Gastritis is an inflammation of the stomach lining that can cause pain, indigestion, bloating and nausea. It can be caused by H. pylori bacteria, alcohol, NSAIDs, stress or other factors. Symptoms include abdominal pain, nausea and vomiting. Treatment depends on the cause but may include antibiotics to kill H. pylori, medications to reduce acid production and promote healing, and antacids.

1. Gastritis
Dr. Sami

3. Definition:
 Gastritis is an inflammation or irritation of the lining of the stomach (Gastric
Mucosa). That can Cause Stomach pain, indigestion (dyspepsia), bloating and
nausea.
 It can occur suddenly (acute) or gradually (chronic).

5. Gastric Mucosa:
 Gastric: Related Stomach
 Mucosa: The moist, inner lining of some organs and body cavities (such as the
nose, mouth, lungs, and stomach). Protective Layer.

6.  Gastric mucosa
 is the mucous membrane layer of the stomach, which contains the glands and
the gastric pits. (Gastric pits are indentations in the stomach which denote
entrances to the tubular shaped gastric glands. )
 There are approximately 90 to 100 gastric pits per square millimetre (58,000
to 65,000 per square inch) of surface epithelium.
 In humans, it is about 1 mm thick, and its surface is smooth, soft, and velvety.
 It consists of simple columnar epithelium, lamina propria, and the muscularis
mucosae.

8.  Gastric mucus
 The mucosa is always covered by a layer of thick mucus that is secreted by
tall columnar epithelial cells.
 Gastric mucus is a glycoprotein that serves two purposes:
 1: the lubrication of food masses in order to facilitate movement within the
stomach
 2: the formation of a protective layer over the lining epithelium of the
stomach cavity.
 This protective layer is a defense mechanism. the stomach has against being
digested by its own protein-lyzing enzymes,
 The acidity, or hydrogen ion concentration, of the mucous layer measures pH7
(neutral)

9. Types of Cells In Gastric Mucosa:
 The gastric mucosa contains six different types of cells.
 Epithelial Cells
 Mucoid cells
 Zymogenic, or chief, cells
 Gastrin cells
 Parietal, or oxyntic, cells
 Endocrine cells

10.  Mucoid cells
 secrete gastric mucus and are common to all types of gastric glands. Mucoid
cells are the main cell type found in the gastric glands in the cardiac and
pyloric areas of the stomach.
 Zymogenic, or chief, cells
 These cells secrete pepsinogen, from which the proteolytic (protein-digesting)
enzyme pepsin is formed. There are two varieties of pepsinogen, known as
pepsinogen I and pepsinogen II.
 These cells cells are located predominantly in gastric glands in the body and
fundic portions of the stomach.

11.  Gastrin cells,
 also called G cells, are located throughout the antrum. These endocrine cells
secrete the acid-stimulating hormone gastrin Gastrin has two principal biological
effects: stimulation of acid secretion from gastric parietal cells and stimulation of
mucosal growth in the acid-secreting part of the stomach. Circulating gastrin
regulates the increase in acid secretion that occurs during and after meals.
 Parietal, or oxyntic, cells,
 found in the glands of the body and fundic portions of the stomach, secrete
hydrogen ions that combine with chloride ions to form hydrochloric acid (HCl).
The acid that is produced drains into the lumen of the gland and then passes
through to the stomach.
 Hydrochloric acid helps to digest, breakdown and absorb protein.
 Elimination of Bacteria n Viruses
 Prevent from Infections.

12.  Endocrine cells or Enterochromaffin
 secrete several substances, including the hormone serotonin.
 It appears to stimulate the production and release of gastric and colonic
mucus.

13. Gastric Secretions:
 The gastric mucosa secretes 1.2 to 1.5 litres of gastric juice per day.
 Gastric juice renders food particles soluble, initiates digestion (particularly of
proteins), and converts the gastric contents to a semiliquid mass called
chyme, thus preparing it for further digestion in the small intestine

14. Gastritis:
 Gastritis is an inflammation of the protective lining of the stomach

15. Causes:
 The stomach has a protective lining of mucus called the mucosa. This lining
protects your stomach from the strong stomach acid that digests food.
When something damages or weakens this protective lining, the mucosa
becomes inflamed, causing gastritis. A type of bacteria called Helicobacter
pylori (H. pylori) is the most common bacterial cause of gastritis.
 Alcohol abuse: Chronic alcohol use can irritate and erode the stomach lining.
 Autoimmune disease: In some people, the body’s immune system attacks
healthy cells in the stomach lining.
 Bacterial infection: H. pylori bacteria are the main cause of chronic gastritis
and peptic ulcer disease (stomach ulcers). The bacteria break down the
stomach’s protective lining and cause inflammation.

16.  Bile reflux: The liver Produce bile to help digest fatty foods. “Reflux” means
flowing back. Bile reflux occurs when bile flows back into the stomach instead
of moving through the small intestine.
 Medications: Steady use of nonsteroidal anti-inflammatory drugs (NSAIDs) or
corticosteroids to manage chronic pain can irritate the stomach lining.
 Physical stress: A sudden, severe illness or injury can bring on gastritis. Often,
gastritis develops even after a trauma that doesn’t involve the stomach.
Severe burns and brain injuries are two common causes.

17. Types:
 Acute
 Acute erosive gastritis typically involves surface necrosis due to damage to
mucosal defenses.
 NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the
maintenance of the normal lining of the stomach and intestines.
 COX-1 produce Prostaglandins: a group of lipids made at the site of tissue
damage of infection,
 Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach
called prostaglandin.

18.  These drugs used in a short period are not typically dangerous.
 However, regular use can lead to gastritis.
 Additionally, severe physiologic stress ("stress ulcers") from sepsis, hypoxia,
trauma, or surgery is also a common etiology for acute erosive gastritis.
 This form of gastritis can occur in more than 5% of hospitalized patients.

19.  Chronic
 Chronic gastritis refers to a wide range of problems of the gastric tissues.
 The immune system makes proteins and antibodies that fight infections in the
body to maintain a homeostatic condition. In some disorders the body targets
the stomach as if it were a foreign protein or pathogen; it makes antibodies
against, severely damages, and may even destroy the stomach or its lining.
 Gastritis may also be caused by other medical conditions, including HIV/AIDS,
Crohn's disease, certain connective tissue disorders, and liver or kidney
failure.

20. Other Types:
 We can also divide gastritis as:
 Erosive (reactive):
 Erosive gastritis causes both inflammation and erosion (wearing away or
abrasion) of the stomach lining. This condition is also known as reactive
gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or
bacterial infections and stress from illnesses or injuries.
 Non-erosive:
 Inflammation of the stomach lining without erosion or compromising the
stomach lining.

21. Sings and Symptoms:
 Black, tarry stool.
 Bloating.
 Nausea and vomiting.
 Feeling extra full during or after a meal.
 Loss of appetite.
 Stomach ulcers.
 Losing weight without meaning to.
 Upper abdominal (belly) pain or discomfort.
 Vomiting blood.
 Indigestion

22. Complications:
 Anemia: Erosive gastritis can cause chronic bleeding which, in turn, can lead
to anemia
 Atrophic gastritis: Chronic inflammation in the stomach can cause the loss of
both the stomach lining and glands
 Peptic ulcers: Ulcers can form in the lining of the stomach and duodenum
 Growths in the stomach lining: The risk of both benign and malignant growths
increases in people with gastritis. If Helicobacter pylori (H. pylori) bacteria
cause gastritis, they also increase the risk of a specific form of cancer known
as gastric mucosa-associated lymphoid tissue (MALT) lymphoma.

23.  deficiencies in vitamin B12, vitamin D, folic acid, vitamin C, zinc, calcium,
and magnesium
 bleeding in the stomach
 perforation inside the stomach
 Weakness
 Weight loss

24. Diagnose:
 Blood tests:
 CBC
 Presence of H. pylori.
 Urinalysis
 Stool sample, to look for blood in the stool
 X-rays
 Endoscopy, to check for stomach lining inflammation and mucous erosion
 Stomach biopsy, to test for gastritis and other conditions

25.  Breath test:
 During an H. pylori breath test, you swallow a capsule or liquid containing
urea, a harmless radioactive material. You then exhale into a balloon-like
bag. H. pylori bacteria change urea into carbon dioxide. If you have the
bacteria, the breath test will show an increase in carbon dioxide.

26. Prevention
 Maintaining good hygiene habits. Habits like handwashing may help you
reduceTrusted Source the risk of having a H. pylori infection.
 Taking good care of your mental health. Self-care and de-stressing practices
may reduce your risk of developing Trusted Source stress-induced gastritis.
 Eating smaller meals more slowly and regularly. Also, avoiding or limiting
fried, salty, sugary and spicy foods (these are things that research shows could
trigger gastritis symptoms).
 Quitting smoking, if you smoke.
 Avoiding or limiting alcohol and caffeine.

27. Treatment
 Treatment of gastritis depends on the specific cause. Acute gastritis caused by
nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping
use of those substances.
 Medications used to treat gastritis include:
 Antibiotic medications to kill H. pylori.
 For H. pylori in your digestive tract, doctor may recommend a combination of
antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil,
Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure
to take the full antibiotic prescription, usually for seven to 14 days.

28.  Medications that block acid production and promote healing.
 Proton pump inhibitors reduce acid by blocking the action of the parts of cells
that produce acid. These drugs include the prescription and over-the-counter
medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole
(Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and
pantoprazole (Protonix).

29.  Medications to reduce acid production.
 Acid blockers — also called histamine (H-2) blockers — reduce the amount of
acid released into your digestive tract, which relieves gastritis pain and
encourages healing. Available by prescription or over-the-counter, acid
blockers include famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine
(Axid AR).

30.  Antacids that neutralize stomach acid.
 Antacids neutralize existing stomach acid and can provide rapid pain relief.
Side effects can include constipation or diarrhea, depending on the main
ingredients.
 Aluminum hydroxide gel (Alternagel, Amphojel) Calcium carbonate (Alka-
Seltzer, Tums) Magnesium hydroxide (Milk of Magnesia)