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Line 137: + − • Type A gastritis (Autoimmune gastritis)+ − • Type B gastritis (H. Pylori related)+ − • Type AB gastritis (Mixed gastritis, environmental gastritis, chronic atrophic gastritis)+ − + − + − + − + − + − + + + + + + + + + + + − + − + − + − + + + + + + +
→Chronic gastritis
===Chronic gastritis===
===Chronic gastritis===
Recurrent attacks of acute gastritis may result in chronic gastritis.
Recurrent attacks of acute gastritis may result in chronic gastritis.
It is classified into,
It is classified into,
*Type A gastritis (Autoimmune gastritis)
Type A gastritis – Auto immune gastritis
*Type B gastritis (H. Pylori related)
It mainly involves the body-fundic mucosa and is called as autoimmune gastritis and is usually associated with other autoimmune diseases such as Hashimoto’s thyroditis and Addision’s disease. Antibodies against parietal cells and intrinsic factor cause depletion of parietal cells and this leads to the impaired secretion of intrinsic factor. Ultimately, these changes may lead to significant gastric atrophy.
Type B gastritis (H. Pylori infection)
*Type AB gastritis (Mixed gastritis, environmental gastritis, chronic atrophic gastritis)
It mainly involves the region of antral mucosa and is the common type. It is also called as hypersecretory gastritis because of excessive secretion of acid due to H. Pylori infection. It is usually associated with peptic ulcer.
Type A B gastritis (Mixed / Environmental / Chronic atrophic gastritis)
'''Type A gastritis – Auto immune gastritis'''
It affects the mucosal region of body of stomach-both fundic and antral part. It is the most common type of gastritis affecting all the age groups. It is also called as environmental gastritis, because a number of unidentified environmental factors have been implicated in etiopathogenesis.
It mainly involves the body-fundic mucosa and is called autoimmune gastritis and is usually associated with other autoimmune diseases such as Hashimoto’s thyroiditis and Addison's disease. Antibodies against parietal cells and intrinsic factor cause depletion of parietal cells and this leads to the impaired secretion of intrinsic factors. Ultimately, these changes may lead to significant gastric atrophy.
'''Type B gastritis (H. Pylori infection)'''
It mainly involves the region of antral mucosa and is the common type. It is also called hypersecretory gastritis because of excessive secretion of acid due to H. Pylori infection. It is usually associated with peptic ulcer.
'''Type A B gastritis (Mixed / Environmental / Chronic atrophic gastritis)'''
It affects the mucosal region of the body of the stomach-both fundic and antral parts. It is the most common type of gastritis affecting all age groups. It is also called environmental gastritis because a number of unidentified environmental factors have been implicated in etiopathogenesis.
In its advanced stage, there is progression from chronic superficial gastritis to chronic atrophic gastritis characterized by mucosal atrophy and metaplasia of intestinal or pseudopyrloric type.
In its advanced stage, there is progression from chronic superficial gastritis to chronic atrophic gastritis characterized by mucosal atrophy and metaplasia of intestinal or pseudopyrloric type.
Principle of treatment of chronic gastritis
For treating the chronic gastritis, the principle of treatement of “vata-pitta dominant gulma” is recommended. It includes protecting the [[kapha]], which is the defensive factor. Here, the measures to reduce the penetrating power (tikshnatva) of [[pitta]] should be administered, followed by healing or soothing type of medicines (ropana chikitsa). The combination of Glycyrrhiza Glabra (madhuyashti), Asparagus racemosus (shatavari), Phyllanthus emblica (amalaki) with ghee and honey is best for healing action. Drugs with bitter (tikta) or sweet (madhura) tastes (rasa) are preferable here. Ghee or milk preparation processed with these kind of drugs are also advisable.
'''Principle of treatment of chronic gastritis'''
The psychological component should also be addressed with equal importance, because stress plays an important role in this condition. If a person’s mental status is not positive, it may lead to indigestion.
In second line of treatment, mild purgation therapy (mrudu virecana) can be given. It is better to avoid the ready-made decoctions (kashayas) in bottles, because the preservatives added to it can worsen the condition. Medicated ghee preparations are better to be prescribed.
For treating the chronic gastritis, the principle of treatment of “[[vata]]-[[pitta]] dominant gulma” is recommended. It includes protecting the [[kapha]], which is the defensive factor. Here, the measures to reduce the penetrating power (tikshnatva) of [[pitta]] should be administered, followed by healing or soothing type of medicines (ropana chikitsa). The combination of Glycyrrhiza Glabra (madhuyashti), Asparagus racemosus (shatavari), Phyllanthus emblica (amalaki) with ghee and honey is best for healing action. Drugs with bitter (tikta) or sweet (madhura) tastes (rasa) are preferable here. Ghee or milk preparation processed with these kind of drugs are also advisable.
The psychological component should also be addressed with equal importance because stress plays an important role in this condition. If a person’s mental status is not positive, it may lead to indigestion.
In second line of treatment, mild purgation therapy (mrudu [[virecana]]) can be given. It is better to avoid the ready-made decoctions (kashayas) in bottles because the preservatives added to them can worsen the condition. Medicated ghee preparations are better to be prescribed.
Formulations like avipattikara churna, sitopaladi churna, yashtitriphala churna, dadimadi ghrita, shatavari ghrita, guduchyadi ghrita, ashwagandha mahatiktam ghritam are effective in this condition.
Formulations like avipattikara churna, sitopaladi churna, yashtitriphala churna, dadimadi ghrita, shatavari ghrita, guduchyadi ghrita, ashwagandha mahatiktam ghritam are effective in this condition.
=== Gastro-esophageal reflux disease (GERD) ===
=== Gastro-esophageal reflux disease (GERD) ===
Due to decreased tone of lower oesophageal sphincter, the gastric contents get regurgitated frequently into the oesophagus. It causes damage to the mucous membrane of oesophagus and lead to esophagitis. The risk factors for this condition include obesity, fat rich diet, caffeine, alcohol, smoking and the symptoms are heart burn, regurgitation and dysphagia. It can be diagnosed on the basis of clinical symptoms, 24 hour pH monitoring, endoscopy and biopsy.
Due to decreased tone of lower oesophageal sphincter, the gastric contents get regurgitated frequently into the oesophagus. It causes damage to the mucous membrane of oesophagus and lead to esophagitis. The risk factors for this condition include obesity, fat rich diet, caffeine, alcohol, smoking and the symptoms are heart burn, regurgitation and dysphagia. It can be diagnosed on the basis of clinical symptoms, 24 hour pH monitoring, endoscopy and biopsy.