Gastritis Flashcards
What is gastritis?
Inflammation of the gastric mucosa
What are the types of gastritis?
1) Acute Gastritis
2) Chronic Gastritis:
* Type A - Autoimmune Gastritis
* Type B - H.pylori Gastritis
* Type C - Chemical (Reactive) Gastritis
What are the causes of acute gastritis?
H.pylori, alcohol, NSAIDs, bile acid reflux
What is the cause of Type A chronic gastritis?
AI destruction of parietal cells in the stomach –> B12 deficiency –> pernicious anaemia
What causes Type B chronic gastritis?
Caused by H.Pylori infection
What causes Type C chronic (reactive) gastritis?
Caused by long term exposure to chemical irritants (NSAIDs, Alcohol)
What are common symptoms of gastritis?
- Dyspepsia - upper abdominal pain, burning, heartburn, early satiety, nausea
- Global symptoms: weight loss, loss of appetite
- Upper GI bleed (not common in Type A) - High HR, Low BP, pallor, haematemesis, malaena, SOB, fatigue
What are the initial symptoms of Type A chronic gastritis?
Asymptomatic initially, B12 Deficiency
What are haematological symptoms of B12 deficiency in Type A gastritis?
- Macrocytic Anaemia - dizziness, dyspnoea, palpitation, fatigue, tachycardia, heart murmurs
What are neurological symptoms of B12 deficiency in Type A gastritis?
- Subacute combined degeneration of the spinal cord (SACD) - bilateral loss of proprioception and vibration sense
- Peripheral neuropathy (pins and needles + numbness)
What are the bedside investigations for gastritis?
- Focussed Hx
- Gastric irritant exposure Hx (Acute + Type C)
- H.Pylori breathe test/stool antigen (Type B)
What blood tests are used for Type A chronic gastritis?
- Anti-parietal cell antibodies
- **Anti-intrinsic (IF) factor antibodies **
- B12 levels
When is endoscopy indicated in gastritis?
If actively bleeding or alarms (age > 55)
What is the conservative management for gastritis?
Discontinue irritants (Stops NSAIDs/alcohol)
What medical treatments are used for gastritis?
- PPIs & H2 receptor antagonists to reduce acid secretion (e.g. omeprazole)
- Antacid
* H.pylori TRIPLE therapy + retest after 6-8 weeks - Type A: Lifelong** B12 replacement** (IM hydroxocobalamin weekly for 3 weeks and then 1mg once every 2-3 months)
What surgical interventions may be required for gastritis?
Deal with complicated ulceration or upper GI bleed
What is ALARMS 55?
If dyspepsia + and either >55 or ALARM symptoms present then carry out endoscopy
