-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