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Gastritis

more about Gastritis


  • Gastritis is a somewhat confusing term, as physicians often refer to a variety of illnesses using the same name.  Gastritis means inflammation or infection of the stomach.  Common Gastritis describes a condition in which the stomach lining becomes raw and inflamed.  It is painful and does not improve because the stomach continually produces a strong acid (used in digestion), which is "thrown on top of" these raw areas like fuel on a fire.  Over time, this can lead to an ulcer (a crater in the stomach lining).  (For a discussion of ulcers, please see that section).
  • Gastritis is divided into two basic types as defined by their respective impact on the stomach: hemorrhagic (bleeding) and erosive (stomach lining is damaged).  Treatment depends on the cause.

  • Usually none
  • Can have:
    1. Nausea/vomiting
    2. Loss of appetite
    3. Hiccups
    4. Stomach pain or discomfort, especially after eating
    5. Vomiting blood or "coffee grounds"

  • Anti-inflammatories, e.g., ibuprofen or aspirin
  • Helicobacter pylori, a bacterial infection.
  • Pancreatic juices or bile Reflux
  • Alcohol abuse/misuse
  • Portal Hypertension (damaged liver)
  • Stress Gastritis -- stress from critical illness or surgery (not emotional illness)
  • Chronic erosive Gastritis

  • Examination:
    1. Stomach (epigastrium, i.e., upper middle region of the abdomen) may be tender
    2. Rectal exam may reveal microscopic blood
  • Laboratory:
    1. Check blood count to evaluate blood loss/red blood cell count/anemia
    2. Endoscopy -- scope passed down throat into stomach to evaluate stomach

  • Anti-inflammatory induced -- discontinue anti-inflammatories.  Medications include H2 blockers such as Zantac, sucralfate; or proton pump inhibitors such as Prilosec.
  • Alcoholic Gastritis -- discontinue alcoholic beverages; add one of the above medications.
  • Portal hypertension -- a medication called propranolol is tried first and if this fails, portal shunt decompression surgery (see section on Portal Hypertension) is performed
  • Stress Gastritis -- continuous H2 blocker infusions and/or sucralfate
  • Chronic erosive Gastritis -- no proven treatment
  • Infections by Helicobacter are treated with antibiotics (dual therapy or triple therapy regimens; i.e., 2 or 3 drugs simultaneously) with or without Prilosec.




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