Gastritis

Gastritis
Epidemiology
- inflammatory disorder of the gastric
mucosa
- incidence less than 1% in USA
- acute or chronic
- superficial mucosa of the fundus or antrum
Pathophysiology
- acute gastritis cause by injury of mucosal
layer/barrier layer
- caused by drugs/NSAIDS
- H Pylori infection
- alcohol, histamine, digitalis, metabolic
disorders
- ibuprofen, naproxen, indomethacine,
aspirin
- inhibits the action of prostaglandin
synthesis/prevent mucus secretion
Clinical Presentation
- fundal gastritis
- pain, nausea, vomiting
- acute gastritis
- vague abdominal complaints
- epigastric tenderness
- bleeding
Diagnosis
- clinical presentation of complaints
- acute spontaneously resolves 4 days
- chronic gastritis older adults
- mucosal atrophy
- gastroscopy
- biopsy
- epithelial metaplasia
- type A
- type b
- mixed
- type c
- pancreatic secretions causing injury
- both A & B
- non immune
- H. Pylori
- antrum only
- ETOH, Smoking, NSAIDS
- immune
- most rare
- auto antibodies
- pernicious anemia from poor absorption
Treatment
- discontinue injurious drugs
- antacids
- H2 receptor antagonists facilitate healing
- soft, bland diet
- treat H. Pylori
- stop smoking, stop drinking, stop NSAID
use
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