Helping you cope with heaviness in the stomach

September 22, 2020

Gastritis is an inflammation of the gastric mucosa, leading to disruption of its secretory function

Gastritis is an inflammation of the gastric mucosa, leading to disruption of its secretory function. During the inflammatory process, food entering the stomach is poorly digested, which leads to impaired absorption of nutrients.

Chronic gastritis affects about 60-85% of the world's population, including young people aged 18 to 35 years. Due to the modern rhythm of life, gastritis has begun to occur more often in children aged 5 to 13 years. Among all diseases of the gastrointestinal tract, gastritis is the most common; a common “marker” of gastritis is the appearance of pain in the stomach. American scientists Marshall and Warren received the Nobel Prize for their discovery of the infectious mechanism of gastritis, caused by the microorganism Helicobacter pylori. This microorganism has been identified in the mucous membranes of many patients suffering from chronic gastritis.

Top 8 effective medications for the treatment of gastritis.

May 28, 2021
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Content

• Nolpaza
• Omez
• Nexium
• Gastal
• Rennie
• Maalox
• De-Nol
• Vikair

With gastritis, the gastric mucosa becomes inflamed, and a person experiences symptoms such as nausea, pain, belching, heartburn, etc. Today, gastritis is a very common occurrence, and the disease has become noticeably “younger” and is found even in children. If gastritis is not treated, it becomes chronic and significantly worsens the quality of life.

But you need to understand that there is no universal treatment for gastritis. It can be with high or low acidity, with or without the presence of Helicobacter pylori, with or without concomitant diseases, and many more individual characteristics. Therefore, only a doctor should prescribe drugs for gastritis.

We have compiled a rating of the safest and most effective medications for gastritis, working in three areas: antisecretory agents, antacids and drugs for the treatment of Helicobacter pylori.

The first group of drugs for the treatment of gastritis are drugs that reduce the acidity of gastric juice and the secretory activity of the stomach.

Symptoms

Often gastritis is asymptomatic; symptoms indicating the disease may be aching or sharp burning pain in the pit of the stomach, which appears or intensifies during or after eating, heartburn, nausea, vomiting, flatulence, constant belching and heaviness in the abdomen, unreasonable weight loss , unpleasant taste in the mouth, heaviness, feeling of pressure in the chest.

The manifestation of the disease depends on the type of disease. For example, acute gastritis begins suddenly, often after food poisoning. Pain occurs in different areas of the stomach depending on the location of inflammation, and intensifies when taking foods that irritate the mucous membrane. The main symptoms of the acute phase of the disease: heartburn, vomiting, belching, frequent gas, bloating, headache, rapid heartbeat, dizziness, increased salivation or extreme thirst. Chronic gastritis is sluggish, symptoms in adults may vary, but this pathology is mainly characterized by belching with a characteristic odor, constant heartburn, a feeling of pain and heaviness, loss of appetite, diarrhea or constipation, coating on the tongue, and weight loss.

Depending on the form and type of gastritis, different treatments are prescribed, so it is important to see a doctor immediately.

Nolpaza

These tablets for gastritis not only reduce the amount of hydrochloric acid in the stomach and reduce acidity, but are also indicated in complex therapy (in combination with antibiotics) for Helicobacter pylori. The active substance of Nolpaza, pantoprazole, heals the gastric mucosa during gastritis and ulcers, eliminating unpleasant symptoms. It is recommended to take Nolpaza once or twice a day; the drug is contraindicated for children. We recommend that you study the list of side effects.

Nolpaza

KRKA (KRKA), Slovenia

- gastroesophageal reflux disease (GERD), incl.
erosive and ulcerative reflux esophagitis and symptoms associated with GERD (heartburn, acid regurgitation, pain when swallowing); - erosive and ulcerative lesions of the stomach and duodenum associated with taking NSAIDs; — peptic ulcer of the stomach and duodenum, treatment and prevention; — eradication of Helicobacter pylori in combination with two antibiotics; - Zollinger-Ellison syndrome and other pathological conditions associated with increased gastric secretion. from 700

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Diet for gastritis of the stomach

Of course, to achieve a positive effect in the treatment of gastritis, you need to adjust your diet. This does not mean that now you will have to eat only pureed soups, mashed porridges and wash it down with rice water for the rest of your life. But you need to adhere to certain restrictions: in case of inflammation of the gastric mucosa, you must temporarily exclude spicy, fried in oil, salty foods, fermented products (kvass, beer, black bread), foods with added vinegar, strong broths, mushrooms, carbonated drinks. In the acute stage of gastritis, you should also not lean on fresh vegetables and fruits, they increase fermentation. Vegetables are best eaten stewed or boiled. White, dried bread is preferable. You will have to give up any alcohol during treatment.

Don't overeat. It’s better for your stomach if you eat small meals (5-6 times a day every 3-4 hours).

Omez

This drug against gastritis perfectly reduces the production of stomach acid, thereby relieving discomfort. Omez became the first drug in its category, the effectiveness and safety of which were confirmed by research. The active substance of the drug is omeprazole. “Omez” forms a protective layer on the gastric mucosa and at the same time heals existing damage - the acute symptoms of gastritis disappear. "Omez" can be taken both for treatment and for preventive purposes (for example, when taking non-steroidal anti-inflammatory drugs) to protect the gastrointestinal tract.

Omez

Dr. Reddy's Laboratories, India

Adults - peptic ulcer of the stomach and duodenum (including prevention of relapses);
- gastroesophageal reflux disease (GERD); - hypersecretory conditions (Zollinger-Ellison syndrome, stress ulcers of the gastrointestinal tract, multiple endocrine adenomatosis, systemic mastocytosis); — eradication of Helicobacter pylori in infected patients with gastric and duodenal ulcers (as part of combination therapy); - prevention and treatment of damage to the mucous membrane of the stomach and duodenum caused by taking NSAIDs (NSAID gastropathy): dyspepsia, erosion of the mucous membrane, peptic ulcer; - prevention of Mendelssohn syndrome (aspiration pneumonitis). Children - treatment of gastroesophageal reflux disease in children over 2 years of age, weighing more than 20 kg; - treatment of duodenal ulcer caused by Helicobacter pylori in children over 4 years of age, weighing more than 20 kg. Safety and effectiveness of the drug for other indications in patients children over 60

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Diagnostics.

Diagnosis of chronic gastritis is based on identifying complaints, collecting anamnesis, objective examination and conducting laboratory and instrumental examination methods.

The patient is recommended to undergo a clinical blood test, a biochemical blood test - ALT, AST, total bilirubin, amylase, glucose. The gold standard for diagnosis is an FGDS; to diagnose Helicobacter pylori infection, a urease breath test or a stool test for Hp Ag is used.

Additional methods:

• Ultrasound of the abdominal organs;
• with atrophy of the gastric mucosa - determination in the blood: pepsinogen 1, pensinogen 2, gastrin 17;
• determination of antibodies in the blood to gastric parietal cells and intrinsic Castle factor;
• determination of the level of vitamin B12 in the blood.

Nexium

This is a modern remedy for the treatment of gastritis and reflux disease, which has almost no side effects. Nexium is a proton pump inhibitor that permanently reduces the amount of acid in the stomach. Nexium helps relieve inflammation and heal stomach ulcers, and the effect after treatment lasts a long time. This drug for gastritis is not cheap, but the price is quite justified, especially since it can also be prescribed to children.

Nexium

AstraZeneca, Sweden

Gastroesophageal reflux disease: treatment of erosive reflux esophagitis;
long-term maintenance treatment after healing of erosive reflux esophagitis to prevent relapse; symptomatic treatment of gastroesophageal reflux disease; Peptic ulcer of the stomach and duodenum As part of combination therapy: treatment of duodenal ulcer associated with Helicobacter pylori; prevention of relapses of peptic ulcers associated with Helicobacter pylori. Long-term acid suppression therapy in patients who have suffered bleeding from a peptic ulcer (after intravenous use of drugs that reduce the secretion of gastric glands to prevent relapse). Patients taking NSAIDs for a long time: healing of gastric ulcers associated with taking NSAIDs; prevention of gastric and duodenal ulcers associated with taking NSAIDs in patients at risk. Zollinger-Ellison syndrome or other conditions characterized by pathological hypersecretion of the gastric glands, including from 127

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The next group of drugs are antacids, which eliminate excess acid in the stomach.

Gastal

"Gastal" are lozenges, so they are always convenient to have on hand and do not need to be washed down with water. It contains magnesium and aluminum, which instantly “quench” heartburn, and the positive effect lasts for about two hours after the tablet is dissolved. "Gastal" not only reduces acidity, but also helps the gastric mucosa to recover. The drug is prescribed in the complex treatment of gastritis and ulcers.

The course of treatment with Gastal is selected by the doctor; you can also use the drug as a one-time “first aid” to relieve the symptoms of heartburn. You can take no more than 8 Gastal tablets per day. It is important that side effects from taking this medication are very rare.

Gastal

TEVA, Ukraine

The combined drug Gastal contains aluminum hydroxide, magnesium carbonate and magnesium oxide.
The combination of active ingredients provides a high antacid (reducing stomach acidity) effect and reducing the possibility of constipation. from 156

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Read also: Top 5 best sorbents for poisoning Rating of the most effective and safe sorbents that help with poisoning and hangover syndrome.

Rennie

"Rennie" are heartburn tablets with different flavors (they are even available without sugar). Rennie contains calcium carbonate and magnesium hydroxycarbonate. In the stomach, this gastritis medicine neutralizes excess acid. At the same time, the drug increases the production of mucus, which protects the stomach and heals damage to the mucosa. "Rennie" begins to act very quickly - literally three to five minutes after administration. The big advantage of these tablets is that they can be taken by pregnant women (and heartburn is a common occurrence during this period).

Rennie

Bayer Bitterfeld GmbH, Germany

The drug is taken for diseases of the gastrointestinal tract associated with increased acidity of gastric juice
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Maalox

"Maalox" for gastritis is presented in the form of chewable tablets and suspensions. This drug neutralizes hydrochloric acid and increases the pH level in the stomach. The active ingredients of Maalox are magnesium hydroxide and hydrated aluminum oxide. Also, this medicine for gastritis envelops the stomach, works as an adsorbent, and protects the mucous membrane from acid. "Maalox" is prescribed for gastritis, reflux esophagitis and ulcers. Before taking these tablets for gastritis, we recommend that you carefully read the contraindications.

Maalox

Chinoin (Sanofi-Sintelabo), Hungary

- peptic ulcer of the stomach and duodenum in the acute phase;
- acute gastroduodenitis; — chronic gastroduodenitis with normal or increased secretory function in the acute phase; - hiatal hernia; - reflux esophagitis; - dyspeptic phenomena, such as discomfort or pain in the epigastrium, heartburn, sour belching after errors in the diet, excessive consumption of ethanol, coffee, nicotine, etc.; - dyspeptic phenomena, such as discomfort or pain in the epigastrium, heartburn, sour belching (and their prevention), resulting from the use of certain medications (including NSAIDs, corticosteroids). from 20

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The last group is bismuth preparations, which are prescribed for the treatment of Helicobacter pylori.

Chronic gastritis - symptoms and treatment

Currently there is no generally accepted classification of the disease. In clinical practice in the Russian Federation, the working classification created on the basis of the classification of S.M. is most often used. Ryss and the Houston modification of the Sydney HG classification. It is compiled with the inclusion of clinical and functional sections, with their designation (in the spirit of the Sydney system) by the grammatical terms “inflection” (ending). The group of hCG type C also includes medicinal and professional forms of hCG.[7]

Working classification of CG

By etiology and pathogenesis (prefix):

• CG type A: autoimmune fundic atrophic, including those associated with megaloblastic Addison-Birmer anemia;
• CG type B: bacterial antral nonatrophic, associated with HP infection;
• CG type AB: combined atrophic pangastritis (with damage to all parts of the stomach).

According to topographic and morphological features (root or core):

1. by localization:
2. fundic hCG (type A);
3. antral hCG (type B);
4. pangastritis (type AB) with predominant damage to the antrum or fundus;
5. according to morphological criteria:
6. superficial CG;
7. interstitial hCG;
8. atrophic CG with mild, moderate or severe atrophy;
9. CG with intestinal metaplasia (complete or incomplete, small intestinal or colonic).

According to specific morphological characteristics (suffix):

1. according to the severity of the inflammatory process in the gastric mucosa:
2. minimum;
3. minor;
4. moderate;
5. pronounced (depending on the degree of lymphoplasmacytic inflammatory infiltration of the gastric mucosa);
6. according to hCG activity:
7. no activity;
8. light (I);
9. medium (II);
10. ▪ high (III) (depends on the presence and severity of the neutrophilic - granulocytic component in the inflammatory infiltration of the gastric mucosa);
11. according to the presence and severity of contamination of the coolant with HP infection:
12. absent;
13. light (I);
14. medium (II);
15. high (III);

According to clinical features:

• CG (type B) with a predominance of pain syndrome (Gastritis dolorosa);
• CG (type A) with a predominance of dyspeptic symptoms;
• CG with a latent (asymptomatic) course (~50%).

According to functional criteria (flexion), the following forms of chronic gastritis :

• HCG with preserved (and increased) secretion;
• CG with secretory insufficiency (moderate, severe, total).

Endoscopic criteria for hCG:

• erythematous (exudative) superficial CG;
• CG with flat (sharp) erosions;
• CG with rising (chronic) erosions;
• hemorrhagic hCG;
• hyperplastic hCG;
• HCG complicated by GDR (reflux gastritis).

When formulating a diagnosis, the following algorithm is used: Prefix (etiology) - Root (localization) - Suffix (morphology) - Inflection (function) with the addition of endoscopic criteria.

Example of diagnosis: Chronic Helicobacter gastritis of the antrum of the stomach with moderate inflammation, moderate activity, high contamination with Helicobacter pylorus with preserved secretion.

Due to the greater availability of morphological assessment of the condition of the gastric mucosa based on the results of studies of biopsy material, the CG classification according to the OLGA (Operative Link for Gastritis Assessment) system is increasingly being used. Over time, the morphological classification of CG will become the leading one in the world.

CG, like all chronic diseases, has two stages: exacerbations and remissions, which successively replace each other. With each exacerbation, greater structural changes occur in the mucosa. Exacerbation and remission of hCG can be confirmed clinically or endoscopically (the most accurate confirmation is based on the results of endoscopy and the morphology of the biopsy material).

Based on the cause of occurrence, the following types of chronic gastritis : caused by Helicobacter Pylori infection, drug-induced and autoimmune atrophic gastritis.

Caused by Helicobacter Pylori infection (HP infection)

Currently, HP infection (type B gastritis) plays a leading role in the development of CG. The majority of adults over 60 years of age are infected with this bacterium. In Russia, among children over 5 years old, 30% are infected, at the age of 15-20 years - 63%, adults - more than 85% [10]. The pathogenesis of the effect of this pathogen on the stomach is that chronic Helicobacter Pylori infection causes changes in the tissues of the gastric mucosa. For a long time, the infection occurs without symptoms. As inflammation spreads to the body of the stomach and the response of the mucous membrane increases, the first symptoms of gastritis appear. The longer the infection lasts, the stronger the restructuring of the mucous membrane. This restructuring of the mucosa consistently leads to atrophy, intestinal metaplasia and dysplasia, leading to gastric cancer. The development of gastric atrophy is a critical step in the transition of hCG to gastric cancer.

Drug-induced gastritis (type C)

This is the second most common form of gastritis. The effect on the stomach of non-steroidal anti-inflammatory drugs (NSAIDs) has been most studied. They do not cause direct aggressive action, like acids (hydrochloric acid is tens of times more aggressive). The pathogenesis of their effect on the gastric mucosa is based on the blocking of cyclooxygenase enzymes (isomers COX-1 and COX-2). When COX-1 is blocked, the synthesis of prostaglandins (E2 and I2) is suppressed, which ensure the quality and strength of the mucosal barrier that protects the mucous membrane from the aggressive effects of hydrochloric acid and pepsin. Therefore, long-term use of NSAIDs leads to a thinning of the protective layer of mucus and an increase in the aggressive effect of hydrochloric acid on the gastric mucosa, causing chronic inflammation.

Autoimmune atrophic gastritis (type A gastritis)

The rarest form of hCG is autoimmune atrophic gastritis (type A gastritis). Until now, its etiology is not known. It is based on the production of antibodies by immune cells to the parietal cells of the mucous membrane (synthesize hydrochloric acid) and the internal factor of Castle (participates in the absorption of iron in the intestine). As a result of this, inflammatory changes develop, very early leading to atrophy and achlorhydria (a condition in which there is no hydrochloric acid in the gastric juice). The metabolism of vitamin B12 is also disrupted, aggravating the course of anemia.

In addition to those listed, there is a group of specific types of chronic gastritis.

Radiation gastritis - the causative factor is ionizing radiation, which has both a direct damaging effect on the mucous membrane and through a cascade of reactions with the formation of free radicals and lipid peroxidation of cell membranes. As a result, with prolonged exposure to doses of ionizing radiation exceeding the maximum threshold, chronic radiation gastritis develops.

Lymphocytic gastritis is characterized by specific inflammation in the gastric mucosa, which develops against the background of gluten enteropathy - celiac disease (a pathological disorder of the intestines in which gluten intolerance occurs). The mucous membrane is damaged by its own antibodies with the development of chronic inflammation.

Granulomatous gastritis develops as a result of the involvement of the stomach in the inflammatory process in Crohn's disease (chronic inflammatory bowel disease) and occurs with similar mucosal lesions in the form of erosions and ulcers. Specific foci of chronic inflammation, granulomas, form in the mucosa.

Eosinophilic chronic gastritis develops with food allergies. If you do not follow a diet that excludes the allergen, chronic inflammation develops in the gastric mucosa. The more often allergens enter the stomach, the more pronounced the manifestations of gastritis.

The course of chronic gastritis

CG is a long-term disease: on average, 18-25 years pass before the development of pronounced structural changes in the gastric mucosa in the form of atrophy, dystrophy or dysplasia. Over time, each exacerbation leads to the spread of the inflammatory process not only over the area (breadth), but also into the depth of the mucous membrane. When the body and fundus of the stomach are involved in the process, the production of hydrochloric acid and pepsin begins to decrease, which leads to digestive disorders.

De-Nol

This medication contains 120 mg of bismuth per tablet. "De-Nol" destroys the bacterium Helicobacter pylori and protects the stomach from acid. De-Nol works best in combination with antibiotics. This drug must be prescribed by a doctor and is approved for children over 4 years of age. The cost of De-Nol is high, and while taking it you may experience constipation, and your stool may turn dark.

De-nol

Astellas Pharma Europe, Russia

De-Nol is an antiulcer drug containing the active substance – bismuth subcitrate.
De-Nol belongs to the group of astringent drugs, however, it has a multifaceted effect, influencing various parts of the pathogenesis of peptic ulcer disease. The main pharmacological effects of the drug include astringent, antimicrobial and gastrocytoprotective effects. from 300

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This is interesting

It should be noted that Helicobacter pylori is one of the most common human infections; residents of megacities are more likely to suffer.
According to Russian scientists, the prevalence of this infection in Moscow is 60.7 - 88%, in St. Petersburg - 63.6%, in the cities of Eastern Siberia - up to 90% (data from the TsNIIG GBUZ MKNTs DZM published in the journal "Treating Doctor" in 2021). The less processed and the simpler the product is prepared, the healthier it is for the stomach. Boiled or baked meat is healthier for the stomach than sausages and frankfurters.

Drink water 30-40 minutes before meals (a glass of warm water drunk before meals normalizes stomach acidity). At the same time, do not drink during meals or immediately after it, but at least after half an hour or an hour.

Chew your food thoroughly. If food enters the stomach in large pieces, this creates additional stress, causing discomfort and bloating.

In the evening, try to eat at least three hours before bedtime, and preferably four. Don't sleep after a big lunch.

Don't get used to enduring pain and discomfort. If you begin to “feel” your stomach, immediately consult a gastroenterologist.

Numerous studies show that the main problem in the development of gastritis of the stomach is damage to the mucous membranes by the bacterium Helicobacter pylori. And eliminating contamination with this bacterium is the gold standard of gastroenterology today. It is clear that no diet in the world can get rid of Helicobacter. This requires complex therapy.

Vikair

This medicine for gastritis contains not only bismuth from Helicobacter pylori, but also plant components (buckthorn bark, calamus rhizome extract), as well as magnesium carbonate and sodium bicarbonate. This composition of Vikair makes it both an antispasmodic, an antacid and a drug with an astringent and laxative effect. The medicine has low cost and excellent effectiveness, so it is popular in the treatment of gastritis. But it is worth remembering that Vikair is contraindicated during pregnancy and children.

Vikair