Gastritis

Gastritis

1. Erosive

   • Acute
     • Diagnosis
       • Endoscopy
     • Symptoms
       • Bleeding
         • hematemesis, melena, or blood in the nasogastric aspirate
       • Dyspepsia, N/V
   • Chronic
     • Symptoms
       • Few or None
         • Dyspepsia, N/V
   • Causes
     • NSAIDS
     • Stress
     • ETOH
     • Mechanical Ventilation
       • Treat Propholactically PPI & H2 Blockers Early Enteral Feeding
     • Head Trauma
     • Burn Patient
     • viral (CMV
     • Vascular injury or Trauma
   • Pathophysiology
     • Acidic Gastric erosion of mucosa
       • Destruction of Mucosal Defense
   • Treatment
     • Endoscopic Hemostasis
     • PPI & H2 Blocker
     • IV Fluids & Blood Transfusion
     • Sugery (Fall Back)

2. Non-Erosive

   • Pathophysicology
     • Superficial
       • Lymphocytes & Plasma cells w/neutrophils infiltrate inflammatory cells. Superficial, involve antrum, body or both. Increases with age
     • Deep
       • Mononuclear cells & neutrophils infiltrate the entire mucosa to the level of the muscularis, but exudate or crypt abscesses seldom result, as might be expected by such infiltration
     • atrophy
       • Type A
         • Some patients with gastric atrophy have autoantibodies to parietal cells, usually in association with corpus (type A) gastritis and pernicious anemia
       • Type B
         • Atrophy of gastric glands in gastritis, most often long-standing antral (sometimes referred to as type B) gastritis
     • Metoplasia
       • Mucosal Gland
         • (pseudopyloric metaplasia) occurs in the setting of severe atrophy of the gastric glands, which are progressively replaced by mucous glands (antral mucosa), especially along the lesser curve.
       • Intestinal
         • begins in the antrum in response to chronic mucosal injury & may extend to the body. Gastric mucosa cells change to Gastric mucosa cells change to resemble intestinal mucosa—with goblet cells, endocrine (enterochromaffin or enterochromaffin-like) cells, and rudimentary villi—and may even assume functional (absorptive) characteristics.
   • Cause
     • Helicobacter pylori infection
   • Diagnosis
     • Endoscopy for symptomatic gastritis patients
   • Sympoms
     • Mild dyspepsia vague symptoms
   • Treatment
     • H pylori + patients Eradication of H pylori
     • Negative H pylori - patients PPI & H2 blockers or antacids

3. Pathophysiology

   • Inflamation of the gastric mucosa

4. Causes

   • NSAIDS
   • ETOH
   • Stress
   • AutoImmune
   • H. Pylori

5. Treatments

   • PPI
   • H2Blocker
   • Antibiotics for H. pylori
   • Prostaglandins
   • Sucralfate
   • Stoppin the causative actor

6. Symptoms

   • pain upper abdom
   • Heartburn
   • Early Sataity
   • Indigetion
   • GI bleeding

7. Diagnosis

   • Symptom Depend
   • Endoscopy

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