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Gastritis

What is Gastritis ?

Definition

Gastritis is a condition wherein there is an inflammation in the gastric lining. The white blood cells move into the walls of the stomach because there is injury on that area. Many people may use gastritis and peptic ulcer disease interchangeably but these are two different conditions although they may relate with each other. This happens because there are underlying cases and one of the most common conditions associated with this is dyspepsia. Although gastritis is a common problem, it only accounts to about 10 percent of hospital or emergency room visits.

Acute Gastritis

This is a condition wherein a sudden illness or pain in the epigastric area happens in 3 months or less. Acute gastritis happens when alcohol is ingested or taking aspirin. Sudden epigastric upset can be a symptom of acute gastritis.

Chronic Gastritis

When epigastric pain lasts for more than 6 months, it is already considered a chronic gastritis. This can happen because of other underlying problems. When a patient has Helicobacter pylori bacteria, this can lead to chronic gastritis. Chronic gastritis symptoms include bad breath since it can be associated with bacterial overgrowth syndrome.

Erosive Gastritis

Because the defenses of the mucus  cavity, the gastric mucosa  erodes. This condition is called erosive gastritis. Under an endoscopy, bleeding occurs in the gastric area. Typically, erosive gastritis is acute but it can also be chronic but it does not show any symptoms due to some underlying cause.

Atrophic Gastritis

Atrophic gastritis is a much serious condition because it is a chronic problem where in the stomach  mucosa is inflamed. This results to loss of gastric cells and is replaced by intestinal or fibrous tissue. Ultimately, this affects the secretion of enzymes and substances like the hydrochloric acid, pepson and even the intrinsic factor. As a result, this can cause problems such as vitamin B12 deficiency and even megloblastic anemia. Atrophic gastritis symptoms may include indigestion, nausea, weight loss, lack appetite.

Stress Induced Gastritis

This problem is also referred to as stress-related erosive syndrome wherein patient care critically-ill or those who undergoes extreme psychological stress. In the United States, there are about 6 per cent of people who bleeds due to stress-induced ulcer. This 6 per cent covers mostly of critically ill patients and are transferred to the intensive care unit (ICU) within 24 hours when the problem occurs.

Gastritis in Children

Many school-aged children experience recurrent abdominal pain.  It is very important to assess this problem because it can be gastritis or other abdominal problem. It is important to check where the pain is felt as well as the duration if it is acute or chronic, as well as the onset of the symptoms. The nature of bowel movement should also be monitored. The mother or health care provider should also check of stools are black or tarry or when diarrhea is present.

Gastritis in Dogs

This is a quite common problem in dogs or canines. When dogs loves to go to areas where there is trash or when they are long haired, no matter how healthy they seem to be, they are still susceptible to having gastritis.

There are many factors that can be attributed to gastritis in dogs.  For one, dietary intolerance or allergy on particular food may be a factor. Also, if they ingested spoiled foods or plant material, they can have diarrhea or vomiting and even flatulence. Other conditions such as bacterial, viral or fungal and parasitic infections may also be a contributing factor and whole lot more.

Dog gastritis symptoms may include one or more of the following such as nausea and vomiting, lack of appetite despite giving food or water. If there is blood in the vomitus, it is important to contact the vet and ask for help. What veterinarians would do is that they would obtain a complete blood count or some biochemical profile of the kidney, liver function, electrolytes and even the blood sugar. Urinalysis is an important test since it contains information about urine specific gravity which is associated with the body hydration.

The treatment may include many processes and medications. For one, oral intake may be limited or withheld in the first 24 hours and an intravenous line used. fluids and electrolytes are corrected. If the dog continues to vomit, anti-emetics are given but it is given with great caution. Antacids are also given as well as antibiotics to kill bacteria if bacterial infection is present

The treatment may also require surgical intervention especially of the problem is severe and follow check-ups are also advised by the vet.

Gastritis Causes

Gastric irritation has many causes. It can be because of the medications taken, medical and surgical problems, stress, habits or infections

Medications

  • NSAID or non-steroidal anti-inflammatory drugs such as ibuprofen or naproxene
  • Iron tablets
  • Chemotherapeutic drugs
  • Steroids
  • Aspirin since this causes gastric bleeding

Medical-Surgical Problems

  • Stress- either psychologically or severely ill
  • After removing a part of the stomach because of underlying conditions
  • After a chemotherapy treatment- radiation
  • Autoimmune diseases
  • Anemia such as percutaneous or megalobastic anemia
  • Chronic vomiting

Infections

  • Helicobacter pylori infection is the most common cause of gastritis
  • Syphilis
  • Tuberculosis
  • Fungal infections

Habit or Ingestion

  • Alcohol ingestion
  • Swallowed foreign objects
  • Corrosives such as acids or lye

Gastritis Symptoms

There are a variety symptoms one may feel when they have gastritis. This includes:

  1. Pain or discomfort at the upper abdomen or the epigastric area. It may be also felt at the upper left side of the abdomen and even in the back.  The pain can also be described as a burning sensation, aching, gnawing or sore. Sometimes, acute gastritis will come off as a sharp, stabbing or cutting pain.
  2. Belching when pain is relieved shortly or when it is not relieved at all.
  3. Nausea and vomiting. The vomit may be clear or has yellowish or green stains. If blood streaks or the patient completely vomits blood, it signals that the problem is severe.
  4. Feeling of fullness that is accompanied by burning sensation or heartburn
  5. Hiccups can also happen
  6. When defecating, black tarry tools are also present when a person has gastritis.

In cases of severe gastritis bleeding occurs in the stomach so it is important to observe the signs and symptoms that one may have:

  1. Tachycardia or increased heartbeat along with pallor and sweating
  2. Shortness of breath of feeling faint
  3. Severe stomach ache (on a scale of 1-10)
  4. Vomiting large amounts of blood
  5. Bad breath
  6. Dark, sticky and very foul-smelling bowels

Diagnosis Gastritis

The physician will need to obtain a comprehensive personal and family medical history and study them. A physical evaluation will also be conducted and series of tests will be recommended like:

  1. Upper endoscopy- since the stomach is at the upper part of the abdomen, a thin tube that contains a tiny camera will be inserted through the mouth all the way to the stomach lining. From the monitor, the doctor will be able to see the insides including the inflammation. Biopsy can also be done. This is taking away a sample and brought to the laboratory to check for cancer. When doing endoscopy, a consent will be given and topical anesthesia will be given and necessary preparations should be done.
  2. Blood samples are taken to check the blood count. This is helpful in determining anemia, one of the causes in gastritis. Helicobacter pylori infection will also be check
  3. Fecal occult blood tests are taken to note for presence of blood in the stool. A sample is taken to the laboratory for analysis

Gastritis Treatment

Medicines

  1. Histamines or h2 blockers- this medicine works by blocking the release of the hydrochloric acid from the parietal glands. This allows less acid to be released so the stomach lining can heal. Popular histamines are Cimetidine (Tagamet), Famotidine (Pepcid), Nizatidine (Axid) and Ranitidine (Zantac)
  2. Proton pump inhibitors are powerful blockers when parietal cells release hydrochloric acid.  This includes Lansoprazole and Omeprazole (Prilosec, Losec) these drugs are usually prescribed by the gastroenterologists
  3. Agents that coats the stomach’s lining such  as Sucralfate which coats and protects the stomach lining and Misoprostol or Cytotec. This drug however should not be taken by pregnant woman especially during the first tri-mester.
  4. Antiemetic agents can help a lot in minimizing nausea and vomiting. The subscription depends on the liking of the physician. These are also available over the counter which can be taken even at home.
  5. Antibiotics are given especially when Helicobacter pylori is known to be the cause of gastritis.
  6. After the patient is admitted, follow up care should be done. The person should avoid the things that can irritate the gastric lining and medicines should be taken religiously as ordered by the health care provider. If the symptoms worsen, don’t hesitate to call the physician.

Warning signs signal that the patient should call 911 because the problem is severe when these happen:

  1. The patient vomits and cannot eat foods nor take drinks and even
  2. medication
  3. Fever with abdominal pain
  4. Fainting
  5. Tachycardia
  6. Unexplained sweating
  7. Pallor
  8. Vomit with yellow or green streak
  9. Vomiting with blood
  10. Shortness of breath at the same time, there is chest pain

Gastritis Diet

  • Natural remedies should also be done such as drinking coconut juice. It helps the stomach restore its damaged lining and at the same time, it is also can also provide the nutrients the stomach needs.
  • Eating a bowl of rice for two times a day can help the stomach to calm down and digestion is aided. It also prevents nausea and vomiting to occur.
  • Eating yogurt and cheese will significantly aid in digestion and helps recovering from gastritis. Yogurts have live lactobacilli which help in digestion.
  • Eating balanced diet should be done when a person has gastritis. Habitual over eating is not good. Having fixed meal time is much better because it gives consistency when releasing hydrochloric acid to digest the foods. This greatly helps from indigestion
  • Tomatoes, peppermints, tomato juice and fatty foods should be avoided because this can cause heartburn. Taking onions, cinnamon, garlic can also have an upset stomach
  • Gas-producing foods should be avoided such as broccoli, cabbage, mild and dried beans.

One should take less of tomatoes, peppermint, tomato juice, fatty foods, and citrus juices. These can cause heartburn or pain in your esophagus. One may have to also limit the intake of onions, cinnamon, garlic, and cloves if they have upset stomach.

Gastritis Remedies, Cure and Self-Care

  • Avoid taking aspirin or alcohol since these are the two main causes for gastric problems. These can develop upset stomach when taken.
  • If gastritis is minor, it is ok to continue the recommended medication to treat the abdominal problem
  • It is still best to consult the physician or health care provider when stopping a medicine.
  • Aspirins can cause gastritis however, coated aspirin may not cause the same symptoms are other aspirin can because coated aspirin does not dissolve in the stomach.
  • Taking non-steroidal anti-inflammatory drugs like iburprofen and naproxene, it can be taken with food or other antacids since this can lessen the complications.
  • Acetaminophen, Tyenol, Panadaol are not known to cause gastritis but taking to your health care provider in taking that would be a better idea.
  • Avoid smoking since this triggers the release of hydrochloric acids in the parietal cells.
  • Caffeine and caffeine like substances should also be avoided.
  • When taking antacids, always remember that there are different types of antacid

Magnesium-containing antacids can cause diarrhea and this drug should be taken cautiously by patients with kidney problems.

Aliminun-containing antacid can cause constipation

The calcium containing actacids are mostly used because neither constipation nor diarrhea is experienced but it also adds calcium supplement. This is important to women who are going to menopause.

Also remember that antacids can change the way the body can absorb the medications taken by the patient.

  • Do not share alcoholic drinks or a glass of water with a person known to have Helicobacter pylori infection because it can be transmitted especially droplet transmission.
  • There are Histamine blockers which does not require doctor’s prescription such as Cimetidine or Tagamet, ranitidine or Zantac. However, it is still advisable to ask for doctor’s prescription or suggestion on what drugs will be taken.
  • Natural remedies should also be done such as drinking coconut juice. It helps the stomach restore its damaged lining and at the same time, it is also can also provide the nutrients the stomach needs.
  • Eating a bowl of rice for two times a day can help the stomach to calm down and digestion is aided. It also prevents nausea and vomiting to occur.
  • Eating yogurt and cheese will significantly aid in digestion and helps recovering from gastritis. Yogurts have live lactobacilli which help in digestion.
  • Eating balanced diet should be done when a person has gastritis. Habitual over eating is not good. Having fixed  meal time is much better because it gives consistency when releasing hydrochloric acid to digest the foods. This greatly helps from indigestion
  • If the pain is unbearable or severe, the patient can always put in hot compress into the epigastric area to dilate the blood vessels and makes you relax and feel comfortable.

References

http://www.merck.com/mmpe/sec02/ch013/ch013c.html

http://en.wikipedia.org/wiki/Atrophic_gastritis

http://emedicine.medscape.com/article/176156-overview



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