2. DEFINITION
:
Gastritis is an inflammation of the gastric
mucosa, is
classified as either acute or chronic.
INCIDENCE:
The incidence of gastritis is highest in the fifth
and sixth decades of life; men are more
frequently affected than women. The incidence
is greater in clients who are heavy drinkers and
smokers.
3. ETIOLOGY AND RISK
FACTORS:
It usually stems from ingestion of a corrosive,
erosive, or
infectious substance.
Aspirin and other non-steroidal anti-inflammatory
drugs (NSAIDs), digitalis, chemotherapeutic drugs,
steroids, acute alcoholism and food poisoning
(typically caused by Staphylococcus organisms) are
common causes.
Food substances including excessive amounts of
tea, paprika, clove and pepper can precipitate
acute gastritis.
Foods with a rough texture or those eaten at an
extremely
high temperature can also damage the stomach
4. The mucosal lining of the stomach normally
protects it
from the action of gastric acid. This mucosal
barrier is composed of prostaglandins.
Due to any cause
This barrier is penetrated
Hydrochloric acid comes into contact with the
mucosa
Injury to small vessels
Edema, hemorrhage, and possible ulcer
5. Epigastric discomfort
Abdominal tenderness
Cramping
Belching
Reflux
Severe nausea and vomiting
Hematemesis
Sometimes GI bleeding is the only
manifestation
When contaminated food is the cause of
gastritis,
diarrhea usually develops within 5 hours of
6. Diagnosis is based on a detailed
history of food intake, medications
taken, and any disorder related to
gastritis.
The physician may also perform a
gastroscopic examination with
endoscopy.
Histological examination by biopsy of
a
7. 10
Diagnoses
Tests that may be needed are:
Complete blood count (CBC) to check for anemia
or low blood count
Examination of
the stomach with an endoscope
(esophagogastroduodenoscopy or EGD/OGD)
8. 11
Diagnoses
1.H. pylori Stool antigen test
Stool more sensitive than blood test
2.Stool test
For occult blood
check for small amounts of blood in the stools,
which may be a sign of bleeding in the stomach
due to gastric erosion
9. Anti emetic drugs like Inj. Perinorm or
Tab. Domperidone are frequently effective
in vomiting.
PPIS. e.g omeprazole , lansoprazole .
Esomeprazole
H2 Receptor antagonist eg.cimetidine,
Ranitidine, or Famotidine are effective to
reduce the pain.
If ingestion of NSAIDs is a problem, a
prostaglandin E1 (PGE1) analog may be
prescribed to protect the stomach mucosa
and inhibit gastric acid secretion.
10. Initially foods and fluids are withheld until
nausea and vomiting subside.
Once the client tolerates food, the diet
includes decaffeinated tea, gelatin, toast,
and simple bland foods.
The client should avoid spicy foods,
caffeine and large, heavy meals.
In the continued absence of nausea,
vomiting and bloating, the client can slowly
return to a normal diet.
11. Chronic gastritis occurs in 3 different
forms
1) Superficial gastritis, which causes a
reddened, edematous mucosa with small
erosions and hemorrhages.
2) Atrophic gastritis, which occurs in all layers of the
stomach, develops frequently in association with
gastric ulcer and gastric cancer, and is invariably
present in pernicious anemia; it is characterized
by a decreased number of parietal and chief cells.
3) Hypertrophic gastritis, which produces a dull
and nodular mucosa with irregular, thickened,
or nodular rugae; hemorrhages occur
frequently.
12. Peptic Ulcer Disease (PUD), infection
with Helicobacter pylori bacteria or
gastric surgery may lead to chronic
gastritis.
After gastric resection with a gastro-
jejunostomy, bile and bile acids may
reflux into the remaining stomach,
causing gastritis.
H.Pylori infection can lead to chronic
atrophic
gastritis.
Age is also a risk factor; chronic gastritis
13. The stomach lining first becomes thickened
and erythematous and then becomes thin
and atrophic.
Continued deterioration and atrophy
Loss of function of the parietal cells
Acid secretion decreases
Inability to absorb vitamin B12
Development of pernicious anemia
14. Manifestations are vague and may be absent
because the problem does not cause an increase
in hydrochloric acid.
Assessment may reveal
Anorexia
Feeling of fullness
Dyspepsia
Belching
Vague epigastric pain
Nausea
Vomiting
Intolerance of spicy and fatty foods
