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Erosions of the stomach and 12-perintestine
Medical expert of the article
Last reviewed: 07.07.2025
Erosions of the stomach and duodenum are superficial defects that do not extend beyond the tunica muscularis of the mucous membrane of the stomach and duodenum and heal without scar formation.
Causes of erosions of the stomach and duodenum
The main etiological factors of erosions of the stomach and duodenum are:
- infection of the mucous membrane with Helicobacter pylori;
- psycho-emotional stress situations (adaptation disease according to G. Selye with erosive and ulcerative lesions of the gastroduodenal system);
- consumption of coarse, spicy, hot food and alcohol;
- taking salicylates and other NSAIDs, as well as glucocorticoids, reserpine, digitalis, and some antibiotics;
- congestion in the portal vein in liver cirrhosis or portal vein thrombosis (erosions form in the esophagus and stomach; chronic erosions are more often observed in alcoholic cirrhosis, and acute ones in viral cirrhosis of the liver);
Causes of erosions of the stomach and duodenum
Pathogenesis of erosions of the stomach and duodenum
Under the influence of etiological factors, the following mechanisms of development of erosions of the gastroduodenal zone are activated:
- decreased activity of protective factors of the gastroduodenal mucosa. Protective factors include gastric mucus, optimal blood circulation in the stomach wall, cellular regeneration, the inhibitory effect of gastrointestinal hormones on gastric secretion (primarily the formation of hydrochloric acid), saliva, and alkaline pancreatic juice. Of particular importance are the disruption of mucus production and the slowing down of the regeneration processes of the gastric epithelium, which reduces the resistance of the gastric mucosa and promotes the development of erosions;
Pathogenesis of erosions of the stomach and duodenum
Classification of erosions of the stomach and duodenum
Acute erosions include flat erosions whose epithelialization period does not exceed 2-7 days; chronic erosions include erosions that do not undergo reverse development within 30 days or more.
Types of erosions of the stomach and duodenum
Clinical picture of erosions of the stomach and duodenum
Patients suffering from erosions of the stomach and duodenum complain of pain in the epigastric region, occurring 1-1.5 hours after eating, heartburn, nausea, belching, and often vomiting. During an objective examination of patients, weight loss can be noted (with long-term existence of erosions), which is caused by a decrease in appetite, sometimes refusal to eat due to fear of pain and vomiting. Palpation of the abdomen can reveal local soreness in the epigastric region. Thus, a characteristic feature of erosions of the gastroduodenal region is ulcer-like clinical symptoms.
Symptoms of erosions of the stomach and duodenum
FEGDS allows us to differentiate between mature and immature chronic complete erosions. Immature complete erosions are those that have only a rim of hyperemia at the top. Mature complete erosions are those with signs of desquamation and necrosis. Immature erosions are observed in the remission phase, mature ones - in the exacerbation phase.
Gastric erosions should be carefully differentiated from the erosive-ulcerative form of cancer, for which it is necessary to perform a biopsy from suspicious areas of the mucous membrane with subsequent morphological examination.
[ What tests are needed?