INTRODUCTION:- Gastritis is inflammation of the lining of the stomach. It may occur as a short episode or may be of a long duration. The most common symptom is upper abdominal pain. Other symptoms include nausea and vomiting, bloating, loss of appetite and heartburn.
SIGN & SYMPTOMS:- 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. Pain is usually located in the upper central portion of the abdomen, but it may occur anywhere from the upper left portion of the abdomen around to the back.
Other signs and symptoms may include the following:
• 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)
• Early satiety
• Loss of appetite
• Unexplained weight loss
Common causes include Helicobacter pylori and NSAIDs. Less common causes include alcohol, cocaine, severe illness and Crohn disease, among others.
Helicobacter pylori colonizes the stomachs of more than half of the world’s population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases. Colonization of the gastric mucosa with Helicobacter pylori results in the development of chronic gastritis in infected individuals, and in a subset of patients chronic gastritis progresses to complications (e.g., ulcer disease, gastric neoplasias, some distinct extragastric disorders) However, over 80 percent of individuals infected with the bacterium are asymptomatic and it has been postulated that it may play an important role in the natural stomach ecology.
Gastritis may also develop after major surgery or traumatic injury (“Cushing ulcer”), burns (“Curling ulcer”), 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.
Evidence does not support a role for specific foods including spicy foods and coffee in the development of peptic ulcers.
Acute erosive gastritis typically involves discrete foci of surface necrosis due to damage to mucosal defenses NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the biosynthesis of eicosanoids in the stomach, which increases the possibility of peptic ulcers forming. Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach called prostaglandin. These drugs used in a short period are not typically dangerous. However, regular use can lead to gastritis.
Chronic gastritis refers to a wide range of problems of the gastric tissues . The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining. In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis.
Often, a diagnosis can be made based on the patient’s description of their symptoms, but other methods which may be used to verify gastritis include:
• Blood tests:
o Blood cell count
o Presence of H. pylori
o Liver, kidney, gallbladder, or pancreas functions
• Stool sample, to look for blood in the stool
• Endoscopy, to check for stomach lining inflammation and mucous erosion
• Stomach biopsy, to test for gastritis and other conditions
Antacids are a common treatment for mild gastritis. When antacids do not provide enough relief, medications such as H2 blockers and proton-pump inhibitors that help reduce the amount of acid are often prescribed.
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.