Gastritis

1. clinical presentation

1.1. fundal gastritis

1.2. pain, nausea, vomiting

1.3. acute gastritis

1.4. vague abdominal complaints

1.5. epigastric tenderness

1.6. bleeding

2. diagnosis

2.1. clinical presentation of complaints

2.1.1. acute spontaneously resolves 4 days

2.2. chronic gastritis older adults

2.3. mucosal atrophy

2.4. gastroscopy

2.5. biopsy

2.6. epithelial metaplasia

2.6.1. type A

2.6.1.1. type b

2.6.1.1.1. mixed

2.6.1.1.2. both A & B

2.6.1.2. non immune

2.6.1.3. H. Pylori

2.6.1.4. antrum only

2.6.1.5. ETOH, Smoking, NSAIDS

2.6.2. immune

2.6.3. most rare

2.6.4. auto antibodies

2.6.5. pernicious anemia from poor absorption

3. treatment

3.1. discontinue injurious drugs

3.1.1. antacids

3.1.1.1. H2 receptor antagonists facilitate healing

3.2. soft, bland diet

3.3. treat H. Pylori

3.4. stop smoking, stop drinking, stop NSAID use

4. pathophysiology

4.1. acute gastritis cause by injury of mucosal layer/barrier layer

4.1.1. caused by drugs/NSAIDS

4.1.1.1. H Pylori infection

4.1.1.2. alcohol, histamine, digitalis, metabolic disorders

4.1.2. ibuprofen, naproxen, indomethacine, aspirin

4.1.3. inhibits the action of prostaglandin synthesis/prevent mucus secretion

5. epidemiology

5.1. inflammatory disorder of the gastric mucosa

5.2. incidence less than 1% in USA

5.2.1. acute or chronic

5.2.1.1. superficial mucosa of the fundus or antrum