Gastritis commonly refers to inflammation of the lining of the stomach, but the term is often used to cover a variety of symptoms resulting from stomach lining inflammation and symptoms of burning or discomfort. True gastritis comes in several forms and is diagnosed using a combination of tests.An inflammation of the gastric mucosa, gastritis may be acute or chronic. Acute gastritis produces mucosal reddening, edema, hemorrhage, and erosion. Chronic gastritis is common among elderly people and those with pernicious anemia. It's often present as chronic atrophic gastritis, in which all stomach mucosal layers are inflamed, with reduced numbers of chief and parietal cells.
Acute and chronic gastritis vary in causative factors.
Acute gastritis has a number of causes, including:
Acute gastritis also may develop as a complication in acute illnesses, particularly major traumatic injuries, burns, infectious processes, major surgical procedures, and hepatic, renal, or respiratory failure.
Chronic gastritis may be associated with peptic ulcer disease, which causes chronic reflux of pancreatic secretions, bile, and bile acids from the duodenum into the stomach.
Recurring exposure to irritating substances, such as drugs, alcohol, cigarette smoke, and environmental agents, also may lead to chronic gastritis. Chronic gastritis may occur in patients with a history of pernicious anemia, underlying kidney disease, or diabetes mellitus.
Bacterial infection with Helicobacter pylori is a common cause of nonerosive chronic gastritis.
Signs and symptoms
Sometimes there are no symptoms at all. When symptoms are present, some of the most common symptoms are: hiccups, abdominal indigestion, loss of appetite, nausea, vomiting, vomiting blood or coffee-ground like material, and dark stools.
Signs and tests
Tests vary depending on the specific cause. An upper GI X-ray, EGD , or other tests may be advised.
H. pylori infection with gastritis may be eradicated with a number of tripledrug regimens. Eliminating the cause of gastritis is the first step to treating it.
Histaminez-receptor antagonists, such as cimetidine and ranitidine, may block gastric secretions. Antacids may also be used as buffers.
For critically ill patients, antacids administered every 4 hours when the pH of the stomach is less than 4.0, with or without histamine-receptor antagonists, may reduce the frequency of gastritis attacks. Some patients also require analgesics. Until healing occurs, oxygen needs, blood volume, and fluid and electrolyte balance must be monitored.
When gastritis causes massive bleeding, treatment includes blood replacement, nasogastric lavage, angiography with vasopressin infused in normal saline solution and, sometimes, surgery.
Vagotomy and pyloroplasty have achieved limited success when conservative treatments have failed. Rarely, partial or total gastrectomy may be required.
Simply avoiding aspirin and spicy foods may relieve chronic gastritis. If symptoms develop or persist, antacids may be taken. If pernicious anemia is the cause, vitamin B12 may be administered parenterally.
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