Gastritis

Inflammation of gastric mucosa

One of most common problems
affecting the stomach

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Gastritis
Result of a breakdown in gastric
mucosal barrier
Stomach tissue unprotected
from autodigestion by HCl acid
and pepsin

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Gastritis
Tissue edema results
Disruption of capillary walls
With loss of plasma into gastric

lumen
Possible hemorrhage

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Gastritis
Etiology and Pathophysiology
Risk factors
Drugs
Direct irritating effect on gastric
mucosa
Aspirin, NSAIDs, and
corticosteroids
Diet
Alcohol, spicy food
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Gastritis
Etiology and Pathophysiology
Risk factors (contd)
Microorganisms
Helicobacter pylori
Important cause of chronic gastritis
Promotes breakdown of gastric
mucosal barrier

Staphylococcus organisms

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Gastritis
Etiology and Pathophysiology
Risk factors (contd)
Environmental factors
Radiation, smoking
Pathophysiologic conditions
Burns, renal failure, sepsis

Other factors
Psychologic stress, NG tube
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Gastritis
Etiology and Pathophysiology
Risk factors (contd)
Autoimmune atrophic gastritis
Affects fundus and body of stomach
Associated with increased risk of
gastric cancer
May be link to presence of H. pylori
and development of autoimmune
chronic gastritis
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Acute Gastritis
Clinical Manifestations
Self-limiting
Lasts few hours to a few days
Complete healing of mucosa

expected

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Acute Gastritis
Clinical Manifestations
Anorexia
Nausea
Vomiting
Epigastric tenderness
Feeling of fullness
Hemorrhage
Common with alcohol abuse
May be only symptom
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Chronic Gastritis
Clinical Manifestations
Symptoms are similar to acute

gastritis
Loss of intrinsic factor can occur
when acid-secreting cells are lost
or are nonfunctioning
Essential for absorption of
cobalamin (vitamin B12)

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Gastritis
Diagnostic Studies
Acute gastritis
Diagnosis most often based on

history of drug and alcohol abuse

Chronic gastritis
Diagnosis may be delayed or

missed due to nonspecific

symptoms
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Gastritis
Diagnostic Studies
Endoscopic examination with
biopsy
Necessary for definitive diagnosis

Breath, urine, serum, stool, and

gastric tissue to determine
H. pylori

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Gastritis
Diagnostic Studies
Radiologic studies not helpful
CBC
Confirm presence of anemia

Occult blood test

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Gastritis
Diagnostic Studies
Gastric analysis
Determines achlorhydria (lack of acid

secretion)
Associated with severe atrophic
gastritis

Serum antibody tests to parietal

cells and intrinsic factor

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Gastritis
Diagnostic Studies
Tissue biopsy with cytologic
examination
Rule out gastric carcinoma

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Acute Gastritis
Collaborative Care
Supportive care similar to N/V
If vomiting
NPO
Fluids
Dehydration can occur rapidly

Rest
Antiemetics

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Acute Gastritis
Collaborative Care
NG tubeif severe symptoms
Observe for bleeding
Lavage of precipitating agent from
stomach
Keep stomach empty and free of
noxious stimuli

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Acute Gastritis
Collaborative Care
If hemorrhage likely
Frequent VS
Testing vomitus for blood

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Acute Gastritis
Collaborative Care
Drug therapy
Focused on reducing irritation of

mucosa
Providing symptomatic relief

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Acute Gastritis
Collaborative Care
Drug therapy
Antacids, H2R blockers, PPIs,

combinations
Nurse must teach patient about
medications and side effects

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Chronic Gastritis
Collaborative Care
Focuses on evaluating and

eliminating cause

H. pyloriantibiotics
Pernicious anemiacobalamin
supplements

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Chronic Gastritis
Collaborative Care
Lifestyle changes
Diet
Alcohol
Smoking

Close medical follow-up

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Nursing Diagnosis
1.

Pain R/T irritation of gastric mucosa

-Planning: relief of discomfort by removing irritating
factor or agent
-

-Implementation:the nurse should focus on teaching the client

about causes of gastritis& food that may aggravate the disease*
-The nurse should helpthe client assess factor that increase
symptoms such as stress or fatique*
-Nutritional altered less than body requirement
R/Tdecrease appitite,nausia&vomitting&pian*
-Plnning : improve nutriton intake by eating abalanced diet as
evidanced by w,t gain*
-Implementation:N P O if nausia & vomiting is severe& give him
I-V fluid until the symptoms subsite*

-the nurse can help the client identify food that stimulate development of gastritis&
incourage the client to avoid these agent*

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