Gastritis

Question 1

What is gastritis

Answer 1

• inflammation of stomach lining

- may be acute or chronic

Question 2

What are the causes of gastritis

Answer 2

• alcohol
• NSAIDs
• irritating substances eg. coffee
• viruses, bacteria, autoimmune disorders

Question 3

What is ACUTE gastritis

Answer 3

• infiltration of edematous gastric mucosa predominantly by neutrophils
• direct damage to the epithelium

Question 4

Symptoms of ACUTE gastritis

Answer 4

• may be asymptomatic
• nausea
• vomiting
• anorexia
• haematemesis

Question 5

What is CHRONIC gastritis

Answer 5

• infiltration of gastric mucosa w chronic inflammatory cells

Question 6

What are the adaptations of CHRONIC gastritis

Answer 6

mucosal atrophy & metaplasia

Question 7

The 2 types of chronic gastritis

Answer 7

Type A: autoimmune (fundal)

Type B: H.pylori (antral)

Question 8

H.pylori infection is spread through:

Answer 8

• saliva

- contamination of food/ water

Question 9

Pathogenesis of H.pylori infection

Answer 9

1. H.pylori colonises stomach
2. inducing activation of IL-8 (cytokine)
3. recruits neutrophils
4. production of urease– buffer created to HCL
5. enhance gastric acid secretion & impairment of duodenal bicarbonate production
6. Adherence to surface epithelial cells, secreting proteases & phospholipases
7. Production of VacA gene

Question 10

Pathogenesis of autoimmune gastritis

Answer 10

1. Decreased gastric acid secretion

2. Decreased intrinsic factor production

Question 11

Complications of ACUTE gastritis

Answer 11

• GI bleeding

- Perforation

Question 12

Complications of CHRONIC gastritis

Answer 12

• hypergastrenemia (peptic ulcer)
• hypochlorhydria, achlorhydria
• intestinal metaplasia which can lead to gastric carcinoma

Question 13

Treatments

Answer 13

• remove causative agent
• antibiotics (if H.pylori is the cause)
• proton-pump inhibitors
• H2 Blockers
• antacids

Question 14

Triple therapy for H.pylori infection

Answer 14

1. proton pump inhibitors eg. omeprazole
2. amoxicillin
3. clarithromycin

Question 15

Nur management of gastritis

Answer 15

• acute: food and fluids withheld until symptoms subside, then clear liquids, then solid food
• avoid spicy food & highly seasonal goods, caffeine, alcohol
• monitor for signs of hemorrhagic gastritis (tachycardia, hypotension)