Gastritis in the elderly

Gastritis in elderly people is less pronounced than in young people, although the disease is more severe: it is often accompanied by a sharp deterioration in condition, severe intoxication, symptoms of cardiovascular failure up to collapse. Complaints and clinical picture of chronic gastritis in elderly and senile people are less expressive than in young people, often proceeds latently.

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What causes gastritis in older people?

Acute gastritis in the elderly develops as a result of consuming poor-quality infected food, mistakenly consuming strong solutions of acids or alkalis, or improper and prolonged use of medications (salicylates, reserpine, corticosteroids, cardiac glycosides).

Among the causes of chronic gastritis, exogenous and endogenous factors can be distinguished. Exogenous factors include dietary disorders, consumption of poorly processed coarse food, and long-term use of medications. Endogenous causes include neurovegetative disorders, neuroreflexive effects in diseases of other organs, damage to the pituitary-adrenal system, chronic infectious diseases, metabolic disorders, hypoxia of gastric tissue in chronic cardiovascular, respiratory, and renal failure, and allergic diseases.

Damage to the gastric mucosa in chronic gastritis: superficial (initial phase), with damage to the glands without atrophy (intermediate phase) and atrophic (final phase). In contrast to young people, the most common type in elderly and old people is atrophic bacterial (type B).

How does gastritis manifest itself in older people?

Gastritis in the elderly occurs acutely. It is characterized by a syndrome of gastric discomfort - nausea, vomiting, belching of air or food eaten the day before, pain mainly in the upper abdomen (epigastric angle, supraumbilical region), sometimes radiating to the right and left hypochondrium. In severe cases - increased pulse rate, decreased blood pressure.

Features of chronic gastritis in the “third age”:

• predominance of dyspeptic syndrome over pain syndrome;
• more often secretory insufficiency of the gastric glands;
• wave-like flow without significant loss of body weight;
• the presence of not only gastric but also intestinal dyspepsia; The disease is characterized by mild symptoms. Patients often complain of a feeling of heaviness and fullness in the epigastric region, sometimes mild pain after eating. Bloating, belching, rumbling in the abdominal cavity, general weakness, constipation, sometimes replaced by diarrhea are noted. In this case, an exacerbation of the disease is associated with a change in the nature of nutrition, the use of whole milk, meat or spicy dishes, alcohol, and medications.

How is gastritis treated in the elderly?

During the first few days, you should refrain from eating. In the following days, a chemically, mechanically and thermally gentle diet is prescribed in small portions. It is recommended to drink plenty of fluids (unsweetened tea, slightly alkaline mineral waters, rosehip and herbal decoctions). In case of frequent vomiting, it is necessary to combat dehydration, monitor hemodynamics and water balance. It is advisable to monitor and correct homeostasis: transfuse water-salt solutions, plasma. Large doses of vitamins (C - 300 mg, PP - 100 mg per day), antispasmodic and sedative therapy are indicated. If necessary, drugs that normalize the activity of the cardiovascular system are used.

One of the main components of complex treatment of chronic gastritis is the correct diet, sleep, work and rest. Food is taken at least 5 times a day in a warm form. The diet should contain a normal amount of table salt, extractive nitrogenous substances, an increased amount of vitamins, especially ascorbic (500 mg / day) and nicotinic (50-200 mg / day) acids. For the elderly, especially those living alone, compliance with the terms and conditions of storage of food products, the rules for taking medications is of particular importance.

Depending on the integrity and functionality of the gastric secretory apparatus, it is advisable to prescribe replacement therapy (gastric juice, acidin-pepsin, abomin) to replenish the secretory function of the stomach. Plantaglucid, centaury, infusion of plantain leaves, dandelion roots, etc. are used to stimulate appetite and juice secretion.

Since chronic gastritis in the elderly is a progressive inflammatory process, the complex of drug treatment includes substances that have an anti-inflammatory effect: infusion or extract of chamomile, bismuth preparations (De-Nol), course use of oxacillin, ampicillin, furazolidone, trichopolum.

To improve metabolic processes in the stomach wall, multivitamin preparations such as undevit, pangeksavit, dekamevit, vitamin B (0.05 g 3 times a day) and ascorbic acid (500 mg per day for 12-20 days), methyluracil (0.5-1.0 g i 3 times a day) are recommended.

The metabolic therapy complex includes co-carboxylase, anabolic steroids (methandrostenolone 5-10 mg 2-3 times a day, retaboyil 500 mg intramuscularly once every 1-2 weeks) and prophylactic courses of cyanocobalamin.

To normalize motor-evacuation disorders, cerucal or reglan is prescribed, 1 tablet orally 3 times a day 5 minutes before meals or parenterally 1-2 mg for 2-3 weeks, and motilium is also used, which has no side effects on the central nervous system.