Bacterial
gastritis:
due to
infection of the stomach mucosa with a bacteria called
Helicobacer pylori.
Atrophic gastritis:
due to
auto immune reaction.
Chronic erosive gastritis:
due to prolonged use of alcohol or anti
inflammatory drugs like aspirin or ibuprofen.
Radiation gastritis:
is due to exposure to radio-active rays during
treatment for cancer.
Acute
gastritis:
Acute
inflammation of the gastric mucosa is
called acute gastritis. This is due to various causes including
excessive use of alcohol,NSAIDS, ingestion of corrosive substances,
cortico-steroids and sudden stress like surgery , injury or
infection.
Clinical
features:
Acute gastritis
presents as pain upper abdomen associated with dyspepsia, nausea
or vomiting. There may be bleeding in the stomach with the
resultant bloody vomiting (hematemesis) or passage of black tarry
stools. Chronic erosive gastritis presents as long standing
dyspepsia, and chronic pain in the upper abdomen. There may be
pain behind the sternum (heart burn).
Management:
Gastritis is diagnosed by
the history of dyspepsia, pain and nausea or vomiting. Endoscopy
is useful for diagnosing gastritis. Endoscopic biopsy may be
necessary for chronic gastritis to diagnose bacterial infection.
Acute gastritis due to drugs or alcohol is treated by
administration of antacids, H2 antagonists or Proton
pump inhibitors. Bleeding due to gastritis is
difficult to treat but misoprostol may be useful. Blood
transfusion, administration of styptics either
locally or systemically may be necessary. If all the above
methods fail to control the bleeding, emergency surgery and
gastrectomy may be necessary. Treatment
of
chronic
gastritis
follows the same
general lines as that of acute gastritis. Bacterial gastritis due
to Helicobacter pylori needs elimination of the bacteria with
administration of Bismuth salts,
antibiotics and metronidazole.