Hello everyone so we’re going to talk about what this condition is what causes it we’re also going to talk about the signs and symptoms of acute gastritis how it’s diagnosed and how it’s treated acute gastritis is an inflammation of the gastric or stomach mucosa so it’s in the word gastritis gastra that prefix refers to the stomach and itis means inflammation so inflammation of the gastric mucosa acute gastritis may affect part of the stomach or the entire stomach if it affects the entire stomach it’s known as pan gastritis.
• Now acute gastritis is caused by a variety of factors we’re going to talk about a large list of causes in the next slide but they all have something in common in that they lead to an imbalance between destructive processes and protective mechanisms so with these factors with regards to why acute gastritis occurs destructive processes outweigh protective mechanisms in the gastric mucosa we’ll talk a bit more about this in the next slide and there are two types i just want to briefly introduce here we’re not going to talk about them in so much detail in this lesson.
• But there is erosive and non-erosive acute gastritis so now let’s talk about the causes of acute gastritis one of them is infections and these infections can be by bacteria like helicobacter pylori and this is actually the most common cause of acute gastritis helicobacter pylori associated gastritis is the most common form of gastritis some viruses can also lead to an acute gastritis and these include cytomegalovirus although this is very rare alcohol is another cause of acute gastritis so you can imagine that there’s irritation of the stomach lining from alcohol consumption.
• So this leads to inflammation of that stomach mucosa smoking may also contribute to or cause acute gastritis bile acid reflux is another cause ischemia so we can see this in shock patients or icu patients so if there’s issues with blood flow to the stomach we’re essentially reducing the amount of blood getting to the stomach the nutrients get into the stomach reducing the protective mechanism of the stomach so this can lead to acute gastritis food allergies and poisoning can also lead to acute gastritis there’s another form of acute gastritis known as autoimmune gastritis.
• So this is where there are auto antibodies that are formed that attack the stomach mucosa this is more common in young women certain medications can also cause acute gastritis these include nsaids or non-steroidal anti-inflammatory drugs you can think of ibuprofen or advil iron supplements can also cause this we can see colchicine being a cause so this is a gout medication k-exylade which is something individuals take to help reduce their potassium levels and certain chemotherapies gastroesophageal reflux disease can also lead to some gastritis as well and then certain injuries and illnesses.
• So any injuries or illnesses may lead to gastritis so the stress or physiological stress that is associated with the injuries or illnesses especially if there are significant injuries or illnesses this can also lead to gastritis as well and as for the acute gastritis that is caused by injuries and illnesses this causes what we call acute stress gastritis so as we mentioned before in the last slide all of these causes lead to an imbalance in destructive processes and protective mechanisms where the destructive processes overcome or out-compete those protective mechanisms.
• Now that we know some of the causes let’s talk about the clinical features what are some of the signs and symptoms of acute gastritis now it’s important to note that some patients with acute gastritis may be asymptomatic so some patients with non-erosive gastritis may have no symptoms we can see this in some cases of h pylori gastritis so in the acute setting h pylori gastritis may have no symptoms at all but when there are symptoms we often see symptoms like dyspepsia which is a gnawing burning sensation in the epigastric area so the epigastric area is the area in the middle of the stomach above the belly button or above the embolicus.
• So that is the epigastric area so we can have dyspepsia or a sensation of indigestion we can also have epigastric pain so we can have a more overt pain in that same area there can also be nausea and vomiting in acute gastritis reduced or loss of appetite and bloating and belching so these are some of the more common signs and symptoms of acute gastritis and some other more uncommon symptoms that can occur in acute gastritis include fever and chills and hiccups now there are certain complications of acute gastritis that are important to note here one of them is gastrointestinal bleeding so we can imagine that if there is inflammation or any damage to the lining of the stomach.
• There may be some bleeding so one of those is molina which is black tarry stool hematokesia which is bright red blood in your stool or hematemesis which is vomiting up of blood so with regards to why each of these happens with molina this is digested blood if there is a very slow bleed from acute gastritis this can give the body time to digest that blood and produce a black tarry and smelly stool with regards to hematophysia this is a bright red stool and this is more likely to occur if there is a very quick rapid brisk bleed from the acute gastritis and then.
• if there is so much bleeding there may be some vomiting up of blood and that is hematemesis and because of all this gastrointestinal bleeding we may have issues with anemia or a low blood count and associated symptoms of anemia like fatigue acute gastritis can eventually lead to peptic ulcer disease a lot of the pathogenesis in acute gastritis is similar to peptic ulcer disease so if you have ever watched my lesson on peptic ulcer disease you’ll note a lot of similarities here so if there is erosion of the gastric mucosa from this process that continues we can have ulcer formation and then in some cases we can also see nutrient deficiencies we see this more commonly in autoimmune gastritis.
• And some of these nutrient deficiencies include vitamin b12 and iron now let’s talk about the diagnosis and treatment so clinicians diagnose gastritis oftentimes by endoscopy with biopsy so they put an endoscope down and they take biopsy samples they can also assess for h pylori as you mentioned before h pylori associated gastritis is the most common form of gastritis they can do this by doing a urease breath test a stool sample checking for h pylori or through serology testing so serology testing is looking for antibodies that have been formed against h pylori but this doesn’t necessarily mean that you have a current infection of h pylori if you have antibodies it just means that you’ve been exposed to h pylori at some points.
• So that is the problem with serology testing and then auto antibodies can be checked if there’s concern of autoimmune gastritis now how do clinicians treat gastritis it’s important to identify and avoid causes of acute gastritis these include alcohol use nsaid use and some other effects as well including infection with h pylori so good food handling hygiene is important in other methods to reduce the spread as well it’s also important to help reduce those destructive processes by way of either using antacids if it’s very very mild case antacids may be used temporarily but in most cases we’re going to see h2 blockers or proton pump inhibitors like pantopers all being used this helps reduce the acidity in the stomach lowering the destructive processes.
• Allowing more of a balance between destructive processes and protective mechanisms and then in the case of h pylori associated gastritis more specifically triple therapy in order to eradicate the h pylori is important this is done with the antibiotics clarithromycin and amoxicillin and then also using a proton pump inhibitor as well and then in the case of autoimmune gastritis because of those nutrient deficiencies iron supplementation and b12 supplementation are also important as well.