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Gastritis
ICD-10
K29.0-K29.7
ICD-9
535.0-535.5
MedlinePlus
001150
eMedicine
emerg/820 med/852
MeSH
D005756
Gastritis is an inflammation of the lining of the stomach, and has many possible causes.[1] The main acute causes are excessive alcoholconsumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal
bloating, nausea, and vomiting and pernicious anemia. Some may have a feeling of fullness or burning in the upper abdomen.[2][3] A gastroscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis.[4] Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given, but more often oral B12 supplements are recommended.[5]
Contents
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3 Diagnosis
Many people with gastritis experience no symptoms at all. However, upper central abdominal pain is the most common symptom; the pain may be dull, vague, burning, aching, gnawing, sore, or sharp.[6] Pain is usually
located in the upper central portion of the abdomen,[3] but it may occur anywhere from the upper left portion of the abdomen around to the back. Other signs and symptoms may include:
Nausea Vomiting (if present, may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation)
Belching (if present, usually does not relieve the pain much) Bloating Early satiety[6] Loss of appetite Unexplained weight loss
metaplasia typically begins in response to chronic mucosal injury in the antrum, and may extend to the body. Gastric mucosa cells change to resemble intestinal mucosa and may even assume absorptive characteristics. Intestinal metaplasia is classified histologically as complete or incomplete. With complete metaplasia, gastric mucosa is completely transformed into small-bowel mucosa, both histologically and functionally, with the ability to absorb nutrients and secrete peptides. In incomplete metaplasia, the epithelium assumes a histologic appearance closer to that of the large intestine and frequently exhibits dysplasia.[2]
Blood tests:
Blood cell count Presence of H. pylori Liver, kidney, gallbladder, or pancreas functions
Urinalysis Stool sample, to look for blood in the stool X-rays ECGs Endoscopy, to check for stomach lining inflammation and mucous erosion Stomach biopsy, to test for gastritis and other conditions [14]
Over-the-counter antacids in liquid or tablet form are a common treatment for mild gastritis. [15] Antacids neutralize stomach acid and can provide fast pain relief. When antacids do not provide enough relief, medications such as cimetidine, ranitidine, nizatidine or famotidine that help reduce the amount of acid the stomach produces are often prescribed.[15] An even more effective way to limit stomach acid production is to shut down the acid "pumps" within acid-secreting stomach cells. Proton pump inhibitors reduce acid by blocking the action of these small pumps.[15] This class of medications includes omeprazole, lansoprazole, rabeprazole, and esomeprazole. Proton pump inhibitors also appear to inhibit H. pylori activity.[16] Cytoprotective agents are designed to help protect the tissues that line the stomach and small intestine. They include the medications sucralfate and misoprostol. If NSAIDs are being taken regularly, one of these medications to protect the stomach may also be taken. Another cytoprotective agent is bismuth subsalicylate. Many people also drink milk to relieve symptoms, however the high calcium levels actually stimulate release of gastric acid from parietal cells, ultimately worsening symptoms. In addition to protecting the lining of stomach and intestines, bismuth preparations appear to inhibit H. pyloriactivity as well. Several regimens are used to treat H. pylori infection. Most use a combination of two antibiotics and a proton pump inhibitor. Sometimes bismuth is also added to the regimen. The antibiotic aids in destroying the bacteria, and the acid blocker or proton pump inhibitor relieves pain and nausea, heals inflammation, and may increase the antibiotic's effectiveness.[17]
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Zajac, P; Holbrook, A; Super, ME; Vogt, M (March-April 2013). "An overview: Current
clinical guidelines for the evaluation, diagnosis, treatment, and management of dyspepsia". Osteopathic Family Physician 5 (2): 7985. doi:10.1016/j.osfp.2012.10.005. 16. Jump up^ Boparai V, Rajagopalan J, Triadafilopoulos G (2008). "Guide to the use of proton pump inhibitors in adult patients". Drugs 68 (7): 92547. doi:10.2165/00003495-20086807000004.PMID 18457460. 17. Jump up^ "Gastritis: Treatment". CNN (CNN.com). 2008. Retrieved 2008-11-18.
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