All about gastritis.

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. ETIOLOGYAND RISK FACTORS:
⦁ It usuallystems from ingestion of acorrosive, erosive, or
infectioussubstance.
⦁ Aspirin and other non-steroidal anti-inflammatorydrugs
(NSAIDs), digitalis, chemotherapeutic drugs, steroids,
acutealcoholismand food poisoning (typicallycaused by
Staphylococcusorganisms) arecommoncauses.
⦁ Food substances including excessive amounts of tea,
paprika, cloveand peppercan precipitateacutegastritis.
⦁ Foodswith a rough textureor thoseeaten atan extremely
high temperaturecan alsodamage thestomach mucosa.
⦁ Acutegastritis is usuallyof shortduration unless the
gastric mucosa has suffered extensivedamage.

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 anycause
↓
This barrier is penetrated
↓
Hydrochloric acid comes into contact with the mucosa
↓
Injury to small vessels
↓
Edema, hemorrhage, and possible ulcer formation

5.  Epigastricdiscomfort
 Abdominal tenderness
 Cramping
 Belching
 Reflux
 Severe nauseaand vomiting
 Hematemesis
 Sometimes GI bleeding is theonly manifestation
 When contaminated food is the cause of gastritis,
diarrhea usuallydevelopswithin 5 hoursof ingestion

6. Diagnosis is based on adetailed historyof
food intake, medications taken, and any
disorderrelated togastritis.
The physician may also perform a
gastroscopicexamination with endoscopy.
Histological examination by biopsyof a
sample.

7.  Anti – emeticdrugs like Inj. Perinorm orTab.
Domperidone are frequently effective in
vomiting.
 Antacids likecimetidine, Ranitidine, or
Famotidineareeffective to reduce the pain.
 If ingestion of NSAIDs is a problem, a
prostaglandin E1 (PGE1) analog may be
prescribed to protect the stomach mucosaand
inhibitgastricacid secretion.

8.  Initially foods and fluids arewithheld until nausea
and vomiting subside.
 Once the client tolerates food, the diet includes
decaffeinated tea, gelatin, toast, and simple bland
foods.
 Theclient should avoid spicy foods, caffeineand
large, heavy meals.
 In thecontinued absence of nausea, vomiting and
bloating, the client can slowly return to a normal
diet.

9. ⦁ Chronicgastritis occurs in 3 different forms
1) Superficial gastritis, which causesa 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
numberof parietal and chief cells.
3) Hypertrophic gastritis, which produces a dull and
nodular mucosawith irregular, thickened, or nodular
rugae; hemorrhages occur frequently.

10. Peptic Ulcer Disease (PUD), infection with
Halicobacterpylori bacteria orgastric surgery
may lead to chronic gastritis.
Aftergastric resection with agastro-
jejunostomy, bile and bile acids may reflux
into the remaining stomach, causing gastritis.
H.Pylori infection can lead to chronic atrophic
gastritis.
Age isalsoa risk factor; chronic gastritis is
morecommon in olderadults.

11. The stomach lining first becomes thickened and
erythematousand then becomes thinand atrophic.
↓
Continued deterioration and atrophy
↓
Loss of function of the parietal cells
↓
Acid secretion decreases
↓
Inabilitytoabsorbvitamin B12
↓
Development of pernicious anemia

12. Manifestations are vague and may be absent because
the problemdoes notcausean increase in hydrochloric
acid.
Assessment may reveal
 Anorexia
 Feeling of fullness
 Dyspepsia
 Belching
 Vagueepigastric pain
 Nausea
 Vomiting
 Intoleranceof spicy and fatty foods

13. Bleeding
Pernicious anemia
Gastriccancer

14.  Discomfort may lessen with a bland diet, small frequent
meals, antacids, H2 receptor antagonists, proton pump
inhibitors, and avoidance of food that cause
manifestations.
 If H.pylori bacteria are present, anti-biotics and other
medicationsareadministered toeliminate the bacteria.
 If 1 week of this regimen does notsucceed in eliminating
the bacteria, the regimen may be repeated foran
additional week.
 If perniciousanemia develops, intramuscular injections
of vitamin B12 may be administered monthly for the
remainderof theclient’s life.

15. Nursing Diagnosis:
1) Acutepain related to irritated stomach mucosa.
2) Imbalanced nutrition, less than body requirement,
related to inadequate intakeof nutrition.
3) Risk for imbalanced fluid volume related to
insufficient fluid intakeand excessive fluid loss
subsequenttovomiting.
4) Anxiety related totreatment.
5) Deficient knowledgeaboutdietary management
and disease process.