Gastritis

Erosive
1. Acute
  1. Diagnosis
    1. Endoscopy
  2. Symptoms
    1. Bleeding
      1. hematemesis, melena, or blood in the nasogastric aspirate
    2. Dyspepsia, N/V
2. Chronic
  2. Symptoms
    1. Few or None
      1. Dyspepsia, N/V
3. Causes
  1. NSAIDS
  2. Stress
  3. ETOH
  4. Mechanical Ventilation
    1. Treat Propholactically PPI & H2 Blockers Early Enteral Feeding
  5. Head Trauma
  6. Burn Patient
  7. viral (CMV
  8. Vascular injury or Trauma
4. Pathophysiology
  1. Acidic Gastric erosion of mucosa
    1. Destruction of Mucosal Defense
5. Treatment
  1. Endoscopic Hemostasis
  2. PPI & H2 Blocker
  3. IV Fluids & Blood Transfusion
  4. Sugery (Fall Back)
Non-Erosive
1. Pathophysicology
  1. Superficial
    1. Lymphocytes & Plasma cells w/neutrophils infiltrate inflammatory cells. Superficial, involve antrum, body or both. Increases with age
  2. Deep
    1. Mononuclear cells & neutrophils infiltrate the entire mucosa to the level of the muscularis, but exudate or crypt abscesses seldom result, as might be expected by such infiltration
  3. atrophy
    1. Type A
      1. Some patients with gastric atrophy have autoantibodies to parietal cells, usually in association with corpus (type A) gastritis and pernicious anemia
    2. Type B
      1. Atrophy of gastric glands in gastritis, most often long-standing antral (sometimes referred to as type B) gastritis
  4. Metoplasia
    1. Mucosal Gland
      1. (pseudopyloric metaplasia) occurs in the setting of severe atrophy of the gastric glands, which are progressively replaced by mucous glands (antral mucosa), especially along the lesser curve.
    2. Intestinal
      1. begins in the antrum in response to chronic mucosal injury & may extend to the body. Gastric mucosa cells change to Gastric mucosa cells change to resemble intestinal mucosa—with goblet cells, endocrine (enterochromaffin or enterochromaffin-like) cells, and rudimentary villi—and may even assume functional (absorptive) characteristics.
2. Cause
  1. Helicobacter pylori infection
3. Diagnosis
  1. Endoscopy for symptomatic gastritis patients
4. Sympoms
  1. Mild dyspepsia vague symptoms
5. Treatment
  1. H pylori + patients Eradication of H pylori
  2. Negative H pylori - patients PPI & H2 blockers or antacids
Pathophysiology
1. Inflamation of the gastric mucosa
Causes
1. NSAIDS
2. ETOH
3. Stress
4. AutoImmune
5. H. Pylori
Treatments
1. PPI
2. H2Blocker
3. Antibiotics for H. pylori
4. Prostaglandins
5. Sucralfate
6. Stoppin the causative actor
Symptoms
1. pain upper abdom
2. Heartburn
3. Early Sataity
4. Indigetion
5. GI bleeding
Diagnosis
1. Symptom Depend
2. Endoscopy

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Gastritis

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	Created by KERRY EVANS over 6 years ago