Gastritis

Gastroenterology (12%) Core Clinical Conditions

1A: Able to diagnose and manage

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Gastritis is a medical term used to describe the inflammation of the stomach lining. This condition can arise due to various factors. Understanding gastritis is crucial because it impacts a significant number of individuals worldwide, causing discomfort and potential complications if not properly treated.

• Infection with Helicobacter pylori (H. pylori), a type of bacteria that can infect the stomach and cause gastritis. It can cause persistent inflammation and damage to the protective lining of the stomach, resulting in gastritis.

• Use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen frequently or for an extended period of time. Actually, these medications can irritate the stomach lining and disrupt its protective mechanisms. This irritation and disruption can ultimately result in inflammation and damage, causing gastritis.

• An excessive amount of alcohol consumption.

• Stress, smoking, and poor eating habits are additional factors.

Gastritis occurs when the stomach lining, also known as the gastric mucosa, becomes inflamed. Depending on the underlying cause and duration of the condition, inflammation can be either acute or chronic.

The protective layer of the gastric mucosa may become compromised during gastritis, exposing the underlying tissues to gastric acid and digestive enzymes. This exposure can worsen inflammation and contribute to the onset of symptoms.

In addition, gastritis can alter the normal equilibrium of gastric acid production. The stomach normally produces hydrochloric acid, which aids in food digestion. In gastritis, however, there may be an increase in acid production, resulting in a potential imbalance and damage to the stomach lining.

• The frequent use of NSAIDs.

• Age: older individuals are more vulnerable.

• H. pylori infection.

• Abdominal pain: persistent, nagging ache in the upper abdomen (around epigastric area). Typically, this occurs after meals or when consuming beverages (acidic or alcohol).

• Nausea and vomiting.

• Loss of appetite and feeling satiated even with small portions of food.

• Abdominal distention, which causes a sensation of fullness and discomfort in the abdomen.

• Good history and physical examination.

• Stool test for H. pylori infection.

• Routine blood test: FBC may show signs of anaemia.

• Endoscopy and biopsy.

• Treatment of H. pylori infection: PAC (PPI, amoxicillin, clarithromycin).

• Lifestyle modifications: avoid triggers such as spicy or acidic foods, smoking cessation, maintain a healthy weight.

• Over-the-counter antacids or Proton pump inhibitors (PPIs).

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