GASTRITIS

 

GASTRITIS!!!!

👉Definition:

Inflammation,irritation or erosion of the stomach mucosa(lining of the stomach).

 It can be acute (lasting several hours to a few days)or chronic (prolonged inflammation caused by ulceration of the stomach by bacteria).

Causes/Etiology:

✔Highly seasoned foods

✔Infection by m.org(H.pylori)

✔Alcohol

✔Drugs.e.g.Aspirin and NSAIDs

✔Bile reflux

✔Auto immune dx

✔Radiation Therapy

✔Smoking

✔Intestinal reflux

✔Ingestion of acid/alkali.

NOTE:📝

The main cause of GASTRITIS is bacterial infection by HELICOBACTER PYLORI (H.PYLORI).

 Pathophysiology:

👉The mucosal lining normally protects it from action of hydrochloric acid.

👉Any of the following causes (mention it ooo,biko) would penetrate and destroy this barrier (the lining).

👉As a result of this damage, the stomach mucosa comes in contact with excess HCL. 

👉This excessive secretion of hydrochloric acid is absorbed by small vessels in the stomach and this injures the blood vessels.

👉All this effects manifests in edema,hemorrhage and ulcer formation/ulceration.

Clinical Manifestation:

✏Abdominal pain

✏N&V

✏Anorexia

✏Hiccupping

✏Headache

✏Ulceration 

✏Colic and diarrhoea 

✏Heartburn

✏Belching

✏Sour taste

✏Cachexia(Weight loss).

Diagnostic Evaluation:

👌Absence or low levels of HCL(Achlorhydia and hypochlorhydia).

👌Endoscopy,gastroscopy (to visualize the stomach).

👌Gastrointestinal radiography(will reveal abnormalities).

👌Biopsy with histologic examination.

 Management:

Medical mgt:

💊Antacid. e.g. AlOH (Aluminium Hydroxide) to dilute and neutralize acids.

💊Neutralize alkali with diluted lemon juice or diluted vinegar.

💊Avoid emetics and lavage (risk for perforation if corrosion is extensive).

💊Supportive therapy .e.g. NG intubation,analgesics and sedatives.

💊Antibiotics .e.g. Tetracycline(To combat H.pylori and other organisms).

💊Emergency surgery(may be required to remove gangrenous or perforated tissue).e.g. Gastric resection(gastrojejunostomy) to treat pyloric obstruction.

Nursing mgt:

👠Perform complete physical assessment noting abdominal tenderness,pain,dehydration and systemic dxrs. 

👠Encourage rest to conserve energy and reduce stress.

👠Maintain NPO for hours or days until acute symptoms subside.

👠Discourage caffeinated beverages to reduce gastric activity and pepsin secretion.

👠Discourage alcohol and cigarette smoking/and avoid irritating foods.

👠Monitor daily intake and output. 

👠Assess electrolyte values every 24hrs for fluid imbalance. 

👠Give prescribed analgesics to reduce pain.

👠Provide a list of substances to avoid .e.g. caffeine, nicotine, spicy foods and highly seasoned foods,alcohol.

Nursing diagnoses:

🐵Pain rt irritated stomach mucosa eb facial grimacing/pt's verbalization of pain.

🐵Imbalanced nutrition less than body requirements rt inadequate intake of nutrients eb weight loss.

🐵Risk for deficient fluid volume rt insufficient fluid intake and excessive fluid loss from vomiting.

🐵Anxiety rt unknown outcome of dx eb restlessness. 

🐵Deficient knowledge rt dietary management/disease process/prognosis of disease eb pt asking too many questions.

Complications:

⚠Perforation 

⚠Hemorrhage 

⚠Dehydration 

⚠Shock

⚠Pyloric obstruction 

⚠Infection/Sepsis.