Focus on

Gastritis

(Relates to Chapter 42,

“Nursing Management:
Upper Gastrointestinal Problems,”
in the textbook)
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 Gastritis

• Inflammation of gastric mucosa

• One of most common problems
affecting the stomach

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 Gastritis

• Result of a breakdown in gastric

mucosal barrier
• Stomach tissue unprotected
from autodigestion by HCl acid
and pepsin

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 Gastritis

• Tissue edema results

• Disruption of capillary walls
 With loss of plasma into gastric
lumen
 Possible hemorrhage

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 Gastritis
Etiology and Pathophysiology
• Risk factors
 Drugs
• Direct irritating effect on gastric
mucosa
• Aspirin, NSAIDs, and
corticosteroids
 Diet
• Alcohol, spicy food

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 Gastritis
Etiology and Pathophysiology
• Risk factors (cont’d)
 Microorganisms
• Helicobacter pylori
– Important cause of chronic gastritis
– Promotes breakdown of gastric
mucosal barrier
• Staphylococcus organisms

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 Gastritis
Etiology and Pathophysiology
• Risk factors (cont’d)
 Environmental factors
• Radiation, smoking
 Pathophysiologic conditions
• Burns, renal failure, sepsis
 Other factors
• Psychologic stress, NG tube

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 Gastritis
Etiology and Pathophysiology
• Risk factors (cont’d)
 Autoimmune atrophic gastritis
• Affects fundus and body of stomach
• Associated with increased risk of
gastric cancer
• May be link to presence of H. pylori
and development of autoimmune
chronic gastritis

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 Acute Gastritis
Clinical Manifestations
• Self-limiting
 Lasts few hours to a few days
 Complete healing of mucosa
expected

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 Acute Gastritis
Clinical Manifestations
 Anorexia
 Nausea
 Vomiting
 Epigastric tenderness
 Feeling of fullness
 Hemorrhage
• Common with alcohol abuse
• May be only symptom

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 Chronic Gastritis
Clinical Manifestations
 Symptoms are similar to acute
gastritis
 Loss of intrinsic factor can occur
when acid-secreting cells are lost
or are nonfunctioning
• Essential for absorption of
cobalamin (vitamin B12)

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 Gastritis
Diagnostic Studies
• Acute gastritis
 Diagnosis most often based on
history of drug and alcohol abuse
• Chronic gastritis
 Diagnosis may be delayed or
missed due to nonspecific
symptoms

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 Gastritis
Diagnostic Studies
• Endoscopic examination with
biopsy
 Necessary for definitive diagnosis
• Breath, urine, serum, stool, and
gastric tissue to determine
H. pylori

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 Gastritis
Diagnostic Studies
• Radiologic studies not helpful
• CBC
 Confirm presence of anemia
• Occult blood test

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 Gastritis
Diagnostic Studies
• Gastric analysis
 Determines achlorhydria (lack of acid
secretion)
 Associated with severe atrophic
gastritis
• Serum antibody tests to parietal
cells and intrinsic factor

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 Gastritis
Diagnostic Studies
• Tissue biopsy with cytologic
examination
 Rule out gastric carcinoma

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 Acute Gastritis
Collaborative Care
 Supportive care similar to N/V
 If vomiting
• NPO
• Fluids
– Dehydration can occur rapidly
• Rest
• Antiemetics

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 Acute Gastritis
Collaborative Care
• NG tube—if severe symptoms
• Observe for bleeding
• Lavage of precipitating agent from
stomach
• Keep stomach empty and free of
noxious stimuli

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 QuickTime™ and a
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are needed to see this picture.

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 Acute Gastritis
Collaborative Care
• If hemorrhage likely
• Frequent VS
• Testing vomitus for blood

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 Acute Gastritis
Collaborative Care
• Drug therapy
 Focused on reducing irritation of
mucosa
 Providing symptomatic relief

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 Acute Gastritis
Collaborative Care
• Drug therapy
 Antacids, H2R blockers, PPIs,
combinations
 Nurse must teach patient about
medications and side effects

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 Chronic Gastritis
Collaborative Care
 Focuses on evaluating and
eliminating cause
• H. pylori—antibiotics
• Pernicious anemia—cobalamin
supplements

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 Chronic Gastritis
Collaborative Care
• Lifestyle changes
• Diet
• Alcohol
• Smoking
• Close medical follow-up

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