Gastritis (dyspepsia): suggestions on how to have patients approach making them understand the problem and looking for solutions

LETTER TO THE EDITOR

Gastritis (dyspepsia): suggestions on how to have patients approach making them understand the problem and looking for solutions

Jorge Alberto Langbeck Ohana

^{Correspondence}

Popularized as "gastritis", the painful discomfort located in the epigastric region ("mouth of the stomach") , is more appropriately called dyspepsia .

In the minds of the population , gastritis is an inflammation that can progress to ulcer and gastric cancer. In fact, these pathological conditions are very individualized, taking peculiar origins. Clinical complaints may cause some difficulties to discern them.

Another major concern of patients is whether " gastritis can be cured" . It is very important that they understand the five main groups causing dyspepsia . It should be very clear that , excluding the complete eradication of the bacterium Helicobacter pylori, other situations of aggression to the gastric mucosa may be recurring , depending on permanent display or re-exposure.

I suggest the patient approach as visualized in Figure 1 , demonstrating the main factors of aggression to the stomach :

1. Helicobacter pylori - Is a bacteria inhabiting between 60 and 80% of the world's human stomachs . It is usually asymptomatic but may harm the gastric mucosal barrier protection , determining clinical dyspeptic manifestations . It is sensitive to specific treatment , however may show resistance or recurrence in small percentages. In these cases, it can be retreatment .

2. Poor diet - Both the composition of foods and indiscipline in the recommended eating times, failure on brunching , eating out frequently, eating hastily , abusing fried foods, condiments , canned food , sausages, spicy peppers , meats preserved in salt, soft drinks and fast foods, are great villains .

3. Alcoholic beverages - Is bad in known circumstances: quantity, daily intake and beverage quality. Ingested occasionally (socially) and in small doses, should not cause inconvenience .

4. Medicines - The first advice is to avoid any kind of self-medication . Even when prescribed by a doctor , hormonal anti-inflammatory drugs, some antibiotics and antivirals, can cause aggression of the stomach mucosa and requires protective medication Illegal drugs also harm the stomach.

5. Stress - Patients always ask if " there is, really, nervous gastritis?". Of course it does . We can tell them that the central nervous system has a nerve called vagus , which reaches several organs including the stomach. It can cause an excessive gastrin and hydrochloric acid production - both aggressive to the stomach -, under conditions of greater stress. The competitive life , losses , charges the modern world , family and financial tensions and the constant feeling of insecurity , are among the main factors of stress .

So , it's necessary to tell that it is very difficult to ensure the "cure " of gastritis . More than medical assistance and medication , it is necessary to make patients to understand that they must solve the problems inside themselves , look for solutions to their interior aggressions and follow the doctor's instructions - to whom should maintain unconditional fidelity. The doctor, above of all, must maintain doctor-patient relationship in the highest possible level.

It is important to always remember that human beings are inseparable in their bio -psycho - social integrity.

Received for publication: 17/12/2012

Accepted for publication: 05/03/2013

Financial source: none

Conflicts of interest: none

Publication Dates

• Publication in this collection
  05 Feb 2014
• Date of issue
  Dec 2013