Gastritis.pptx

For 2nd year B.Sc Nursing students

1. GASTRITIS Presented By: Mr. Nandish. S Asso. Professor Mandya Institute of Nursing Sciences

2. INTRODUCTION : It is a general term used for group of conditions with the inflammation of lining of stomach. It is an inflammation of the gastric mucosa. It is the most common GI problem. It affects both the genders equally, more in older adults. It is also called as Hostelites disease.

3. Types : It may be A cute or Chronic and may be D iffused or Localized . Acute will last for several hours to few days. Acute is classified into erosive or non – erosive based on the pathologic manifestations present in the gastric mucosa. Erosive : it is caused by local irritants such as Aspirin and other NSAID’s. Non – erosive : it is caused by an infection with Helicobacter Pylori (H. Pylori). 70% of the cases in developing countries are reported due to this organism.

4. Chronic Gastritis which results from repeated exposure to irritating agents or recurring episodes of acute gastritis. It is further divided into 3 subtypes. Auto immune : it involves body & fundus of stomach. Diffuse antral : it primarily affects the antrum . Multifocal : it diffuse through out the stomach.

5. Etiology : Drugs / Medications Aspirin, Non Steroidal Anti-Inflammatory Drugs (NSAID’s), Digitalis, Corticosteroids, Anticoagulants. Diet indiscretions Eating large quantities of spicy & irritating foods Repeated consumption of alcohol . Environmental Factors Exposure to radiation Smoking

6. Micro organisms Helicobacter Pylori : This infection acquire in childhood & is able to survive in gastric mucosa. It is capable of promoting breakdown of gastric mucosal barrier. Salmonella Staphylococcus Cytomegalovirus Syphilis

7. Pathophysiologic conditions Burns Physiologic Stress Reflux of bile & pancreatic secretions Sepsis, Auto immune disease (Addison, Grave’s) Uremia / Renal failure. Other Factors : - Endoscopic procedures - Nasogastric suction .

8. Pathophysiology : Digestive juices protect gastric mucosa Impaired mucosal barrier allows corrosive HCL to come in contact with gastric mucosa Transient & self limiting inflammation of gastric mucosa Gastric mucosa becomes edematous & hyperemic Superficial erosion & ulceration Clinical symptoms

9. Clinical Manifestations : Acute gastritis may have rapid onset of symptoms. It is self limiting. Anorexia Nausea & vomiting Epigastric tenderness / discomfort Hiccups Indigestion Erosive gastritis may cause bleeding which manifest as blood in vomit or stool. Possible signs of shock.

10. Chronic gastritis Fatigue Pyrosis (a burning sensation in the stomach & esophagus that move upto mouth) Belching Vague epigastric pain relieved by eating A sour taste in the mouth Early satiety Nausea & vomiting Intolerance to spicy & fatty foods Cobalamin deficiency Pernicious anemia

11. Diagnostic studies : History collection & physical examination Endoscopy with biopsy Complete blood count Stool examination for occult blood Gastric analysis Serum test for antibodies

12. Management : Acute Gastritis: Treatment concentrates on eliminating the cause and preventing it in future. Adequate bed rest Administration of IV Fluids to replace fluid loss. Maintain NPO Status if vomiting is present. Clear fluids can be resumed once symptoms subside with gradual reintroduction of Bland diet. Monitor the vital signs if hemorrhage is present .

13. Drug therapy : Antacids : Gelucil H2 Receptor blockers : ranitidine, cimetidine Proton pump inhibitors : omeprazole, Lansoprazole .

14. Chronic gastritis : Treatment focuses on evaluating & eliminating the specific cause (cessation of alcohol intake & H.Pylori eradication). Antibiotic & A ntisecretory Agent Combinations are used to remove H.Pylori infection.

15. Treatment Duration Eradication rate Triple Drug Therapy Ranitidine bismuth citrate Amoxicillin Clarithromycin 7 days > 90 % Dual Therapy Ranitidine bismuth citrate Clarithromycin 7 days > 90 % Quadruple Therapy Ranitidine Bismuth Tetracycline metronidazole 14 days 60 % - 80 %

16. Lifestyle modifications : Non irritating diet consisting of 6 small meals per day must be initiated. Cessation of smoking. strictly follow drug regimen. An interdisciplinary team approach for consistent information (team members are Physician, Nurse, Dietician & Pharmacist). Close medical follow up in case of chronic gastritis.

17. Thank you