-IBIS-1.5.0-
tx
digestive system
gastritis
diagnoses
definition and etiology
definition:
inflammation of the gastric mucosa
etiology:
Gastritis may be acute or chronic, and takes several forms.
acute gastritis (aka acute erosive gastritis, acute stress erosion, acute hemorrhagic gastritis): common predisposing factors include ASA or NSAIDs, severe injuries or burns, surgery, alcohol, corticosteroids, respiratory/renal/liver failure, food or drug allergens, sepsis, and shock
corrosive gastritis: from swallowing strong alkalis or acids, iodine, potassium permanganate, or heavy metal salts; damage, which depends on what was ingested and in what amount, may range from mild edema to severe destruction of tissues and hemorrhage
atrophic gastritis: idiopathic and seen mainly in the elderly population; exhibits inflammatory infiltrate and gland loss
giant hypertrophic gastritis (a.k.a. Menetriere's disease): This is a rare idiopathic condition distinguished by large tortuous gastric rugae throughout the stomach.
signs and symptoms
acute gastritis
signs and symptoms: may be relatively asymptomatic
hematemesis (may be massive) and/or melena
mild epigastric discomfort, nausea
anorexia, vomiting
lab findings:
(+) endoscopy
(+) biopsy
(+) occult blood, perhaps
corrosive gastritis
signs and symptoms: The patient may present with
oropharyngeal ulceration
dysphagia
severe abdominal pain
hematemesis
melena
shock
atrophic gastritis
signs and symptoms: nonspecific; many patients are asymptomatic
nausea
pain
gastric discomfort after eating
signs and symptoms of pernicious anemia
lab findings:
(+) biopsy
Schilling test for B12/IF deficiency
iron deficiency from malabsorption
Heidelberg test for hypo- or achlorhydria
elevated serum gastrin
giant hypertrophic gastritis
signs and symptoms:
upper GI distress
pain similar to ulcer pain
anorexia, nausea, vomiting
edema (from hypoproteinemia)
weight loss, diarrhea
lab findings:
(+) endoscopy
(+) x-rays
(+) biopsy
hypoproteinemia
hypochlorhydria with excess mucus in gastric secretions
decreased serum albumin
course and prognosis
acute gastritis:
In general, the prognosis is good; however, if bleeding is severe enough to warrant surgery, the mortality rate increases to > 50% (usually from the underlying condition).
corrosive gastritis:
Treatment and prognosis depends on what was ingested.
atrophic gastritis:
Conventional treatment consists of IM B12 shots to prevent or treat pernicious anemia.
giant hypertrophic gastritis:
Conventional treatment consists of a high protein diet, partial gastrectomy, and periodic check-ups, as patients with the disease have an increased risk of developing gastric carcinoma.
differential diagnosis
Infectious, inflammatory, or other gastrointestinal or related conditions causing upper GI symptoms
footnotes