What happens to the mucous membrane
Normally, the gastric mucosa contains glands that produce hydrochloric acid, enzymes and protective mucus. With this disease, mucus-producing cells grow rapidly, and acid-producing glands are replaced and disappear. The folds thicken and become massive, especially in the body and vault of the stomach. The altered epithelium allows plasma protein to pass into the lumen of the organ, and it is lost with digestive juices. At the same time, acid production decreases, which interferes with digestion and increases the risk of bacterial growth. In the development of the disease, the role of excessive activity of growth factors affecting mucosal cells is discussed.
- Proliferation of mucus-producing cells
- Decrease in the number of acid-producing glands
- Thickening of the folds of the body and vault of the stomach
- Loss of protein through altered mucosa
- Reducing the acidity of gastric juice
Symptoms
Most often, the disease begins gradually. Worries include aching pain or heaviness in the upper abdomen, nausea, sometimes vomiting, loss of appetite and early satiety. As protein is lost, swelling appears: first on the legs in the evening, then on the face and in the abdominal cavity. A person loses weight, becomes weaker, and tolerates stress worse. Diarrhea and minor bleeding from damaged mucous membranes are possible, leading to anemia. In children, the disease usually develops acutely after a viral infection, occurs with swelling and vomiting and, as a rule, goes away on its own within a few weeks.
- Pain and heaviness in the epigastric region
- Nausea, vomiting, loss of appetite
- Swelling of the legs, face, abdomen
- Weight loss and weakness
- Diarrhea
- Anemia due to occult blood loss
- In children - acute course with recovery
How to distinguish from a tumor
Thickening of the folds of the stomach also occurs with malignant diseases: infiltrative cancer, gastric lymphoma, as well as with some infections and the syndrome of excess gastrin production. Therefore, gastroscopy with a superficial biopsy alone is not enough - deep biopsies are needed, covering the entire thickness of the mucosa, sometimes repeated. Computed tomography and endoscopic ultrasound can help, showing which layers of the wall are thickened. The doctor also checks gastrin levels and the presence of H. pylori. Until the diagnosis is definitively confirmed, the patient is observed especially carefully.
- Deep and repeat biopsies are required
- Computed tomography of the upper abdomen
- Endoscopic ultrasound if possible
- Exclusion of lymphoma and infiltrative cancer
- Testing for H. pylori
- Gastrin level assessment
Diagnostics
The examination begins with gastroscopy, during which characteristic convoluted, thickened folds are visible that do not straighten when the stomach is inflated with air. Be sure to take deep biopsies from several areas. Blood tests reveal low total protein and albumin, often anemia; inflammatory parameters are usually normal. Additionally, protein loss through the intestines is assessed and other causes, such as kidney and liver diseases, are excluded. Tests for H. pylori are performed on everyone because once an infection is detected, treating it sometimes leads to significant improvement.
- Gastroscopy with deep multiple biopsy
- Total protein and blood albumin
- Clinical blood test
- Tests for H. pylori
- Computed tomography of the abdomen
- Rule out kidney and liver diseases
- Assessment of gastrin levels according to indications
Treatment
There is no specific treatment recognized as universal, so the approach is selected individually. The basis is a high protein diet that replenishes losses, if necessary with intravenous albumin. If an H. pylori infection is found, it is treated: in some patients this significantly improves the condition. Your doctor may prescribe medications that reduce acidity and medications that reduce mucous membrane growth. In case of severe, untreatable protein loss, exhaustion and suspicion of a malignant process, partial or complete removal of the stomach is performed. In children, supportive treatment is usually sufficient.
- High Protein Meals
- Intravenous albumin for severe edema
- Treatment of H. pylori infection when detected
- Drugs prescribed by a gastroenterologist
- Surgical treatment for severe cases
- Observation with control gastroscopy
- In children, observation is often sufficient