This document discusses chronic gastritis and peptic ulcer disease. It defines gastritis as inflammation of the gastric mucosa and describes different types including acute, chronic, hypertrophic, lymphocytic, eosinophilic and granulomatous gastritis. It also discusses classifications of gastritis and lists various etiological factors. For peptic ulcers, it provides a definition and classification including localization, etiology, phase of the ulcerative process and possible complications. Laboratory and instrumental studies for diagnosis are outlined along with differential diagnosis and drug treatment options.

1. Chronic gastritis
and peptic ulcer
disease

2. gastritis
 Gastritis - a focal or diffuse inflammation
of the gastric mucosa in response to its
damage with disorders of the secretory,
motor, and sometimes inkretory functions.

3. types of gastritis
 acute;
 chronic;
specific forms of gastritis :
 hypertrophic;
 lymphocytic;
 eosinophilic;
 granulomatous;
 reactive.

4. International Classification
of gastritis (Houston, 1994)
 Nontrofic (type B)
 Atrophic, autoimmune (type A)
 Specific forms:
-Chemical (reflux gastritis, type C)
-Radiative
-Lymphocytic
-Noninfectious granulomatous
-Eosinophilic
-Some infections

5. Etiologic factors
Exogenous:
 Alimentary disorders
 Smoking
 Alcohol
 Neuropsychiatric stress
 Occupational hazard
 The uncontrolled use of drugs

6. Etiologic factors
Endogenous:
 Chronic infection
 Diseases of the nervous and endocrine
systems
 Cardiovascular and respiratory systems
 Renal failure

7. Clinical syndromes
 Pain
 Gastric dyspepsia
 Intestinal dyspepsia
 Asthenic-neurotic

8. Laboratory studies:
 complete blood count (deviation possible more prolonged chronic
disease with symptoms of atrophic gastritis, iron deficiency or B12
deficiency anemia);
 urinalysis;
 fecal occult blood worms and eggs;
 cytology of byoptites (during the first endoscopy, the dynamics - if
necessary, after the end of treatment);
 histological examination of biopsy samples (if necessary – in
dynamics);
 tests for Helicobaster pylory detection (fast urease test, breath test,
smear-mark);
 total protein and protein fractions of blood serum;
 determination of glucose in blood and urine.

9. Instrumental study:
 esophagogastroduodenoscopy with
mandatory biopsy and brush cytology;
 ultrasound of the abdomen;
 X-ray examination: X-ray examination of
esophagus, stomach, duodenum and other
parts of the intestine, if necessary -
radiography of these bodies.

10. Differential diagnosis
 ulcer
 stomach cancer
 diseases of the biliary tract
 gastric polyposis

11. Drug treatment of autoimmune gastritis
(type A)
 1. Drugs that stimulate the secretory function of the
stomach (Lymontar, Pentagastrin, Calcium Gluconate).
2. Replacement therapy (gastric juice pepsydyl, pepsin,
pepsin-atsydyn, Abomin, Panzinorm, Hydrochloric Acid).
3. In the presence of pain and frustration Dyspepcyc -
Cerukal, Eglonil, Nospanum, Halidor.
4. Anti-inflammatory therapy (plantain leaves,
Plantahlyutsyd, Venter).
5. Enzymes (Solizym, Oraz, Festal, Mezim forte).
6. Mineral water ("Mirgorodskaya", "Slov'yanivska" - in the
form of heat for 15-20 minutes before meals, in small sips
to 1/2-1 cup 2-3 times a day).

12. ulcer
 Peptic ulcer disease - a chronic disease
with cyclic flow and a tendency to
progression, which is characterized by
the formation of a defect in the lining of
the stomach or duodenum due to the
reduction of its security properties or
increasing aggressiveness of gastric
juice.

13. Classification of peptic ulcer
1. Localization ulcer:
-ulcer
-duodenal ulcer (bulbar, postbulbar)
-combined gastric and duodenal ulcers;
-hastroyeyunal ulcer (ulcer anastamoses).
2. Etiology:
-HP - positive ulcer;
-HP - negative ulcer.
3. Phase ulcerative process:
-active (acute, fresh);
-scarring;
-stage of scar;
-prolonged absence of scarring.

14. 4. Accompanying morphological changes:
-localization and activity of gastritis and duodenitis;
-the presence and severity of mucosal atrophy
-the presence of intestinal metaplasia;
-erosions, polyps;
-availability gastroezofagal or duodenogastric reflux.
5. Complications:
-bleeding
-perforation
-penetration
-stenosis
-malignization