Classification

I. According to the type of dyspepsia there are distinguish:

- the ulcer-like type;

- the dysmotor type;

- the nonspecific type.

II. According to the stage of dyspepsia there are distinguish:

• stage of aggravation;

• stage of unstable remission;

• stage of remission.

Clinical features

In patients with functional dyspepsia the clinical picture includes the general neurologic displays - sleeplessness, migraines, irritability, bad mood and special (gastric) that depend on a type of dyspepsia.

Ulcer-like type - is characterized by periodic pain in epigastria, the moderate intensity, as a rule without irradiation, arising on an empty stomach (hungry pains) or at night (night pains), relieved after reception of food and/or antacids.

Dysmotor type - is characterized by the feeling of early saturation, weight, overflow, a swelling in the epigastria; sensation of discomfort after meal; nausea, sometimes vomiting; decrease in appetite.

At a nonspecific type there can be various attributes, which difficultly carry to any of described variants.

For functional dyspepsia there are specific three attributes (according to Roman (III) diagnostic criteria):

- constant or recurrent dyspepsia (a pain or the discomfort localized in epigastria), which duration not less than 12 weeks for last 6 months (between aggravations there can be light intervals);

- on the basis of the anamnesis, endoscopic researches of the upper part of a gastrointestinal tract and ultrasound examination of abdominal cavity organs there are absent proofs of organic disease;

- absence of proofs, that dyspepsia is facilitated by defecation or connected with change of frequency of a stool.

Establishment of the diagnosis probably only by exception of disease with a similar clinical picture, especially that connected with the «symptoms of alarm» (a fever, an impurity of blood in stool, an anemia, accelerated ESR, unmotivated behaviors).

Chronic gastritis

Chronic gastritis - chronic inflammatory-dystrophic process in the stomach mucous with recurrent duration that passing with cells regeneration disturbances, progressive atrophies of secretory epithelium, impairment secretory, motoric and incretory functions of the stomach.

Chronic gastritis is morphologic concept with stereotypic reactions in the stomach mucosa: inflammation, atrophy, impaired cells regulation with metaplasia and dysplasia.

Etiology

- the leading role in development of the chronic gastritis belongs to Helicobacter pylori;

- genetic predisposition;

- influence of other infectious factors (parasites invasions, virus infectious, fungus damage);

- autoimmune factors;

- particularities of nutrition;

- food allergy; influence of harmful factors of an environment;

- radiating irradiation;

- influence of drugs therapy.

Classification

The international classification of chronic gastritis, 1996

The type of gastritis	Synonyms	Etiologic factors
Non-atrophy	Type B Superficial Antral gastritis Chronic antral gastritis Hypersecretory	Helicobacter pylori Other factors
Atrophy	Type A Autoimmune Associated with pernicious anemia	Autoimmune Helicobacter pylori Particularities of nutrition Influence of harmful factors of an environment
The special forms
Chemical	Type C Reactive reflux-gastritis	Contents of duodenum
Radiating		Radiating irradiation
Lymphocytary	Variolomorphy Associated with celiakia	Idiopathic mechanisms Autoimmune mechanisms Helicobacter pylori
Non-infective granulomatous	Isolated granulomatous	Crone's disease Sarcoidosis
Eoshynophily	Food allergy Other allergens	Allergic
Other infections		Bacteria Viruses Fungus Parasites