Gastritis:

By:
Prof. Dr. Nadia Ather
 Definition:
 Gastritisis an inflammation, irritation, or
erosion of the lining of the stomach
 Causes:
Most common are:
 Alcohol
 Infection with H-pylori (chronic)
 Medications sp NSAIDS and aspirin.
 Smoking.
 Steroids.
Less common are:
 Autoimune chronic gastritis , such as pernicious anemia
 Bile reflux.
 Corrosives
 Viral infections.
 Stress.
 Clinical features:
 Epigastric pain: be dull, vague, burning, aching,
gnawing, sore, or sharp. Pointing sign.
 Nausea
 Vomiting
 Heametemesis.
 Bloating.
 Wt. loss
 Loss of appetite.
 Melena (black tarry stools)
 Investigations:
 Blood cp: anemia
 Test for H-pylori: antigen in blood, stools
and breath.
 Endoscopy: inflammation, ulcers,bleeding
spots.
 Biopsy: inflammation, detection of H-pylori.
 Barium swallow: ulcers.
 BRAIN STORMING
 What is hemetemesis?
 What is melena?
 Treatment:
 Antibiotic medications to kill H. pylori:
Antibiotic regimens for treatment of H. pylori
include amoxicillin, clarithromycin,
metronidazole and tetracycline for two weeks,
plus an acid blocking drug.
 Medications that block acid production and
promote healing. Proton pump inhibitors
reduce acid by blocking the action of the parts of
cells that produce acid include omeprazole,
lansoprazole, rabeprazole, esomeprazole,
dexlansoprazole and pantoprazole.
 Medications to reduce acid production.
H2 receptor blockers: reduce the amount
of acid released, relieves gastritis pain and
encourages healing. include ranitidine,
famotidine, cimetidine and nizatidine.
 Antacids that neutralize stomach acid.
Antacids neutralize existing stomach acid
and can provide rapid pain relief. Side
effects: constipation or diarrhea.
 problem
A 42 yrs old male came in an ER with
epigastric pain, vomiting containing coffee
ground substance and melena for 1 day.
The most suitable diagnostic investigation
is:
 Barium swallow
 Duodenal biopsy
 H- pylori antibody titer
 Upper GI endoscopy