gastritis

enUK

gastritis

inflammation of the lining of the stomach

Gastritis

an inflammation disease of the mucosa of the stomach. The development of gastritis is caused by exogenous factors (prolonged nutritional imbalance, overeating, insufficiently varied diet, alcohol abuse, nicotine abuse, and other kinds of intoxication and infection) and endogenous factors (functional disorders of the nervous system, neural reflexes from other diseased organs, such as the intestine and the gall bladder). The form of gastritis is determined by the nature, the intensity, and the duration of the exposure to the irritant that caused the gastritis and also by the organism’s resistance and the occurrence of relapses. Types of gastritis include acute and chronic, localized and diffuse, hypertrophic, atrophic, erosive, polypous, and gastritis with a high or low acidity of the gastric mucus.

Severe gastritis develops as a result of overeating, alcohol abuse, poisoning by alkalis or acids, the intake of irritative medicines, or the ingestion of food that is mechanically irritating, spicy, or too cold or too hot or fatty food that is hard to digest; severe gastritis can also be caused by certain microbes (streptococci, staphylococci, salmonellae, etc.), which enter the organism from contaminated food. Sometimes gastritis develops as a result of the endogenous intoxication of the organism, for example, in uremia and also in cases of individual intolerance of certain foods (fish, crayfish, crab, strawberries, eggs, etc.). Acute gastritis usually begins abruptly with the appearance of an unpleasant sensation in the abdomen, burning and heaviness in the epigastrium, headache, loss of appetite, nausea, eructation, and recurrent vomiting (sometimes with bile and mucus) that brings temporary relief; in some cases symptoms include thirst, chills, and fever. As the inflammation spreads to the intestine sharp colicky pain, borborygmus, and diarrhea appear. The sickness lasts for three to five days and, as a rule, ends with recovery. But there may be relapses.

Chronic gastritis is characterized by chronic inflammation of the mucosa of the stomach with gradual atrophy. Chronic gastritis develops either as a result of frequently recurring acute gastritis or as a result of the prolonged effects on the organism of the same causes that bring about acute gastritis. Often, chronic gastritis is caused by a chronic disease (tuberculosis, hepatitis, dental caries, etc.), by a dysfunction of the central nervous system, or by a metabolic disorder; occupational hazards (working in soap factories and hot shops and candle and margarine factories; the swallowing of metallic, cotton, or coal dust) and the prolonged ingestion of certain medicines can also cause gastritis. Chronic gastritis may take its course with insufficient, normal, or increased secretion of gastric juice. In the case of gastritis with decreased secretion patients are disturbed by lack of appetite, an unpleasant astringent or metallic taste in the mouth, eructation of air or with a rotten-egg aftertaste, nausea, a sensation of heaviness in the epigastrium, and occasional vomiting soon after eating. Sharp pains appear when food is ingested into the intestine. Chronic gastritis with normal or increased secretion begins at an early age. It is accompanied by pains and heaviness in the epigastrium, persistent heartburn, acidic eructation, a burning sensation, and a sensation of pressure and bursting that usually occurs two to three hours after eating. After the ingestion of food the pains pass.

Treatment for gastritis includes the elimination of the causes of acute gastritis, regulation of the functions of the central nervous system, treatment of the underlying diseases, the elimination of focal infection, improvement of oral hygiene, and elimination of occupational hazards. Of special importance are the hygienic and sanitary measures and adequate control of the food products for sale and the preparation of food in public catering facilities. Health-resort therapy yields good results (Essentuki, Zheleznovodsk, Borzhomi, Piatigorsk, Arzni, Druskininkai, etc.).

REFERENCES

Gordon, O. L. Khronicheskii gastrit i tak nazyvaemye funktsional’nye zabolevaniia zheludka. Moscow, 1959.
Sobakin, M. A. “Elektrograficheskoe issledovanie motornoi deiatel’nosti zheludka pri pishchevarenii v eksperimente i v klinike.” In the collection Voprosy fiziologii i patologii pishchevareniia. Moscow, 1958. Pages 141-60.

I. S. SAVOSHCHENKO

Gastritis in animals. Gastritis is observed in all animal species; in ruminants the equivalent is inflammation of the abomasum. It is caused by feeding on spoiled feeds, overfeeding, abrupt changes in diet, poisoning by poisonous plants and chemicals, tooth diseases, abnormal wearing down of teeth, and secondarily by certain infectious and parasitic diseases. The clinical aspects of gastritis include a decrease or absence of appetite, apathy, pain during palpation of the stomach, and colic; among carnivores and swine gastritis is accompanied by vomiting. In the diagnosis of gastritis the examination of the contents of the stomach obtained by means of a probe or by a needle puncture (in ruminants) is of great importance. Acute gastritis runs a course of several days and has a favorable outcome; chronic gastritis can effect permanent changes and can persist for months. Treatment focuses on elimination of the causes and prescription of an appropriate diet. In cases of intoxication, lavage of the stomach and laxatives are prescribed; for dogs and swine emetics must be used. In order to improve secretory and motor activity, Karlovy Vary salts, hydrochloric acid, pepsin, bitters, and other medicines are administered orally. Systematic veterinary and sanitary monitoring of the quality of feeds, the condition of pastures, the feed diet, and the watering places is necessary for prevention of gastritis.

N. M. PREOBRAZHENSKII

gastritis

[ga′strīd·əs] (medicine) Inflammation of the stomach.

gastritis

enUK

Gastritis

Definition

Gastritis commonly refers to inflammation of the lining of the stomach, but the term is often used to cover a variety of symptoms resulting from stomach lining inflammation and symptoms of burning or discomfort. True gastritis comes in several forms and is diagnosed using a combination of tests. In the 1990s, scientists discovered that the main cause of true gastritis is infection from a bacterium called Helicobacter pylori (H. pylori).

Description

Gastritis should not be confused with common symptoms of upper abdominal discomfort. It has been associated with resulting ulcers, particularly peptic ulcers. And in some cases, chronic gastritis can lead to more serious complications.

Nonerosive h. pylori gastritis

The main cause of true gastritis is H. pylori infection. H. pylori is indicated in an average of 90% of patients with chronic gastritis. This form of nonerosive gastritis is the result of infection with Helicobacter pylori bacterium, a microorganism whose outer layer is resistant to the normal effects of stomach acid in breaking down bacteria.The resistance of H. pylori means that the bacterium may rest in the stomach for long periods of times, even years, and eventually cause symptoms of gastritis or ulcers when other factors are introduced, such as the presence of specific genes or ingestion of nonsteroidal anti-inflammatory drugs (NSAIDS). Study of the role of H. pylori in development of gastritis and peptic ulcers has disproved the former belief that stress lead to most stomach and duodenal ulcers and has resulted in improved treatment and reduction of stomach ulcers. H. pylori is most likely transmitted between humans, although the specific routes of transmission were still under study in early 1998. Studies were also underway to determine the role of H. pylori and resulting chronic gastritis in development of gastric cancer.

Erosive and hemorrhagic gastritis

After H. pylori, the second most common cause of chronic gastritis is use of nonsteroidal anti-inflammatory drugs. These commonly used pain killers, including aspirin, fenoprofen, ibuprofen and naproxen, among others, can lead to gastritis and peptic ulcers. Other forms of erosive gastritis are those due to alcohol and corrosive agents or due to trauma such as ingestion of foreign bodies.

Other forms of gastritis

Clinicians differ on the classification of the less common and specific forms of gastritis, particularly since there is so much overlap with H. pylori in development of chronic gastritis and complications of gastritis. Other types of gastritis that may be diagnosed include:

Acute stress gastritis-the most serious form of gastritis which usually occurs in critically ill patients, such as those in intensive care. Stress erosions may develop suddenly as a result of severe trauma or stress to the stomach lining.
Atrophic gastritis is the result of chronic gastritis which is leading to atrophy, or decrease in size and wasting away, of the gastric lining. Gastric atrophy is the final stage of chronic gastritis and may be a precursor to gastric cancer.
Superficial gastritis is a term often used to describe the initial stages of chronic gastritis.
Uncommon specific forms of gastritis include granulomatous, eosiniphilic and lymphocytic gastritis.

Causes and symptoms

Nonerosive h. pylori gastritis

H. pylori gastritis is caused by infection from the H. pylori bacterium. It is believed that most infection occurs in childhood. The route of its transmission was still under study in 1998 and clinicians guessed that there may be more than one route for the bacterium. Its prevalence and distribution differs in nations around the world. The presence of H. pylori has been detected in 86-99% of patients with chronic superficial gastritis. However, physicians are still learning about the link of H. pylori to chronic gastritis and peptic ulcers, since many patients with H. pylori infection do not develop symptoms or peptic ulcers. H. pylori is also seen in 90-100% of patients with duodenal ulcers.Symptoms of H. pylori gastritis include abdominal pain and reduced acid secretion in the stomach. However, the majority of patients with H. pylori infection suffer no symptoms, even though the infection may lead to ulcers and resulting symptoms. Ulcer symptoms include dull, gnawing pain, often two to three hours after meals and pain in the middle of the night when the stomach is empty.

Erosive and hemorrhagic gastritis

The most common cause of this form of gastritis is use of NSAIDS. Other causes may be alcoholism or stress from surgery or critical illness. The role of NSAIDS in development of gastritis and peptic ulcers depends on the dose level. Although even low doses of aspirin or other nonsteroidal anti-inflammatory drugs may cause some gastric upset, low doses generally will not lead to gastritis. However, as many as 10-30% of patients on higher and more frequent doses of NSAIDS, such as those with chronic arthritis, may develop gastric ulcers. In 1998, studies were underway to understand the role of H. pylori in gastritis and ulcers among patients using NSAIDS.Patients with erosive gastritis may also show no symptoms. When symptoms do occur, they may include anorexia nervosa, gastric pain, nausea and vomiting.

Other forms of gastritis

Less common forms of gastritis may result from a number of generalized diseases or from complications of chronic gastritis. Any number of mechanisms may cause various less common forms of gastritis and they may differ slightly in their symptoms and clinical signs. However, they all have in common inflammation of the gastric mucosa.

Diagnosis

Nonerosive h. pylori gastritis

H. pylori gastritis is easily diagnosed through the use of the urea breath test. This test detects active presence of H. pylori infection. Other serological tests, which may be readily available in a physician's office, may be used to detect H. pylori infection. Newly developed versions offer rapid diagnosis. The choice of test will depend on cost, availability and the physician's experience, since nearly all of the available tests have an accuracy rate of 90% or better. Endoscopy, or the examination of the stomach area using a hollow tube inserted through the mouth, may be ordered to confirm diagnosis. A biopsy of the gastric lining may also be ordered.

Erosive or hemorrhagic gastritis

Clinical history of the patient may be particularly important in the diagnosis of this type of gastritis, since its cause is most often the result of chronic use of NSAIDS, alcoholism, or other substances.

Other forms of gastritis

Gastritis that has developed to the stage of duodenal or gastric ulcers usually requires endoscopy for diagnosis. It allows the physician to perform a biopsy for possible malignancy and for H. pylori. Sometimes, an upper gastrointestinal x-ray study with barium is ordered. Some diseases such as Zollinger-Ellison syndrome, an ulcer disease of the upper gastrointestinal tract, may show large mucosal folds in the stomach and duodenum on radiographs or in endoscopy. Other tests check for changes in gastric function.

Treatment

H. pylori gastritis

The discovery of H. pylori's role in development of gastritis and ulcers has led to improved treatment of chronic gastritis. In particular, relapse rates for duodenal and gastric ulcers has been reduced with successful treatment of H. pylori infection. Since the infection can be treated with antibiotics, the bacterium can be completely eliminated up to 90% of the time.Although H. pylori can be successfully treated, the treatment may be uncomfortable for patients and relies heavily on patient compliance. In 1998, studies were underway to identify the best treatment method based on simplicity, patient cooperation and results. No single antibiotic had been found which would eliminate H. pylori on its own, so a combination of antibiotics has been prescribed to treat the infection.DUAL THERAPY. Dual therapy involves the use of an antibiotic and a proton pump inhibitor. Proton pump inhibitors help reduce stomach acid by halting the mechanism that pumps acid into the stomach. This also helps promote healing of ulcers or inflammation. Dual therapy has not been proven to be as effective as triple therapy, but may be ordered for some patients who can more comfortably handle the use of less drugs and will therefore more likely follow the two-week course of therapy.TRIPLE THERAPY. As of early 1998, triple therapy was the preferred treatment for patients with H. pylori gastritis. It is estimated that triple therapy successfully eliminates 80-95% of H. pylori cases. This treatment regimen usually involves a two-week course of three drugs. An antibiotic such as amoxicillin or tetracycline, and another antibiotic such as clarithomycin or metronidazole are used in combination with bismuth subsalicylate, a substance found in the over-the-counter medication, Pepto-Bismol, which helps protect the lining of the stomach from acid. Physicians were experimenting with various combinations of drugs and time of treatment to balance side effects with effectiveness. Side effects of triple therapy are not serious, but may cause enough discomfort that patients are not inclined to follow the treatment.OTHER TREATMENT THERAPIES. Scientists have experimented with quadruple therapy, which adds an antisecretory drug, or one which suppresses gastric secretion, to the standard triple therapy. One study showed this therapy to be effective with only a week's course of treatment in more than 90% of patients. Short course therapy was attempted with triple therapy involving antibiotics and a proton pump inhibitor and seemed effective in eliminating H. pylori in one week for more than 90% of patients. The goal is to develop the most effective therapy combination that can work in one week of treatment or less.MEASURING H. PYLORI TREATMENT EFFECTIVENESS. In order to ensure that H. pylori has been eradicated, physicians will test patients following treatment. The breath test is the preferred method to check for remaining signs of H. pylori.

Treatment of erosive gastritis

Since few patients with this form of gastritis show symptoms, treatment may depend on severity of symptoms. When symptoms do occur, patients may be treated with therapy similar to that for H. pylori, especially since some studies have demonstrated a link between H. pylori and NSAIDS in causing ulcers. Avoidance of NSAIDS will most likely be prescribed.

Other forms of gastritis

Specific treatment will depend on the cause and type of gastritis. These may include prednisone or antibiotics. Critically ill patients at high risk for bleeding may be treated with preventive drugs to reduce risk of acute stress gastritis. If stress gastritis does occur, the patient is treated with constant infusion of a drug to stop bleeding. Sometimes surgery is recommended, but is weighed with the possibility of surgical complications or death. Once torrential bleeding occurs in acute stress gastritis, mortality is as high as greater than 60%.

Alternative treatment

Alternative forms of treatment for gastritis and ulcers should be used cautiously and in conjunction with conventional medical care, particularly now that scientists have confirmed the role of H. pylori in gastritis and ulcers. Alternative treatments can help address gastritis symptoms with diet and nutritional supplements, herbal medicine and ayurvedic medicine. It is believed that zinc, vitamin A and beta-carotene aid in the stomach lining's ability to repair and regenerate itself. Herbs thought to stimulate the immune system and reduce inflammation include echinacea (Echinacea spp.) and goldenseal (Hydrastis canadensis). Ayurvedic medicine involves meditation. There are also certain herbs and nutritional supplements aimed at helping to treat ulcers.

Prognosis

The discovery of H. pylori has improved the prognosis for patients with gastritis and ulcers. Since treatment exists to eradicate the infection, recurrence is much less common. As of 1998, the only patients requiring treatment for H. pylori were those at high risk because of factors such as NSAIDS use or for those with ulcers and other complicating factors or symptoms. Research will continue into the most effective treatment of H. pylori, especially in light of the bacterium's resistance to certain antibiotics. Regular treatment of patients with gastric and duodenal ulcers has been recommended, since H. pylori plays such a consistently high role in development of ulcers. It is believed that H. pylori also plays a role in the eventual development of serious gastritis complications and cancer. Detection and treatment of H. pylori infection may help reduce occurrence of these diseases. The prognosis for patients with acute stress gastritis is much poorer, with a 60 percent or higher mortality rate among those bleeding heavily.

Prevention

The widespread detection and treatment of H. pylori as a preventive measure in gastritis has been discussed but not resolved. Until more is known about the routes through which H. pylori is spread, specific prevention recommendations are not available. Erosive gastritis from NSAIDS can be prevented with cessation of use of these drugs. An education campaign was launched in 1998 to educate patients, particularly an aging population of arthritis sufferers, about risk for ulcers from NSAIDS and alternative drugs.

Key terms

Duodenal — Refers to the duodenum, or the first part of the small intestine.Gastric — Relating to the stomach.Mucosa — The mucous membrane, or the thin layer which lines body cavities and passages.Ulcer — A break in the skin or mucous membrane. It can fester and pus like a sore.

Resources

Periodicals

Podolski, J. L. "Recent Advances in Peptic Ulcer Disease: H. pylori Infection and Its Treatement." Gastroenterology Nursing 19, no. 4: 128-136.

Organizations

National Digestive Diseases Information Clearinghouse. 2 Information Way, Bethesda, MD 20892-3570. (800) 891-5389. http://www.niddk.nih.gov/health/digest/nddic.htm.

Other

American College of Gastroenterology Page. http://www.acg.org.HealthAnswers.com. http://www.healthanswers.com.

gastritis

[gas-tri´tis] inflammation of the lining of the stomach. Gastritis is one of the most common stomach disorders, and occurs in acute, chronic, and toxic forms.acute gastritis severe gastritis that may be caused by intake of aspirin or other nonsteroidal antiinflammatory drugs, food poisoning, overeating, excessive intake of alcoholic beverages, or bacterial or viral infection; it is often accompanied by enteritis. The outstanding symptom is abdominal pain, and there is also a feeling of distention, with loss of appetite and nausea. There may be a slight fever and vomiting. The substance causing the irritation can often be identified, in which case it should be avoided. Treatment may include the use of antacids. A bland diet of liquids and easily digested food should be followed for 2 or 3 days. Simply prepared solid foods in small quantities can then be added.atrophic gastritis chronic gastritis with atrophy of the mucous membranes and glands.chronic gastritis gastritis that occurs repeatedly or continues over a period of time. Although pain, especially after eating, and symptoms associated with indigestion may occur in chronic gastritis, most patients are asymptomatic; however, the condition may lead to hemorrhage and ulcer formation. Among its possible causes are Helicobacter pylori, vitamin deficiencies, abnormalities of the gastric juice, ulcers, hiatus hernia, excessive use of alcohol, or a combination of any of these.
Chronic gastritis is treated with a bland diet; food should be taken frequently and in small amounts. Antacids or anticholinergics may also be used in moderation to minimize stomach acidity. If bleeding is a problem that cannot be controlled by conservative measures, partial gastrectomy, pyloroplasty, vagotomy, or total gastrectomy may be indicated.giant hypertrophic gastritis Ménétrier's disease.toxic gastritis gastritis resulting from ingestion of a corrosive substance such as a strong acid or poison. There is an acute burning sensation and cramping stomach pain, accompanied by diarrhea and vomiting; the vomit may be bloody. The victim may collapse. This condition is an emergency and immediate measures must be taken to prevent serious damage to the tissues of the stomach. First aid measures are begun at once to flush out and neutralize the poison.

gas·tri·tis

(gas-trī'tis), Inflammation, especially mucosal, of the stomach. [gastr- + G. -itis, inflammation]

gastritis

(gă-strī′tĭs)n. Chronic or acute inflammation of the stomach, especially of the mucous membrane of the stomach.

gastritis

Medtalk Inflammation of the stomach mucosa. See Atrophic gastritis, Giant hypertrophic gastritis.

gas·tri·tis

(gas-trī'tis) Inflammation, especially mucosal, of the stomach. [gastr- + G. -itis, inflammation]

gastritis

Inflammation of the stomach from any cause. See also GASTRIC EROSION.

gas·tri·tis

(gas-trī'tis) Inflammation, especially mucosal, of the stomach. [gastr- + G. -itis, inflammation]

gastritis

gas·tri·tis

gastritis

gas•tri•tis

gastritis

gastritis

gastritis

Gastritis

REFERENCES

gastritis

gastritis

Gastritis

Definition

Description

Nonerosive h. pylori gastritis

Erosive and hemorrhagic gastritis

Other forms of gastritis

Causes and symptoms

Nonerosive h. pylori gastritis

Erosive and hemorrhagic gastritis

Other forms of gastritis

Diagnosis

Nonerosive h. pylori gastritis

Erosive or hemorrhagic gastritis

Other forms of gastritis

Treatment

H. pylori gastritis

Treatment of erosive gastritis

Other forms of gastritis

Alternative treatment

Prognosis

Prevention

Key terms

Resources

Periodicals

Organizations

Other

gastritis

gas·tri·tis

gastritis

gastritis

gas·tri·tis

gastritis

gas·tri·tis

gastritis

Words related to gastritis

noun inflammation of the lining of the stomach

Related Words