inflammation of the lining of the stomach. Gastritis is one of the most common stomach disorders, and occurs in acute, chronic, and toxic forms.
severe gastritis that may be caused by intake of aspirin
or other nonsteroidal antiinflammatory drugs
, food poisoning
, overeating, excessive intake of alcoholic beverages, or bacterial or viral infection; it is often accompanied by enteritis
. The outstanding symptom is abdominal pain, and there is also a feeling of distention, with loss of appetite and nausea. There may be a slight fever and vomiting. The substance causing the irritation can often be identified, in which case it should be avoided. Treatment may include the use of antacids
. A bland diet of liquids and easily digested food should be followed for 2 or 3 days. Simply prepared solid foods in small quantities can then be added.
atrophic gastritis chronic gastritis with atrophy of the mucous membranes and glands.
chronic gastritis gastritis that occurs repeatedly or continues over a period of time. Although pain, especially after eating, and symptoms associated with indigestion may occur in chronic gastritis, most patients are asymptomatic; however, the condition may lead to hemorrhage and ulcer formation. Among its possible causes are Helicobacter pylori, vitamin deficiencies, abnormalities of the gastric juice, ulcers, hiatus hernia, excessive use of alcohol, or a combination of any of these.
Chronic gastritis is treated with a bland diet; food should be taken frequently and in small amounts. Antacids or anticholinergics may also be used in moderation to minimize stomach acidity. If bleeding is a problem that cannot be controlled by conservative measures, partial gastrectomy, pyloroplasty, vagotomy, or total gastrectomy may be indicated.
gastritis resulting from ingestion of a corrosive substance such as a strong acid or poison
. There is an acute burning sensation and cramping stomach pain, accompanied by diarrhea and vomiting; the vomit may be bloody. The victim may collapse. This condition is an emergency and immediate measures must be taken to prevent serious damage to the tissues of the stomach. First aid measures are begun at once to flush out and neutralize the poison.
Acute, sudden irritation of the gastric mucosa. It may be caused by ingestion of toxic substances such as alcohol or poisons or overuse of NSAIDs. Symptoms include anorexia, nausea, epigastric pain, vomiting, thirst, and, when patients become dehydrated, prostration. Therapy includes antacids, H2
receptor blockers, or proton pump inhibitors (all of which reduce gastric acidity). Antibiotics treat bacterial and endotoxic infections.
A thorough patient history is conducted to assist in determining the cause. Vital signs, fluid intake and output, appearance, and gastric symptoms are monitored. Symptomatic and supportive therapy is given as prescribed (e.g., antiemetics, IV fluids). Prescribed histamine antagonists and proton pump inhibitors such as pantoprazole are administered, and the patient is instructed in their use. Antibiotic therapy for H. pylori is also discussed if appropriate. The patient is advised to avoid aspirin-containing over-the-counter (OTC) compounds and other NSAIDs. Antiemetics and analgesics may be provided before meals to manage associated nausea and pain. The patient is assisted to identify foods that contribute to symptoms and to eliminate them from the diet. The nurse can provide an initial diet that is bland and contains frequent small servings; referral to a dietitian enables further instruction. Emotional support is given to help the patient manage symptoms and to deal with lifestyle changes (e.g., stress reduction, smoking cessation, alcohol elimination) that may be required.