DISTURBANCES IN DIGESTION ● Chronic

○ H. pylori infection
● Digestion - problem associated in the stomach ○ Chemical gastric injury
○ Long term drugs therapy (steroids, NSAID,
GASTRITIS radiation therapy)
○ Autoimmune disease
● Inflammation of the gastric or stomach mucosa
● A healthy stomach comprises of rugae whether it is PATHOPHYSIOLOGY
in the fundus, antrum, or pylorus
● Inflammation either on the fundus, antrum, or ● Erosive
pylorus can diagnose the patient with gastritis ○ irritants → increase hydrochloric acid
● Inflammation = impaired digestion concentration → irritation → injury →
○ Excessive or lack of release of hydrochloric inflammation
acid ● Non-erosive
○ Parietal cell will also be affected ○ Infection → presence microorganism
● Two types of gastritis: Acute and Chronic Gastritis (antigen) → WBC will be stimulated →
○ Acute gastritis - less than 6 months ■ (1) Stimulation of hypothalamus → send
■ Acute gastritis is divided into 2: Erosive signal to body to activate cytokines → to
and Non-erosive (erosion - destruction of release pyrogens → thermoregulator →
the lining) increases temperature
● Erosive - swollen with ulceration ■ (2) Phagocytosis → increase WBC →
● Nonerosive - swollen without through the process of diaphoresis and
ulceration hemostasis
■ Chronic gastritis - more than 6 months ■ (3) Chemical mediators → vasodilation →
(affected by substances: ex. 5 cardinal signs of inflammation
chemotherapy) ● increase blood volume - hot to
touch (calor)
RISK FACTORS / ETIOLOGY ● Redness - rubor
● Swelling - tumor
● Non-erosive - H. pylori infection ● Pain
○ H. pylori natural flora of the stomach ● Loss of function
(enhance digestion, promotes digestion
process together with hydrochloric acid) CLINICAL MANIFESTATION
○ Caused by impaired immunity
○ If there is decreased in the immunity of the ● Acute (Rapid onset)
patient all normal flora can cause infection in ○ Epigastric pain (sharp pain) / discomfort
the body (cramping), dyspepsia, nausea / vomiting,
hiccups, anorexia (muscle wasting / loss of
● Erosive - Local irritants protein)
○ Erosive - destruction in the gastric lining ○ (+) Erosive: bleeding (UGIT: hematemesis,
○ Local irritants - alcohol (hyperacidity), NSAID LGIT: melena (problem is UGIT but
(salicylates - produces gastric irritation causing manifestation is LGIT), LGIT: hematochezia)
ulcer) ■ Blood → oxygen split with carbon
○ Radiation therapy - counteracts with (particularly comprised with carbon
hydrochloric acid causing inflammation dioxide) → undergo oxygenation →
○ Traumatic injuries (burn, surgery, curling ulcer carbon separate causing the black
associated with gastritis) discoloration of the stool
○ Stress-related
● Chronic
 ○ Vague discomfort relieved by eating ○ Serum electrolyte
■ Eating → hydrochloric acid → neutralizes ■ Diarrhea, impairment in digestive process
by the food ■ Hypo- in all electrolytes
○ Fatigue (cannot tolerate; oxygen is ○ Fecal Occult Blood Test (FOBT)
decreased) ■ Blood in the stool
■ Tiredness - lack of energy (the patient ■ Nursing consideration:
becomes tired with few movements) ● Avoid dark colored food
■ Impaired physical mobility - part of the ● Avoid red meat (false positive result)
body cannot be moved (ex. paralysis, ○ Schilling Test
weakness) ■ Detection of pernicious anemia
■ Activity intolerance - full range of motion
but there are other factors that inhibit the
patient (ex. pain)
○ Anorexia
○ Nausea / vomiting
○ Pyrosis
○ Belching (burping)
■ Gas formation → excessive hydrochloric
acid
○ Sour taste in mouth
■ Regurgitation of hydrochloric acid
○ Early satiety
■ Feeling of fullness easily → if there is
inflammation → the volume inside the
stomach is diminished
○ Intolerance to spicy and fatty food
■ Triggers excessive release of hydrochloric
acid

COMPLICATIONS

● Pyloric stenosis
● Gastric adenocarcinoma
● Lymphoid tissue lymphoma
○ Lymphoma - hardest anemia to survive
● Pernicious anemia
○ Destruction of parietal cell → absence or lack
of intrinsic factor → impairment in the
absorption of Vitamin B12

DIAGNOSTICS

● Assessment: Clinical Feature

● Laboratory:
○ Complete Blood Count (CBC)
■ Signs of anemia brought about by
hemorrhage (ulceration)
■ Secondary to pernicious anemia
(impaired absorption)