to recognize the formation, since the patient is regularly disturbed severe pain, nausea, bleeding./li>

In addition to such serious complications, gastritis during pregnancy can cause damage to the intestines, biliary tract, the development of chronic pancreatitis, and iron deficiency anemia.

How and how to treat gastritis during pregnancy

Since drug therapy during the period of bearing a baby has serious limitations, a strict diet becomes the basis of treatment, recipes traditional medicine and sparing drugs that do not pose a threat to the development of the fetus.

First of all, the expectant mother will have to give up products that can provoke an exacerbation. It is necessary to carefully approach the selection of the diet, since one should not forget that the child needs fortified and nutritious food.

Traditional medicine has proven itself well, where there are a lot of recipes that can be used to maintain the body during pregnancy. As for mineral waters, caution should be exercised here, since some compounds are prescribed for low acidity, others for high acidity. What kind of water to start drinking during treatment will be told by the attending physician.

information Medical therapy is also present. And it consists of enveloping, analgesic, enzyme and stabilizing drugs. Antibacterial treatment can be prescribed only after delivery.

Treatment of gastritis during pregnancy: diet

Nutritional correction is 80% of the success of gastritis treatment. To maintain the body at the proper level, you will have to revise taste preferences, and refuse sour, spicy, fried and spicy. Dishes should undergo such heat treatment: boiled, steamed, baked in foil. It is necessary to plan the diet, as it should be fractional and frequent. It is better to eat in small portions, but at least 6 times a day.

information Be sure to include mucous porridge, fish, jelly, lean meat, 1 soft-boiled egg, low-fat cheeses. It must be remembered that food should be warm, as cold and hot food causes serious damage to the mucous membrane. As for fruits, you can eat baked apples and bananas. Sour fruits and especially citrus fruits are excluded.

Treatment of gastritis during pregnancy: medications

Drug treatment is aimed at relieving painful symptoms, and reducing the exacerbation of gastritis. During pregnancy, the following drugs may be prescribed:

• Enzymes to facilitate digestion: Creon, Festal,.
• Enveloping and protecting the mucous membrane: Almagel,.
• Microflora stabilizers: Linex, Laktovit, Gastroform.
• Spasmolytic:, Platifillin.
• With frequent vomiting, Cerucal, but only on the strict prescription of a doctor.

information If gastritis occurs against the background of the Helicobacter bacterium, then a probiotic and De-Nol can be prescribed, which normalizes the functioning of the gastrointestinal tract, and antagonistically acts on the pathogenic organism. The course of treatment is prescribed only by a gastroenterologist, and must be strictly observed by the patient. Drug therapy will be ineffective if you do not limit yourself in nutrition.

Treatment of gastritis during pregnancy: folk remedies

In combination with medicines and diet food you can apply traditional medicine recipes that will help eliminate unpleasant symptoms, adjust acidity, relieve inflammation and normalize the entire system. The choice of herbal preparations must be approached responsibly, since some of them are prescribed for increased, others for reduced secretion.

• With increased acidity, flocks are prepared from such plants: calamus root, bird mountaineer, shamrock, celandine, mint, St. John's wort.
• With reduced secretion, the most effective are: fennel, cumin, parsley, oregano, plantain leaves, thyme.

You need to prepare healing infusions as follows: take 2 types of herbal preparation for a tablespoon, pour 500 ml of boiling water, leave for 30-40 minutes, and take three tablespoons after eating. It is not recommended to self-medicate, as herbal medicine can cause a hidden negative effect. Only a doctor will help to gain confidence in alternative treatment.

Preventive measures during pregnancy from gastritis

The presence of such an ailment as gastritis is not a contraindication to pregnancy. But the expectant mother must understand all the responsibility that is entrusted to her. Therefore, when planning a pregnancy, it is necessary to undergo an appropriate examination and course of treatment in order to avoid exacerbation.

important During pregnancy, you need to properly organize your diet, chew food thoroughly, and not get carried away with harmful snacks. It is necessary to avoid products that irritate the microflora: fatty meat broths, carbonated drinks, hot spices, smoked meats, pickles.

It will also be useful for preventive purposes to drink prescribed mineral water, take multivitamins, walk more often and avoid stressful situations.

Gastritis during pregnancy is considered quite common. Firstly, very often at this time a woman has an exacerbation of all existing chronic diseases. Of course, it would be desirable to put your health in order even at the stage of family planning. But the fact is that gastritis is still not completely treated. If it has already passed into a chronic form, then the maximum that can be done is to keep it in remission for a long time.

But for pregnant women, it is impossible to exclude exacerbations of gastritis, since the body future mother very vulnerable. Therefore, it is important to know what can trigger an attack, how to eliminate risk factors and how to treat this disease if it has not been prevented.

Causes of exacerbation of gastritis

During pregnancy, symptoms of gastritis can appear due to a variety of reasons. At an early stage, this may be due to toxicosis, strong stress plays a negative role (and in this position, all emotions become much more pronounced due to hormonal imbalance). In addition, not all expectant mothers follow the recommendations of doctors regarding proper nutrition; many continue to eat refined fats and fast carbohydrates. And besides, during pregnancy, immunity decreases and the body becomes more vulnerable to bacterial infection or fungal infection. But gastritis is caused precisely special kind bacteria.

But with gastritis of the autoimmune type, the symptoms appear due to the fact that over time the synthesis of pepsin with hydrochloric acid decreases in the body. In addition, this disease is associated with the development of a special type of anemia, in which the body lacks vitamin B12.

Other reasons should not be discounted - metabolic problems, hypovitaminosis due to the fact that the fetus requires more and more nutrients, duodenogastric reflux, in which the contents of the stomach are thrown back into the esophagus, and this happens not only with elevated physical activity, but also when the growing fetus presses on the internal organs.

Symptoms of gastritis during pregnancy

In the first trimester, the symptoms of gastritis may not be noticeable. After all, toxicosis in each woman is different, it happens that it lasts 14-17 weeks and is accompanied by severe vomiting, and it can be provoked by a completely ordinary smell or even a change in body position after sleep. At the same time, you simply won’t be able to notice any discomfort or other similar symptoms of gastritis. Is it possible to say that toxicosis is especially pronounced. By the way, it is often not toxicosis that provokes gastritis, but vice versa - the disease already existed, only in remission, but aggravated due to metabolic disorders during pregnancy and took the form of morning sickness.

During this period, a serious restructuring of the body takes place. You can even say that the internal organs move a little to make room for the growing fetus. Because of this, the acid enters the esophagus, irritates the mucous membrane and a vicious circle comes out. Although this does not harm the child, it negatively affects the health of the mother.

So, in the acute stage, gastritis can be detected. If it is a chronic type of pathology, then its symptoms are not so pronounced. In addition, each person has this disease manifests itself in its own way. For example, the most common signs of gastritis are pain in the epigastric region (it occurs when there is an increase in the level of acidity of the stomach), belching, nausea and vomiting, as well as digestive disorders, which can be expressed both in regular constipation and in frequent diarrhea. Sometimes pain is observed around the navel or on the right under the rib.

With gastritis, pain intensifies after fatty, spicy or sweet foods, but in some cases they can occur even at night, although it would seem that the person has not eaten anything. In general, if such sensations occur, it is better to immediately consult a doctor in order to exclude other possible complications. All of the above symptoms, except for pain in the epigastric region, can also be observed during a normal pregnancy.

How to treat gastritis when carrying a baby: proper nutrition

Pregnant women are often unable to take medication. The doctor may prescribe some medications, provided that the benefits outweigh the potential harm to the fetus. So diet remains the only effective method. Moreover, folk remedies, most of which are based on the action of medicinal herbs, can be dangerous when carrying a baby.

Dietary nutrition during pregnancy is not just the rejection of some foods and the inclusion of their safe substitutes in the diet. You need to adhere to certain principles:

1. Fractional nutrition, that is, in small portions and 5-6 times a day.
2. Compliance with certain restrictions, which are expressed in the rejection of fried, spicy, fatty foods and spices - that is, what could irritate the gastric mucosa.
3. Reduction in the diet of sweets. You don’t need to completely abandon them - one marshmallow or marmalade will not hurt, but chocolate will have to be completely excluded.
4. Inclusion in the diet of milk soups and whole grain cereals, which need to be boiled as much as possible so that the stomach can more easily cope with them.

Diet food for gastritis

How to eat with gastritis, any gastroenterologist can tell. Moreover, treatment tables with various pathologies internal organs have been developed for a long time. So, with gastritis, you can use the recommendations that contain the so-called treatment table No. 1, developed by M.I. Pevzner.

The diet in this case pursues two goals at once - on the one hand, it is necessary that the expectant mother receives all the necessary nutrients. On the other hand, food should be sparing so as not to burden the stomach too much. And what will be the acidity of the environment plays important role in choosing the right diet.

So, with increased acidity, you should try to eat fewer foods that could release acid. And with low acidity, on the contrary, they use products that simulate the production of hydrochloric acid.

Among the permitted products, even with an increased level of acidity, are those that do not affect the production of gastric juice. This:

1. Bread, but only slightly dried in a toaster, or yesterday's loaf, you can eat crackers and dry biscuit cookies without herbs and spices.
2. You can eat meat and fish, but only dietary varieties, especially since you can cook many different dishes from them.
3. From dairy products, low-fat cottage cheese, cream, and various yogurts are also needed, since expectant mothers often lack calcium. In addition, such products perform the function of antacids, that is, they remove accumulated in the body harmful substances.
4. Vegetables cooked and mashed. It is advisable to eat seasonal fruits. It can be: potatoes, carrots, beets, as well as peeled tomatoes. And here White cabbage may worsen the situation with flatulence during pregnancy. It is advised to replace broccoli, but not to get too carried away with it.
5. You can eat fruits, but only those that do not contain coarse fibers are bananas and pre-baked apples.

From drinks, berry fruit drinks, kissels, compotes are recommended. It is allowed to drink vegetable and fruit juices, but only freshly squeezed. It can be carrot or potato juice, as they also help to remove harmful substances. But you will have to forget about coffee for a long time.

With gastritis with low acidity, rich soups, including meat broths, will be allowed (and even recommended). You can eat any sweet and sour fruits, drink juices, eat canned vegetables, but only in limited quantities, the less vinegar they contain, the better. In addition, with low acidity, they drink mineral table water, but only without gas (during pregnancy, this is done only after consulting a doctor). It is better to refuse whole-milk products, replacing them with sour-milk ones.

Possible medical treatment

Theoretically, gastritis can still be treated with medications, but only if it is accompanied by increased acidity. Then the doctor may prescribe the drug Maalox. It has an antacid effect, that is, it neutralizes hydrochloric acid, which is part of the gastric juice. Take it in the form of tablets or suspension, at the dosage prescribed by the doctor, about an hour after eating.

Sometimes doctors prescribe a remedy such as the adsorbent drug Attapulgite. During pregnancy and lactation, it is used carefully, but still, ladies in a position can drink it. This drug forms a thin film on the mucous membranes of the gastrointestinal tract, which performs several functions at once. On the one hand, it protects and soothes the irritated mucosa, on the other hand, it helps to adsorb toxins, pathogenic microflora, etc. Gradually, this film moves towards the end of the alimentary canal, and then it is removed from the body - along with what it managed to pull out . Thanks to this, Attapulgite reduces the manifestations of toxicosis, helps to normalize stools, and has an astringent effect.

Doctors may prescribe other medications, including those that have an antispasmodic effect. But usually this is done in the presence of pain.

Moreover, it is not always healthy eating, even the most balanced, makes it possible to obtain the necessary substances. In such cases, it is required to take vitamin complexes. The list of specific vitamins is determined in each individual case. For example, there are forms of gastritis in which it is necessary to take individual B vitamins, as well as PP, ascorbic acid and retinol. Most of them are found in fruits and vegetables. But B vitamins are usually present only in sufficiently high-calorie foods, including brown bread, which expectant mothers should not eat due to the fact that it causes increased flatulence. Therefore, doctors advise getting vitamins not through nutrition, but from ready-made complexes that are sold in pharmacies, strictly observing the prescribed dosage.

Physiotherapy methods

If gastritis is observed during pregnancy, treatment does not have to be reduced to a diet and taking drugs from the antacid group. There are no less effective physiotherapy methods. Some people think that such treatment comes down to just acupuncture. But in fact, this is not so, and just acupuncture is not the safest method during pregnancy.

This also applies to a number of other procedures. For example, electrophoresis, which is the transportation of the prescribed drug directly to the area of ​​​​the violation. In pregnancy, this method is used with caution, since no one has conducted large enough studies to help identify all possible consequences. However, it is believed that it is better not to use it in the presence of late toxicosis, accompanied by severe vomiting, and for situations where there is chronic kidney disease. But magnetotherapy is considered a safer option, although it has its limitations.

Gastritis during pregnancy is one of the most common extragenital pathologies. Being, in essence, inflammation, it negatively affects not only the well-being of a pregnant woman, but also the fetus.
Statistics say that gastritis occurs in more than 70% of pregnant women. Moreover, only in 1% an acute episode of pathology is recorded, in the rest the disease acquires a chronic form.

The disease has a varied clinical picture even in ordinary people, to say nothing about women "in position".

Gastritis during pregnancy may not manifest itself and be asymptomatic, which greatly complicates the timely diagnosis. This situation is typical for the chronic form of the disease. The acute stage usually manifests itself rapidly and there are no problems in diagnosing it.

Exacerbation of gastritis during pregnancy is associated with an increased load on female body, as well as with possible malnutrition of the expectant mother, provoked. Doctors distinguish many types of pathology.

Type B is more common, caused by excessive reproduction in the stomach of the opportunistic bacterium H. pylori.

It is able to secrete enzymes that disrupt the full activity of the walls of the stomach, which leads to the appearance characteristic symptoms. Sometimes the disease is associated with an excess of hydrochloric acid or its deficiency. Naturally, the tactics of treatment will be different.

If an excess of hydrochloric acid is recorded, the symptoms of gastritis during pregnancy will be as follows:

• soreness (when specifying the localization of the patient, they mainly indicate the upper abdomen, the epigastric region, the space near the navel, the right hypochondrium);
• pain does not occur on its own, but in response to the intake of certain foods (after carefully questioning the patient, the doctor will be able to determine which food provokes the onset of symptoms);
• V rare cases there is diarrhea accompanied by pain;
• heartburn, belching with sour smell and taste.

Women should remember that pain does not always appear after eating. Unpleasant sensations can disturb women at night or on an empty stomach.

Symptoms of gastritis with low acidity are somewhat different:

• bouts of nausea and vomiting;
• belching, accompanied by the appearance of an unpleasant putrefactive odor from the mouth;
• flatulence;
• feeling of fullness in the stomach;
• bouts of weakness.

Diagnostic methods

In diagnostics, in addition to taking into account complaints, an important place is occupied by instrumental research methods and laboratory diagnostics. To examine a woman during the period of bearing a child, preference is given to endoscopy and analysis of gastric juice.

The intake of the digestive fluid allows you to evaluate its characteristics, determine the acidity and select the optimal treatment regimen.

Endoscopy provides information about how badly damaged the gastric mucosa. This method for the diagnosis of gastritis in pregnant women is rarely used. The main indication for endoscopy is the ineffectiveness of standard therapy.

How can a pregnant woman get rid of gastritis?

Many women are wondering how to treat gastritis during pregnancy, so as not to harm the child and get rid of unpleasant symptoms as soon as possible. It must be understood that therapy for this pathology is long and requires a systematic approach.

To cope with the problem, you should listen to your doctor and follow all his recommendations, both on diet and on taking medications. The peculiarity of the disease is that it easily aggravates at the slightest deviation from the chosen treatment regimen.

If gastritis is diagnosed during pregnancy, treatment is recommended to start with the most obvious, that is, with a complete correction of the woman's nutrition.

You will have to change your food habits, giving up a number of foods that irritate the stomach. From the diet it is necessary to exclude:

• sour;
• salty;
• roast;
• acute;
• smoked;
• spicy;
• canned;
• too hot or too cold.

It is desirable to form a daily menu from boiled products, lean meat or fish, kissels, pasta, cereals, some types of cheeses (low-fat and mild). Drinks are best consumed warm, but not hot. Drinking should not be overly acidic, caffeine should also be excluded.

Medical therapy

The question is also about how to treat gastritis during pregnancy with medication. Sometimes nutritional correction is not enough and women have to resort to medication.

The following drugs are used:

• anti-inflammatory;
• antacids (neutralizing hyperacidity);
• antispasmodics;
• having an enveloping effect;
• symptomatic (suppressing nausea, regulating microflora, etc.).

Now doctors, dealing with the treatment of gastritis, are trying to act directly on the most common causative agent of gastric diseases - the H. pylori bacterium, eliminating its detrimental effect on the membrane digestive organ. This measure is called eradication.

During pregnancy, its implementation is complicated or completely impossible, since the drugs used for this can affect the fetus. This explains the largely symptomatic approach to the treatment of gastritis during pregnancy.

Some women use folk remedies as therapy, but even before using them, it is recommended to consult a doctor. Decoctions and infusions have a smaller range of side effects, but are not always suitable for pregnant women and can cause allergies.

During the period of bearing a child, it is impossible to select medications on your own, without the help of a gastroenterologist, since not all drugs are used during pregnancy.

The combination of several permitted means can also have an undesirable effect. Only a specialist is able to assess the risks and rationality of conducting drug treatment in a specific situation.

Complications and measures to prevent them

Gastritis in itself does not pose a threat to the fetus and does not interfere with the course of pregnancy, but it can cause serious inconvenience to a woman, affecting the general condition of the body.

Only in severe cases, when the expectant mother is deprived of the opportunity to fully eat because of pain, there is a threat to the normal development of the child.

Uncontrolled progression of the disease can lead to a number of complications that manifest themselves during gestation or after delivery.

Uncontrolled gastritis during pregnancy leads to the following complications:

• ulcers of the stomach and duodenum;
• polyps (neoplasms on the gastric mucosa that can be injured, causing pain and occasional bleeding);
• tumors.

The most dangerous are benign or malignant neoplasms. All complications of gastritis are directly related to the inflammatory process, which involves the walls of the stomach.

To prevent such consequences, it is necessary to stop inflammation in a timely manner, using the principles of rational nutrition and drug therapy.

If it was possible to do this and in the future the patient adheres to the recommendations of the doctor, complications rarely develop.

Ways to prevent gastritis

In most cases, gastritis is a chronic disease. The attending physician should advise the woman on the best methods of prevention in order to avoid exacerbation of the disease during childbearing.

Even if there is an increased appetite, pregnant women should not eat up for future use.

The habit of overeating leads to excess stress on the stomach, acting as an additional factor provoking the development or exacerbation of gastritis. It is recommended that you always carry a few permitted foods with you and, if necessary, consume them in small portions.

The difficulties associated with the treatment of gastritis are of concern to many people. Today, the disease is extremely common. According to rough estimates, patients with a diagnosis, there are almost half of the world's population. Symptoms caused by pathology cause a lot of trouble for patients. Women become especially vulnerable during pregnancy, the methods of therapy should not harm the unborn child.

As a rule, the appearance of gastritis is associated with an exacerbation of inflammatory processes that appeared earlier. There are two types of violation. The first is associated with atrophy of the stomach tissues. The second type of the disease is associated with infection of the body by Helicobacter pylori. Moreover, it is possible to become infected with an infection before or after conception.

If the infection occurred in the early stages or before pregnancy, the disease is easy to miss. Pregnancy and gastritis at an acute stage provokes a violation of the hormonal background. During pregnancy, treatment is difficult. Many drugs are contraindicated in patients suffering from the disease. If not during pregnancy, the bearing of a child passes with complications.

What causes an exacerbation of gastritis in the acute stage:

• unbalanced and poor-quality nutrition;
• products of dubious quality containing harmful substances - flavors, stabilizers, preservatives;
• situations leading to stress;
• binge eating.

How to Diagnose

Before prescribing treatment for gastritis in pregnant women, the disease will need to be diagnosed. It is supposed to collect detailed information during the initial examination of patients, gastritis and pregnancy have extensive clinical signs. At this time, a woman is worried about:

• frequent rumbling of the abdomen;
• stomach pain;
• nausea;
• indigestion;
• flatulence;
• heartburn.

Different forms of the disease show their own symptoms. If the exacerbation of gastritis during pregnancy is provoked by high acidity, the pain begins to bother in the right hypochondrium, navel, stomach. The state of discomfort is aggravated by the use of fatty, spicy foods. Pain during sleep and immediately after eating. Treatment of the form is aimed at reducing acid activity.

Toxicosis

Toxicosis with gastritis is difficult, especially with exacerbation of early stage pregnancy. The disease does not affect the development of the fetus. The difficulty is that the body of the expectant mother hardly reacts to the chosen methods of treatment.

Known forms of gastritis

The disease has an acute and chronic form. In the period of exacerbation, the disease manifests itself rapidly. Chronic gastritis during pregnancy is accompanied by a less violent relapse. It is impossible to cure the chronic form. If a person is diagnosed - you have to put up with it.

Acute form of gastritis

In the acute form, the walls of the stomach or intestines become inflamed. There are several reasons for the pathology. Often there are chemical, thermal and mechanical damage.

Exacerbated gastritis during pregnancy proceeds in a similar way:

1. The epithelium of the mucous membrane is affected.
2. Later, the inflammatory process passes to the entire thickness of the stomach, penetrates into the muscle layer.
3. The disease manifests itself after past diseases of the liver, gallbladder, pancreas. More often it begins to worsen after the use of drugs intended for the treatment of allergies and acute poisoning.
4. A sign of gastritis may occur due to metabolic disorders or burns of the mucosa.

Symptoms that occur with gastritis

Symptoms in the acute stage appear within four to eight hours. At this time, a person feels weakness, heaviness in the stomach, nausea, vomiting, diarrhea.

The skin turns pale, perspiration appears. There is profuse salivation or dryness in the mouth.

Chronic form of gastritis

Chronic gastritis differs significantly from the acute form. Patients are characterized by stomach pain, intestinal disorders. Accompanied by symptoms of weakness of the body, irritability, low blood pressure.

In the latter case, toxicosis is severe, the duration is seventeen weeks. In some cases, the disease does not manifest itself. In the acute form, the woman's well-being deteriorates sharply, without affecting the fetus. However, treatment should be started as soon as the diagnosis is made.

Factors that provoke the disease

There are a number of reasons that contribute to the occurrence of pathology. Favorable factors for the onset of the disease are:

• Frequently recurring stressful situations. Stress lurks at home and at work. This causes sleep disturbance, poor appetite. It is recommended to eliminate the causes of stress and calm the expectant mother.
• The use of harmful products. Women who are expecting a baby should not be intercepted on the fly, use low-quality food, and dine dry. Alcohol and cigarettes are strictly contraindicated, poison harms the body of the mother and fetus.
• Infection of the body with the bacterium Helicobacter pylori. As reported, the bacterium is able to enter the body before conception. During pregnancy provokes acute.

Methods for diagnosing gastritis in pregnant women

Before starting treatment, it is desirable to conduct a diagnosis in the laboratory. Diagnostics consists of:

• Taking blood for analysis;
• Acidity level measurements;
• Biopsies of the affected areas of the stomach. The technique is unpleasant and painful, prescribed only in extreme cases.
• Helik-test, which determines the presence of bacteria that cause pathology.

Of course, when establishing an accurate analysis, it is not enough for a gastroenterologist to know the symptoms of the disease. An endoscopy will be required to take gastric juice for analysis.

Probing is usually done to obtain accurate results. The procedure is carried out using a special device inserted directly into the stomach.

The device is safe for the developing fetus. Women who are expecting a baby do not need to worry. The main thing is to establish a diagnosis, to choose a therapy that can eliminate the acute form of the disease.

The described method accurately determines the diagnosis. With its help, erosion of the walls of the stomach is established.

The endoscopy procedure is considered a difficult ordeal. But there is no need to go to extremes. The method is used if other methods have failed.

How to treat acute gastritis during pregnancy

After clarifying the diagnosis, an experienced doctor prescribes medication. Treatment of gastritis during pregnancy is different from the treatment of an ordinary patient, many medications can harm the fetus.

In the acute form of stomach disease, the gastroenterologist prescribes Maalox, Gastrofarm, Gelusil Lacquer - a medicine that has an adsorbing property. It is recommended to consume approximately two hours after eating. When pain occurs, the patient has the right to use drugs: papaverine, no-shpa, hydrochloride. The drug that helps eliminate nausea is cerucal.

Proper nutrition

With an exacerbation, women are assigned bed rest, an appropriate diet. You should eat multiple times, about six times a day. Food must be well chewed.

The diet includes the use of milk and dairy products. Milk soups, consisting of cereals, it is useful to eat with gastritis.

Soft-boiled eggs, meatballs consisting of minced meat or fish, cheese, kefir, vegetable stew, sweet fruits and vegetables are acceptable.

It is possible to diversify the diet due to lean meat, steamed. The diet consists of potatoes, fish, doctor's sausage and pasta. In the absence of an exacerbation, it is allowed to use low-fat ham, hard cheese, not too sour sour cream.

Even without exacerbation, patients are supposed to exclude fried and smoked dishes from the diet. These products should be avoided by all pregnant women without exception, not only those suffering from gastritis.

The diet begins with the use of dairy products - cheese, milk soups and liquid cereals. They eat in small portions. A few hours later, boiled eggs, vegetable stew are introduced into the diet. Later, meat products, mashed potatoes, various cereals, non-acidic sour cream are added to the diet. You do not need to add butter to vermicelli or potatoes.

Is it possible to cure gastritis with mineral waters

If the limbs do not swell, and the acidity level is increased, it is permissible to add mineral water to the diet. An example is "Smirnovskaya" water or "Borjomi". It is supposed to be taken at least three times a day for three hundred milliliters. Women with low acidity are allowed to drink water "Essentuki" No. 4 or 17.

How to cure gastritis with herbs

Treatment of the disease is possible not only with the help of drugs. Herbs will help eliminate unpleasant symptoms.

St. John's wort, pharmacy chamomile or mint are more suitable than others. You can steam the seeds of flax or oats. Of the sedatives, the most common are motherwort, celandine, valerian.

Absolute majority medicinal plants has an anti-inflammatory effect on the mucous membrane. Among the plants noted thyme, bitter wormwood, plantain, parsnips.

It is worth noting that with gastritis with an underestimated secret function, medicinal substances with anti-inflammatory quality are used. Before taking herbs, you need to consult a doctor! The body of pregnant women is able to respond to therapy in an unexpected way.

What to do to prevent the disease

Effective prevention is proper nutrition. Food should be eaten in small portions, about five times a day. Before swallowing food, it is recommended to chew for a long time and thoroughly. Overeating negatively affects patients diagnosed with gastritis. Frequent eating irritates the mucous membranes and stretches the stomach.

It is important that women exclude strong broths, seasonings, smoked meats, and preservation from their own diet. During an exacerbation and after a relapse, they refuse strong tea, coffee, sparkling water.

You should always remember that systematic stress, alcohol abuse provoke the appearance of the disease and have a negative effect on the fetus.

Chronic gastritis is a chronic lesion of the gastric mucosa, accompanied by its structural restructuring with progressive atrophy and impaired 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 the 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 EXAMINATIONS OF GASTRITIS DURING PREGNANCY

Of primary importance is a balanced diet, refusal to use strong alcoholic beverages, smoking.

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

CLASSIFICATION OF GASTRITIS

There are two forms of gastritis:
acute - occurs for the first time, proceeds rapidly;
Chronic - occurs with frequent relapses.

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

Other forms of gastritis are observed much less frequently.

There are chronic gastritis as the main and as a concomitant disease (secondary gastritis).

According to the etiological basis, 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 glandular lesions (without atrophy), atrophic gastritis (moderately pronounced), gastritis with 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. to special forms chronic gastritis include hemorrhagic, rigid, giant hypertrophic and polyposis.

ETIOLOGY (CAUSES) OF GASTRITIS

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

The cause of chronic gastritis can be:

Qualitatively malnutrition (especially deficiency of protein, iron and vitamins);
Prolonged uncontrolled intake of drugs that irritate 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 in diseases of the kidneys, gout (urea, uric acid, indole, skatole and other substances are secreted by the gastric mucosa);
The action 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 long-term exposure to endogenous and exogenous etiological factors, functional secretory and motor disturbances in the activity of the stomach first develop, and later - dystrophic and inflammatory changes and violations of regeneration processes. These structural changes develop primarily in the epithelium of the surface layers of the mucosa, and later the gastric glands are involved in the pathological process, which gradually atrophy or rebuild like crypts. Autoimmune processes play a certain role in the progression of the disease.

PATHOGENESIS OF GESTATION COMPLICATIONS

There is no single theory explaining the causes of toxicosis. Opinions agree on only one thing - toxicosis occurs in those women who have diseases of the gastrointestinal tract, liver, thyroid gland, as well as in those who work hard, smoke, eat improperly, 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 believed that the most likely cause of vomiting in early dates pregnancy is a violation of the interaction of the central nervous system and internal organs. In this case, there is an excitation of the activity of the subcortical structures of the central nervous system, where the vomiting center is located, as well as the centers for the regulation of vascular tone, salivation, and smell. The close location of these centers determines that the vomiting act is preceded by a feeling of nausea, increased salivation, deepening of breathing, increased heart rate, blanching of the skin due to spasm of peripheral capillaries.

CLINICAL PICTURE (SYMPTOMS) OF GASTRITIS IN PREGNANT WOMEN

Chronic gastritis A initially proceeds with normal gastric secretion (excretion of gastric juice); at this stage, patients do not complain 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 the normal range, however, with widespread chronic gastritis B, the secretory function of the stomach decreases sharply, up to its pronounced insufficiency.

Chronic gastritis has no specific symptoms, the clinical picture of the disease is diverse. In most cases, the symptoms of the disease are pain in the epigastric region and dyspepsia (nausea, vomiting, belching, upset stool). In chronic gastritis with secretory insufficiency (low level of hydrochloric acid in gastric juice), gastric dyspepsia (belching, nausea, vomiting) and intestinal dyspepsia (flatulence, rumbling in the abdomen, stool disturbance) 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 are recurring pains in the upper abdomen. Most 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 appear on an empty stomach, at night, or regardless of food intake. The pain can be both moderate and severe (with increased production of hydrochloric acid by the stomach, the pain is usually severe, with reduced production - weak). The pain becomes worse when the walls of the stomach are stretched with a copious amount of food.

The most common is Helicobacter pylori gastritis. Once in the stomach, bacteria multiply intensively, damaging the gastric mucosa and changing the production of gastric juice. This leads to erosions and stomach ulcers.

COMPLICATIONS OF GESTATION

In 75% of women suffering from chronic gastritis, the disease worsens during pregnancy. As a rule, pregnant women suffering from 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.

DIAGNOSIS OF GASTRITIS IN PREGNANCY

ANAMNESIS

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

PHYSICAL EXAMINATION

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

LABORATORY RESEARCH

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

INSTRUMENTAL STUDIES

For the diagnosis of chronic gastritis is carried out:

study of the secretory and motor functions of the stomach.

Gastric secretion: basal up to 10 mmol / h, stimulated (after maximum histamine stimulation) - up to 35 mmol / h. Often there is abundant gastric secretion at night. In chronic gastritis, the acid-forming function of the stomach may be normal or reduced; perhaps the 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 rather burdensome for a pregnant woman, it should be used for diagnosis according to special indications and in case of treatment failure. With superficial gastritis, gastroscopy reveals moderate swelling, sometimes slight vulnerability of the mucous membrane, focal hyperemia, and increased mucus formation. Chronic gastritis with high acidity is often accompanied by erosive damage to the mucous membrane. Superficial erosions appear 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 ​​erosion is hyperemic, edematous, more 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 edematous, 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 bad influence x-rays on the fetus for sure. 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 DIAGNOSIS

Differential diagnosis of the main forms of gastritis is carried out with functional disorders of the secretory function of the stomach ("irritable stomach", gastric or functional achylia). 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.

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

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

INDICATIONS FOR CONSULTATION OF OTHER SPECIALISTS

Consultation of the therapist and gastroenterologist is shown.

EXAMPLE FORMULATION OF THE DIAGNOSIS

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

TREATMENT OF CHRONIC GASTRITIS DURING PREGNANCY

GOALS OF TREATMENT

Achieve disease remission.

NON-DRUG TREATMENT

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

For pregnant women with preserved or increased secretory function of the stomach, it is possible (in the absence of edema, especially in the first half of pregnancy) to prescribe Smirnovskaya and Jermuk mineral waters 150–300 ml three times a day 1.5–2 hours after a meal, since this reduces the time of action of hydrochloric acid on the gastric mucosa. In chronic gastritis with secretory insufficiency, water such as Mirgorodskaya, Essentuki No. 4, No. 17 or Arzni is prescribed.

MEDICAL TREATMENT OF GASTRITIS IN PREGNANT WOMEN

Treatment of pregnant women suffering from chronic gastritis with preserved or increased secretory function is carried out basically in the same way as for patients with peptic ulcer. Elimination of Helicobacter 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. Maalox, which has antacid, analgesic and cytoprotective properties, is prescribed in tablets or suspensions 1 hour after a meal. Attapulgite has an adsorbing property, establishes a physiological balance in the stomach, does not lead to the reactive formation of gastric acid; it is prescribed 3-5 times a day, one powder 1-2 hours after a meal and, if necessary, at night. Antispasmodic drugs (papaverine, drotaverine) eliminate pain syndrome. Metoclopramide regulates the motor function of the stomach. 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, calamus rhizome, celandine, sedatives (valerian root, motherwort herb).

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

In patients with chronic gastritis A, exocrine pancreatic activity and intestinal digestion are often disturbed. To correct these disorders, pancreatin 0.5-1 g before meals 3-4 times a day is useful. As in chronic gastritis B, gastric motility disorders are corrected with metoclopramide, and antispasmodics are prescribed for pain.

PREVENTION AND PREDICTION OF GESTATION 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, hunger and weight loss increase, liver and kidney functions suffer, and blood counts worsen.

FEATURES OF TREATMENT OF GESTATION COMPLICATIONS

Treatment of complications of gestation by trimester

Pregnant women with mild vomiting can be treated on an outpatient basis. With moderate and severe vomiting, treatment is carried out in a hospital. Important for the normalization of the function of the central nervous system is a properly organized therapeutic regimen and the elimination negative emotions. Great importance in the treatment has a rational diet for pregnant women. Food should be varied, easily digestible, contain a large number of vitamins; it should be taken chilled, in small portions every 2-3 hours in the supine position. Mineral non-carbonated alkaline water is shown in small volumes 5-6 times a day.

When hospitalized, the patient must be placed in a separate room. Taking into account the short gestational age, in order to exclude a negative effect on the fetal egg medicines It is advisable to start treatment with non-pharmacological agents. 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. The use of these non-pharmacological methods alone may be sufficient for the treatment of a mild form of vomiting during pregnancy. Complex therapy is continued until a stable cessation of vomiting, normalization general condition gradual increase in body weight. Treatment of mild to moderate vomiting during pregnancy 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 medical supervision.

Treatment of complications in childbirth and the postpartum period

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 this disease and according to obstetric indications.

TREATMENT EFFECTIVENESS ASSESSMENT

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

CHOICE OF DATE AND METHOD OF DELIVERY

Childbirth occurs at term through the natural birth canal. CS only for obstetric indications.

INFORMATION FOR THE PATIENT

As a preventive measure, sanatorium treatment of chronic gastritis without exacerbation of the disease is indicated.