This lesson is on Acute Gastritis. So we're going to talk about what this condition is and what causes it we're also going to talk about the signs and symptoms of acute gastritis how it's diagnosed and how it's treated.
Acute gastritis is an inflammation
of the gastric or stomach mucosa so it's in the word gastritis gastra that
prefix refers to the stomach and itis means inflammation so inflammation of the
gastric mucosa. Acute gastritis may affect part of the stomach or the entire
stomach, if it affects the entire stomach it's known as pan gastritis. Now
acute gastritis is caused by a variety of factors we're going to talk about a large
list of causes in the next slide but they all have something in common in that
they lead to an imbalance between destructive processes and protective
mechanisms so with these factors with regards to why acute gastritis occurs destructive
processes outweigh protective mechanisms in the gastric mucosa we'll talk a bit
more about this in the next slide.
The nutrients get into the stomach reducing
the protective mechanism of the stomach so this can lead to acute gastritis, food
allergies and poisoning can also lead to acute gastritis. There's another
form of acute gastritis known as autoimmune gastritis so this is where there
are autoantibodies that are formed that attack the stomach mucosa this is more
common in young women certain medications can also cause acute gastritis these
include NSAIDs or non-steroidal anti-inflammatory drugs you can think of ibuprofen
or Advil iron supplements can also cause this we can see colchicines being a
cause so this is a gout medication K-Exylade which is something individuals
take to help reduce their potassium levels and certain chemotherapies.
Gastroesophageal reflux disease can also lead to some gastritis as well and then certain injuries and illnesses so any injuries or illnesses may lead to gastritis so the stress or physiological stress that is associated with the injuries or illnesses especially if there are significant injuries or illnesses this can also lead to gastritis as well and as for acute gastritis that is caused by injuries and illnesses this causes what we call acute stress gastritis. So as we mentioned before in the last slide all of these causes lead to an imbalance in destructive processes and protective mechanisms where the destructive processes overcome or out-compete those protective mechanisms, now that we know some of the causes let's talk about the clinical features what are some of the signs and symptoms of acute gastritis now it's important to note that some patients with acute gastritis may be asymptomatic so some patients with non-erosive gastritis may have no symptoms we can see this in some cases of h pylori gastritis. So in the acute setting h pylori, gastritis may have no symptoms at all but when there are symptoms we often see, symptoms like dyspepsia which is a gnawing burning sensation in the epigastric area.
So the epigastric area, is the area in
the middle of the stomach above the belly button or above the umbilicus, so that
is the epigastric area so we can have dyspepsia or a sensation of indigestion we
can also have epigastric pain so we can have a more overt pain in that same
area there can also be nausea and vomiting in acute gastritis reduced or loss
of appetite and bloating and belching so these are some of the more common signs
and symptoms of acute gastritis, and some other more uncommon symptoms that can
occur in acute gastritis include fever and chills and hiccups now there are
certain complications of acute gastritis that are important to note here. One
of them is gastrointestinal bleeding so we can imagine that if there is inflammation
or any damage to the lining of the stomach there may be some bleeding one of
those is Melena which is a black tarry stool, and hematochezia which is
bright red blood in your stool or hematemesis which is vomiting up of blood
so with regards to why each of these happens.
Melena is digested blood if there is a very slow bleed from
acute gastritis this can give the body time to digest that blood and produce a
black tarry and smelly stool. Hematochezia is a bright red stool
and this is more likely to occur if there is a very quick rapid brisk bleed
from acute gastritis. Hematemesis, if there is so much bleeding there
may be some vomiting up of blood, because of all this gastrointestinal bleeding
we may have issues with anemia or a low blood count, and associated symptoms of
anemia like fatigue, acute gastritis can eventually lead to peptic ulcer
disease a lot of the pathogenesis in acute gastritis is similar to peptic ulcer
disease. So if there is the erosion of the gastric mucosa from this process that
continues we can have ulcer formation and then in some cases, we can also see nutrient
deficiencies we see this more commonly in autoimmune gastritis, and some of
these nutrients deficiencies include vitamin b12 and iron.
Now let's talk about the diagnosis
and treatment clinicians diagnose gastritis oftentimes by endoscopy with
biopsy so they put an endoscope down and take biopsy samples they can also
assess for h pylori as we mentioned before h pylori-associated gastritis is the
most common form of gastritis they can do this by doing a urease breath test a
stool sample checking for h pylori or through serology testing so serology testing
is looking for antibodies that have been formed against h pylori but this
doesn't necessarily mean that you have a current infection of h pylori if you
have antibodies it just means that you've been exposed to h pylori at some
points so that is the problem with serology testing and then autoantibodies
can be checked if there's a concern of autoimmune gastritis.
Now how do clinicians treat
gastritis it's important to identify and avoid causes of acute gastritis these
include Alcohol use NSAIDs use and some other effects as well including infection
with h pylori so good food handling hygiene is important in other methods to
reduce the spread as well it's also important to help reduce those destructive processes
by way of either using antacids if it's very mild case antacids may be used
temporarily but in most cases we're going to see h2 blockers or proton pump inhibitors
like pantopers all being used this helps reduce the acidity in the stomach
lowering the destructive processes allowing more of a balance between
destructive processes and protective mechanisms and then in the case of h
pylori-associated gastritis more specifically triple therapy in order to
eradicate the h pylori is important, this is done with the antibiotics Clarithromycin
and amoxicillin and then also using a proton pump inhibitor as well and then in
the case of autoimmune gastritis because of those nutrient deficiencies iron
supplementation and b12 supplementation are also important as well.
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