Gastritis

3. Gastritis
 Inflammation of the gastric or stomach mucosa is a
common GI problem
 It effects women and men equally and is more
common in older adult
 Gastritis may also be classified as
 Erosive (caused by long term used of non steroidal
anti inflammatory drugs, alcohol ,radiation .
 Non erosive (caused by infection with Helicobacter
pylori)

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 A more severe form of acute gastritis is caused by the
ingestion of strong acid or alkali
 Which may caused the mucosa to become gangrenous
 Scarring can occur resulting in pyloric stenosis or
obstruction
 Acute gastritis also may develop in acute illnesses
when patient has had major traumatic injuries burn
severe infection hepatic kidney or respiratory failure or
major surgery (due to raised toxin level)
 Gastritis may be first sign of an acute systemic
infection

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 Chronic gastritis is sometime associated with
autoimmune disease such as pernicious anemia
 Chronic gastritis caused by H pylori infection is
implicated in the development of peptic ulcer gastric
cancer

6. Pathophysiology
 Gastric mucous membrane become edematous and
hyperemic (congested with fluid and blood )and
undergoes superficial erosion
 Because gastric acid is abrasive, the mucosa also
secretes a protective protein-filled mucus that
coats the stomach. In cases of gastritis, this mucus
layer is damaged, allowing the stomach acids to reach
and irritate the lining itself.
 Superficial ulceration may occur as a result of erosive
disease and may lead to hemorrhage

10. Clinical manifestation
 The patient with acute gastritis may have a rapid onset of symptom
such as
 Abdominal discomfort
 Headache
 Lassitude
 Nausea anorexia vomiting hiccupping
 Erosive gastritis may cause bleeding which may manifest as blood in
vomit (hematemesis)black tarry stools (melena)bright red bloody
stools (hematochezia)
 The patient with chronic gastritis may complain of anorexia heartburn
after eating belching or nausea and vomiting

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 Patient with chronic gastritis may not be able to
absorb vitamin B 12 because of diminished production
of intrinsic factor by the stomach parietal cells which
may lead to pernicious anemia

12. Medical management
 Gastric mucosa is capable of repairing itself after an
episode of acute gastritis although the appetite may be
diminished for 2 to 3 days
 Acute gastritis is also managed by instructing the
patient to refrain from alcohol and food until symptom
subside
 Non irritating diet is recommended
 If the symptom persist intravenous fluids may need to
be administered

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 Histamine 2 receptor antagonists (famotidine
ranitidine)
 PPI omeprazole
 In extreme cases emergency surgery may be required
to remove the gangrenous or perforated tissue
 A gastric resection or gastrojejunostomy (anastomosis
of jejunum to stomach .
 Chronic gastritis is managed by modifying the patients
diet promoting rest reduce stress recommended avoid
of alcohol and NSAID