IMPROVING HEALTH OF STEEMIANS #23- Acute Gastritis

Hello my steemit community,

In today's edition of IMPROVING HEALTH OF STEEMIANS, I want to talk to you about Acute gastritis.

Acute gastritis is a term covering a broad spectrum of entities that induce inflammatory changes in the gastric mucosa. Different etiologies (nonsteroidal anti-inflammatory drugs, alcohol, stress, etc.) share the same clinical picture that is presented in epigastric discomfort, nausea and vomiting, and in the severe cases of erosion of the mucous membrane, ulceration, bleeding or rarely massive loss blood. Patients with histologically verified gastritis are mainly asymptomatic and acute gastritis is characterized by the infiltration of antral mucosa and corpus with polymorphonuclear. The inflammation may involve the entire stomach (eg, pangastritis) or a region of the stomach (eg, antral gastritis)

Acute gastritis can be divided into two categories depending on the severity of mucous damage:

• erosive

• non-erosive

Acute gastritis diagnosis is usually established during endoscopic examination of the stomach for some other reason. Epidemiological studies show a wide incidence of gastritis, especially in people over the age of 60.

CAUSES

Acute gastritis occurs when there is an imbalance between aggressive and defensive factors that maintain the integrity of the gastric mucosa.

• Helicobacter pylori- H. pylori induces inflammation of the gastric mucosa by activating numerous toxins (cytotoxins) and enzymes (bacterial proteases, lipases) that activate IL-8, which attracts a great number of polymorphonuclear and monocytes that infiltrate the mucous membrane. The lining surface is usually intact, without erosion (non-erosive gastritis) or hemorrhagic lesions, and if it occurs, erosion is small and shallow. The endoscopic appearance of the mucosa is usually neat and does not follow the histological finding. Evidence of H. pylori infection can be found in 20% of the population under the age of 40 and in 50% of the population older than 60 years

• Viral infection- Cytomegalovirus (CMV) is a common cause of gastritis. Usually it causes it in immunocompromised individuals

• Drugs - NSAIDs, such as aspirin, ibuprofen - these drugs inhibit cyclooxygenase activity in the stomach mucosa. This reduces the synthesis and concentration of endogenous prostaglandins that play an important role in defending the mucous membrane

• Alcohol use

• Stress- severe stress due to major surgery, injury can cause acute gastritis

• Bile- the reflux of bile from the small intestine to the stomach can induce gastritis

SYMPTOMS

The most common symptoms include:

• Abdominal pain- burning ache or pain that begins abruptly and lasts for several days

• Vomiting

• Nausea

• Black, tarry stools

Patients with mild erosive gastritis are mainly asymptomatic but in severe cases of acute gastritis massive blood loss may occur.

DIAGNOSIS

Endoscopy is a gold standard in diagnosis. A flexible, thin tube equipped with a tiny camera is inserted down your throat and into your stomach . It is used for the determination of the inflammation and also for performing biopsy if needed.

Your doctor may perform various blood and stool tests and tests for H. pylori.

Endoscopy

TREATMENT

There is no specific therapy for acute gastritis, except for cases of H. pylori where contemporary combined therapy is used: a combination of two antibiotics against H. pylori with a drug that blocks acid secretion.

Drugs that neutralize gastric acid (antacids) or other drugs that reduce gastric acid secretion will ( proton pump inhibitors or H-2 blockers) can also be used to eliminate the symptoms and improve the course of the disease. Also avoiding spicy food, alcohol and NSAID is recommended.

REFERENCES

[1] Harry LT Mobley, George L Mendz, and Stuart L Hazel- Helicobacter pylori : Physiology and Genetics; Washington (DC): ASM Press; 2001.

[2] Genta RM, Sonnenberg A.- Helicobacter-negative gastritis: a distinct entity unrelated to Helicobacter pylori infection; Aliment Pharmacol Ther. 2015 Jan .

[3] Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo- Harrison's Principles of Internal Medicine, 19e

Factual claims which are not sourced are from my own personal experience and med school.

This advice is for general health and intended to supplement the information you receive from your treating doctor. It in no way replaces the advice of your doctor. Please see your doctor if you have specific concerns regarding your health.

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