GASTRITIS

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Mind Map on GASTRITIS, created by jayyam7465 on 04/21/2014.
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Mind Map by jayyam7465, updated more than 1 year ago
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Created by jayyam7465 almost 11 years ago
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GASTRITIS
  1. EPIDEMIOLOGY
    1. Gastritis affects all age groups
      1. The incidence of H pylori infection increases with age.
        1. No sexual predilection exists.
          1. Autoimmune gastritis is a relatively rare disease
          2. PATHOPHYSIOLOGY
            1. certain drugs; alcohol; bile; ischemia; bacterial, viral, and fungal infections; acute stress (shock); radiation; allergy and food poisoning; and direct trauma.
              1. The common mechanism of injury is an imbalance between the aggressive and the defensive factors that maintain the integrity of the gastric lining (mucosa).
                1. the major mechanism of injury is the reduction in prostaglandin synthesis.
                  1. Bacterial infection is another cause of acute gastritis. The corkscrew-shaped bacterium called H pylori is the most common cause of gastritis
                    1. H pylori gastritis typically starts as an acute gastritis in the antrum, causing intense inflammation, and over time, it may extend to involve the entire gastric mucosa resulting in chronic gastritis
                      1. Antigen-presenting cells activate lymphocytes and other mononuclear cells that lead to chronic superficial gastritis
                        1. H pylori produces inflammation via the production of a number of toxins and enzymes
                          1. Ulcero-hemorrhagic gastritis is most commonly seen in patients who are critically ill. Ulcero-hemorrhagic gastritis is believed to be secondary to ischemia related to hypotension and shock
                          2. CLINICAL PRESENTATION
                            1. Gnawing or burning epigastric distress, occasionally accompanied by nausea and/or vomiting. The pain may improve or worsen with eating
                              1. The physical examination findings are often normal with occasional mild epigastric tenderness
                              2. DIAGNOSIS
                                1. CBC count to assess for anemia, as acute gastritis can cause gastrointestinal bleeding
                                  1. Stool for blood
                                    1. A number of H pylori tests are available
                                      1. Endoscopy may reveal a thickened, edematous, nonpliable wall with erosions and reddened gastric folds.
                                      2. TREATMENT
                                        1. Administer medical therapy as needed, depending on the cause and the pathological findings
                                          1. In patients with persistent H pylori infection despite appropriate initial treatment, a proton pump inhibitor (PPI), levofloxacin, and amoxicillin for 10 days appear to be more effective and better tolerated than a PPI, bismuth, tetracycline, and metronidazole
                                            1. Administer fluids and electrolytes as required, particularly if the patient is vomiting
                                              1. Discontinue the use of drugs known to cause gastritis

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