Gastritis

Gastritis

Acute or chronic inflammation of the gastric mucosa

Causes

Acute gastritis:

• Non−steroidal anti−inflammatory drugs (NSAIDS), eg. aspirin, indomethacin, ibuprofen

• Alcohol

• Regurgitation of bile into the stomach

Chronic gastritis

• Autoimmune gastric ulceration

• Bacterial infection (Helicobacter pylori)

Clinical features

• May be asymptomatic or have associated anorexia, nausea, epigastric pain and heartburn

Differential diagnosis

• Pancreatitis

• Peptic and duodenal ulcers

• Cancer of the stomach

• Cholecystitis

• Epigastric hernia

Investigations

Gastroscopy

Stool for occult blood

Barium meal for chronic gastritis

Management

Alumunium hydroxide + magnesium trisilicate compound

2 tablets every 8 hours as required

If there is no response:

Give ranitidine 150mg every 12 hourly for a total of 4−6 weeks or,

Give cimetidine 200−400mg every 8 hours until symptom−free then reduce to 400mg

every12 hours for a total of 4−6 weeks

If vomiting:

chlorpromazine 25mg deep IM or oral

 (if tolerated) repeated prn every 4 hours or metoclopramide 10mg IM repeated prn up to 3

times daily

Note

Aspirin and other NSAIDS are contraindicated in patients with gastritis

Prevention

• Avoid spices, tobacco, alcohol and carbonated drinks

• Encourage regular, small and frequent meals

• Encourage milk intake