GREEN- Main Topic

BLUE- Sub Topics

RED- Clinical Manifestation
ORANGE- Tagalog Explanation

Gastritis
-inflammation of the gastric or stomach mucosa- may pamamagang nangyayari sa stomach
lining (o ryung tinatawag nating mucosa) na nag caucause ng belly pain,
dyspepsia( indigestion), bloating and nausea. Diba yung lining na yun prinoprotectahan
niya yung stomach from the strong stomach acid na nag didigest ng food. So kapag merong
damages or weakens yung protecttive lining, the mucosa become inflamed, causing gastritis.
And merong type ng bateria na tinatawag na helicobacter pylori or H. pylori na most
common bacterial cause of gastritis.
- It affects women and men about equally and is more common in older adults- bat siya
common sa matatanda kasi they have thinner stomach linings, decreased yung circulation
nila and slower yung metabolism of mucosal repair nila. And ang mga matatanda sila yung
mga naka under sa medication na nonsteroidal anti-inflammatory drugs in which is one
reason but nag kakakroon ng gastritis.

Ang gastritis pwede siyang maging:

ACUTE( suddenly)- lasting several hours to a few days-
CHRONIC( gradually)- resulting from repeated exposure to irritating agents or
recurring episodes of acute gastritis

TYPES:
Erosive- The erosive form of acute gastritis is most often caused by local irritants such as
aspirin and other nonsteroidal anti-inflammatory drugs (e.g., ibuprofen [Motrin]); alcohol
consumption; and gastric radiation therapy- pag erosive gastritis parang inflammation at
erosion or yung pag breakdown ng outer layer ng stomach lining. Itong condition na
to is also known as reactive gastritis. Ang causes nito ay alcohol, smoking, NSAIDs,
corticosteriods, viral or bacterial infections and stress from illness or injuries.

Nonerosive- The nonerosive form of acute gastritis is most often caused by an infection with
Helicobacter pylori (H. pylori). It is estimated that 70% of individuals in developing
countries and between 30% and 40% of individuals in the United States and other
industrialized countries are infected with H. pylori. - ang nonerosive naman ay inflammation
lang ng stomach lining or kaya compromising the stomach lining.

**A more severe form of acute gastritis is caused by the ingestion of strong acid or alkali,
which may cause the mucosa to become gangrenous or to perforate
**Scarring can occur, resulting in pyloric stenosis (narrowing or tightening) or obstruction.
Acute gastritis also may develop in acute illnesses, especially when the patient has had major
traumatic injuries; burns; severe infection; hepatic, kidney, or respiratory failure; or major
surgery. This type of acute gastritis is often referred to as stress-related gastritis
**Chronic H. pylori gastritis is implicated in the development of peptic ulcers, gastric
adenocarcinoma (cancer), and gastric mucosa-associated lymphoid tissue lymphoma
**Autoimmune disorders such as Hashimoto thyroiditis, Addison disease, and Graves’
disease are also associated with the development of chronic gastritis

So ulit ang causes ng gastritis are:

-alcohol abuse- bat alcohol abuse kasi too much consumption of alcohol it irritates thr and
erodes the stomach lining.
-Autoimmune disease- dito kasi merong mga tao na hung immune system nila inaatake yung
mga healthy or normal cells ng stomach lining.
-Bacterial Infection- diba sabi ko kanina ang h. Pylori ang number 1 na bacteria na nag
caucause ng chronic gastritis and reason rin for having stomach ulcers. So dito yung bacteria
na to brinebreakdown niya yung stomach’s protective lining and cause inflammation.
- Bile Reflux- yung liver gumagawa ng bile para tulungan yung body natin na mag digest
ng fatty foods. Reflux means flowing back. So ang bile reflux nangyayari when bile flows
back into the stomach instead na mag move siya sa small interstine.
- Medications- Steady na pag gamit ng nonsteriodal anti-inflammatory drugs or
corticosteriods para imanage ang chronic pain na pwedeng maiiritate yung stomach lining.
-Physical stress- A sudden, severe illness or injury can bring on gastritis. minsan , ang
gastritis ay nadedevelop after ng trauma na di involve ang stomach. So Severe burns and
brain injuries are two common cause.

PATHOPHYSIOLOGY (ACUTE)
1. Due to any cause- yan yung mga like alcohol abuse, autoimmune disease, bacterial
infection, bile reflux, physical stress
2. The barrier is penetrated- meaning yung mucosal barrier ng body is impaired na
3. HCL comes into contact with the mucosa- since impaired na yung barrier corrosive
HCL, pepsin, and other irritating agents come in contact with the gastric mucosa,
resulting in inflammation.
4. Injury to small vessels- that results in
5. Edema, Hemorrhage, and possible ulcer formation.

Chronic gastritis occurs in 3 different forms

1) Superficial gastritis, which causes a reddened, edematous mucosa with small erosions and
hemorrhages.
2) Atrophic gastritis, which occurs in all layers of the stomach, develops frequently in
association with gastric ulcer and gastric cancer, and is invariably present in pernicious
anemia; it is characterized by a decreased number of parietal and chief cells.
3) Hypertrophic gastritis, which produces a dull and nodular mucosa with irregular,
thickened, or nodular rugae; hemorrhages occur frequently.

PATHOPHYSIOLOGY (CHRONIC)
1. The stomach lining first becomes thickened and erythematous and then becomes thin
and atrophic. - dito yung lining ng stomach is thickened and inflamed then den
magiging thin siya na nag cacause ng
2. Continued deterioration and atrophy- so pag continue yung deterioration and
thinning ng stomach lining it leads to
3. Loss of function of the parietal cells
4. Acid secretion decreases- bababa yung pag secrete or production ng acid na very
important body process for us to receive nutrients and vitamins
5. Inability to absorb vitamin B12 - that leads to
6. Development of pernicious anemia

Clinical Manifestations
acute gastritis may have a rapid onset of symptoms such as:
1. epigastric pain or discomfort
2. dyspepsia (indigestion)
3. Anorexia
4. Hiccups or nausea and vomiting- which can last from a few hours to a few days.

Erosive gastritis may cause:

1. bleeding, which may manifest as blood in vomit or as melena (black, tarry stools) or
hematochezia

Chronic gastritis may complain of:

1. Fatigue
2. pyrosis (a burning sensation in the stomach and esophagus that moves up to the
mouth; heartburn) after eating,
3. belching( a sour taste in the mouth, early satiety, anorexia, or nausea and vomiting
4. Some patients may have only mild epigastric discomfort or report intolerance to spicy
or fatty foods or slight pain that is relieved by eating
5. Patients with chronic gastritis may not be able to absorb vitamin B12 because of
diminished production of intrinsic factor by the stomach’s parietal cells due to
atrophy, which may lead to pernicious anemia
6. Some patients with chronic gastritis have no symptoms

ASSESSMENT AND DIAGNOSTIC

Assessment and Diagnosis is based on:
1. a detailed history of food intake, medications taken, and any disorder related to
gastritis.
 2. The physician may also perform a gastroscopic examination with endoscopy.
3. Histological examination by biopsy of a sample.
4. A complete blood count (CBC) may be drawn to assess for anemia as a result of
hemorrhage or pernicious anemia

MEDICAL MANAGEMENT
**The gastric mucosa is capable of repairing itself after an episode of acute gastritis.
1. As a rule, the patient recovers in about 1 day, although the patient’s appetite may be
diminished for an additional 2 or 3 days.
2. instructing the patient to refrain from alcohol and food until symptoms subside.
When the patient can take nourishment by mouth, a nonirritating diet is
recommended. If the symptoms persist, intravenous (IV) fluids may need to be given.
If bleeding is present, management is similar to the procedures used to control upper
GI tract hemorrhage.
3. Therapy is supportive and may include nasogastric (NG) intubation, antacids,
histamine-2 receptor antagonists (H2 blockers) (e.g., famotidine [Pepcid], ranitidine
[Zantac]), proton pump inhibitors (e.g., omeprazole [Prilosec], lansoprazole
[Prevacid]), and IV fluids (NIDDK, 2015; Wehbi et al., 2014).
4. Fiberoptic endoscopy may be necessary. In extreme cases, emergency surgery may be
required to remove gangrenous or perforated tissue. A gastric resection or a
gastrojejunostomy (anastomosis of jejunum to stomach to detour around the pylorus)
may be necessary to treat gastric outlet obstruction, also called pyloric obstruction, a
narrowing of the pyloric orifice, which cannot be relieved by medical management.
5. Chronic gastritis is managed by modifying the patient’s diet, promoting rest, reducing
stress, recommending avoidance of alcohol and NSAIDs, and initiating medications
that may include antacids, H2 blockers, or proton pump inhibitors . H. pylori may be
treated with selected drug combinations which typically include a proton pump
inhibitor, antibiotics, and sometimes bismuth salts.

NURSING MANAGEMENT
1. Reducing Anxiety - The nurse offers supportive therapy to the patient and family
during treatment and after the ingested acid or alkali has been neutralized or diluted.
The patient may be anxious because of pain and planned treatment modalities. The
nurse uses a calm approach to assess the patient and to answer all questions as
completely as possible.
2. Promoting Optimal Nutrition - For acute gastritis, the nurse provides physical and
emotional support and helps the patient manage the symptoms, which may include
nausea, vomiting, and pyrosis (heartburn). The patient should take no foods or fluids
by mouth—possibly for a few days—until the acute symptoms subside, thus allowing
the gastric mucosa to heal. If IV therapy is necessary, the nurse monitors fluid intake
and output along with serum electrolyte values. After the symptoms subside, the
nurse may offer the patient ice chips followed by clear liquids. Introducing solid food
 as soon as possible may provide adequate oral nutrition, decrease the need for IV
therapy, and minimize irritation to the gastric mucosa. As food is introduced, the
nurse evaluates and reports any symptoms that suggest a repeat episode of gastritis.
The nurse discourages the intake of caffeinated beverages, because caffeine is a
central nervous system stimulant that increases gastric activity and pepsin secretion.
The nurse also discourages alcohol use. Discouraging cigarette smoking is important
because nicotine reduces the secretion of pancreatic bicarbonate, which inhibits the
neutralization of gastric acid in the duodenum (the first part of the small intestine)
(Hannah, 2014; Li, Chan, Lu, et al., 2014). When appropriate, the nurse initiates and
refers the patient for alcohol counseling and smoking cessation programs.
3. Promoting Fluid Balance Daily fluid intake and output are monitored to detect early
signs of dehydration (minimal fluid intake of 1.5 L/day, minimal urine output of 0.5
mL/kg/h). If food and oral fluids are withheld, IV fluids (3 L/day) usually are
prescribed and a record of fluid intake plus caloric value (1 L of 5% dextrose in water
= 170 calories of carbohydrate) needs to be maintained. Electrolyte values (sodium,
potassium
4. Relieving Pain Measures to help relieve pain include instructing the patient to avoid
foods and beverages that may irritate the gastric mucosa as well as the correct use of
medications to relieve chronic gastritis. The nurse must regularly assess the patient’s
level of pain and the extent of comfort achieved through the use of medications and
avoidance of irritating substances.

CONCLUSION:
1. Old age
2. Addison’s Disease- is a rare but serious adrenal gland disorder in which the body
can't produce enough of two critical hormones, cortisol and aldosterone. Cortisol
helps the body respond to stress, including the stress of illness, injury, or surgery. It
also helps maintain blood pressure, heart function, the immune system and blood
glucose (sugar) levels. Aldosterone affects the balance of sodium and potassium in
the blood. This in turn controls the amount of fluid the kidneys remove as urine,
which affects blood volume and blood pressure.
-What are the symptoms of Addison’s disease?
The damage to the adrenal glands happens slowly over time, and symptoms occur
gradually. The most common symptoms include:

● Abdominal pain
● Nausea
● Sensitivity to cold
● Vomiting
● Worsening fatigue (extreme tiredness)
● Lightheadedness or feeling faint
3. Hashimoto’s thyroiditis- is an autoimmune disorder. The condition causes white
blood cells and antibodies to mistakenly attack the cells of the thyroid. Doctors do not
know why this happens, but some scientists believe genetic factors may be involved
-anemia
4. Graves' disease is an immune system disorder that results in the
overproduction of thyroid hormones (hyperthyroidism). Although a number
of disorders may result in hyperthyroidism, Graves' disease is a common
cause.

-Common signs and symptoms of Graves' disease include:

● Anxiety and irritability

● A fine tremor of the hands or fingers
● Fatigue
5. Sa signs and symptoms ng gastritis which are present kay lola junabeth -bleeding,
which may manifest as blood in vomit or as melena (black, tarry stools) or
hematochezia, Stomach upset or pain.Belching and hiccups. Belly (abdominal)
bleeding.Nausea and vomiting.Feeling of fullness or burning in your
stomach.Loss of appetite.Blood in your vomit or stool. This is a sign that your
stomach lining may be bleeding.