Gastritis is defined as the inflammation of the gastric or stomach mucous which is a common gastrointestinal problem. It may be acute lasting from several hours to a few days or it can be chronic resulting from repeated exposure to irritating agents or reoccurring episodes of acute gastritis.
Acute gastritis is often caused by dietary indiscretion. A person eats a food that is irritating, highly seasoned or contaminated food. Other causes include overuse of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), excessive alcohol intake, bile reflux and radiation therapy. A more severe form of acute gastritis is caused by the ingestion of strong acid or alkali, which may cause the mucosa to become gangrenous or to perforate. It may also develop in acute illnesses, especially when the person has had major traumatic injuries, burns, severe infection, hepatic, renal, or respiratory failure, or major surgery. It may be the initial sign of an acute systemic infection.
Chronic gastritis is a prolonged inflammation of the stomach that may be caused either by benign or malignant ulcers of the stomach or by bacteria such as Helicobacter pylori. It may be associated with autoimmune diseases such as pernicious anaemia, dietary factors such as caffeine, the overuse of NSAIDs or bisphosphonates, alcohol, smoking or chronic reflux of pancreatic secretions and bile into the stomach.
Pathophysiology of Gastritis
The gastric mucous membrane becomes oedematous and hyperemic (congested with blood and fluid) and undergoes superficial erosion. It secretes a scanty amount of gastric juice, containing very little acid but much mucus. Superficial ulceration may occur and can lead to haemorrhage.
Clinical manifestation of Gastritis
The patient with acute gastritis may have a rapid onset of symptoms such as:
- Abdominal distension or discomfort
- Nausea and vomiting
- Pain in epigastric region
These symptoms can last from several hours to few days.
The patient with chronic gastritis may complain of:
- Heartburn after eating
- A sour taste in mouth
- Nausea or vomiting
- Pain in epigastric
- May be asymptomatic
- Patients with chronic gastritis from vitamin deficiency usually have evidence of malabsorption of vitamin B12.
Diagnostic assessment of Gastritis
- Gastritis is sometimes associated with achlorhydria or hypochlorhydria (absence or low level of hydrochloric acid) or with high acid levels.
- It can be determined by an upper GI x-ray series or endoscopy.
- Histology examination of a tissue specimen obtained by biopsy.
- Serological tests for antibodies to the H. Pylori antigen and a breath test may be performed.
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Treatment of Gastritis
The gastric mucosa is capable of repairing itself after an episode of gastritis. Typically, the patient recovers in about a day, although the appetite may be a loss for an additional 2 or 3 days. The patient should be restricted from consuming alcohol or eating until symptoms subside. Then the patient can progress to a no irritating diet. If the symptoms persist, intravenous fluid may be administered. Bleeding, if it is present, the bleeding has to be managed accordingly. If gastritis is due to ingestion of strong acids or alkali, dilute and neutralize the acid with common antacids, whereas neutralizing alkali with diluted lemon or diluted vinegar. If corrosion is severe, avoid emetics (vomiting) and lavage due to the danger of perforation and damage to the esophagus.
Therapy is supportive and may include nasogastric intubation, analgesic agents and sedative, antacids and intravenous fluids. In extensive cases, emergency surgery may be required to remove gangrenous or perforated tissue. A gastric resection or a gastrojejunostomy (anastomosis of jejunum to stomach to detour around the pylorus) may be done to treat pyloric obstruction which cannot be relieved by medical management.
It is managed by modifying the patient’s diet, promoting rest, reducing stress, avoidance of alcohol consumption and overuse of NSAIDs, and initiating pharmacotherapy. H. Pylori infection is treated with selected drug combinations.
- Reduce anxiety and take rest.
- Do not take medications on empty stomach, the medicine can irritate the mucosal layer of the stomach.
- Encourage on eating nutritious food excluding spicy and oily foods, junk food, or contaminated food consult with a nutritionist if indicated.
- Take plenty of fluids and water 3l/day.
- Eat on time or can make a routine of daily meals.
- Should have knowledge about antibiotic agents, antacids, bismuth salts, sedative medications, or anticholinergic agents that may be prescribed.
- Avoid caffeine, nicotine, and alcohol or soft drinks.
- Regular follow up an appointment with a healthcare provider.