Gastritis

Maulidina Syfa (19028)

 Definition
An acute, chronic diffuse or local inflammation of the gastric mucosa associated with anorexia,
fullness, epigastric discomfort, nausea and vomiting. (Suratun SKM, 2010)Gastritis is
inflammation of the gastric mucosa, often the result of an indiscriminate diet. Usually this
person eats too much or too fast or eats foods that are too spicy or contain disease-causing
microorganisms. (Smelzer2002) `` Gastritis is inflammation of the gastric mucosa which can
be acute, chronic, diffuse or local (Soepaman, 1998).Gastritis is an inflammation of the gastric
mucosa (Arif Mansjoer, 1999).Gastritis is inflammation of the gastric mucosa (Sjamsuhidajat,
R, 1998).Gastritis is an inflammation of the gastric mucosa that is acute, chronic, diffuse or
local in nature. (pathophysology: 378)Gastritis is an inflammation of the gastric mucosa, as it
occurs due to reckless diid, eating too much or too fast or eating foods that are too spicy or
that contain microorganisms that cause disease, besides that other causes include alcohol,
aspiration, bile reflux, radiation therapy (KMB & vol 2: 1062)
 Etiology

The causes of gastritis can be differentiated according to the classification as

follows
• Acute Gastritis the cause is analgesic drugs, anti-inflammatory drugs,
especially aspirin (low doses of aspirin can cause erosion of the gastric
mucosa).Chemicals for example: lisol, alcohol, smoking, caffeine, pepper,
steroids and digitalis.
• Chronic Gastritis the causes and pathogenesis are generally
unknown.Gastritis is a common occurrence in older people, but is suspected
in drinking alcohol and smoking.
 Pathophysiology

Acute Gastritis Many factors cause acute

gastritis, such as certain types of drugs,
alcohol, bacteria, viruses, fungi, acute stress,
radiation, allergies or intoxication from food
and drink bile salts, ischemia, and direct
trauma.
1.Drugs, such as non-steroidal inflammatory drugs / NSAIDs (Indomethacin, Ibuprotein and
Salicylic Acid), sulfonamides, steroids, cocaine, chemotherapy agents (Mitomycin, 5 fluoro-2-
deoxyuridine), salicylates, and digitalis irritate the gastric mucosa ( gelfand, 1999)
2. Alcoholic drinks: such as whiskey, vodka, and gin.
3. Bacterial infections: such as H. pylori (most often), H.heimanii, streptococci, staphylococci,
proteus specifics, clostridium species, E. coli, tuberculosis, and secondary syphflis.
4. Virus infection by cytomegalovirus (Giannakis, 2008)
5. Fungal infections, such as candidiasis, Histoplasmosis, and phycomycosis.
6. Physical stress caused by burns, sepsis, trauma, surgery, respiratory failure, kidney failure,
damage to the central nervous system, and gastrointestinal reflux.
7. Food and drinks that are irritants. Seasoned foods and drinks containing caffeine and alcohol
are agents that cause irritation of the gastric mucosa.
8. Bile salts, occur in conditions of reflux of bile salts (an important component of alkalis for the
activation of gastrointestinal enzymes) from the small intestine to the gastric mucosa, thereby
causing a mucosal inflammatory response.
9. Ischemia, this is associated with a result of decreased gastric blood flow.
 Chronic Gastritis

Helicobacter pylori is a gram negative bacteria. These organisms attack gastric surface
cells, aggravate the appearance of cell desquamation and develop a chronic inflammatory
response in the stomach, namely: glandular destruction and metaplasia. Metaplasia is one
of the body's defense mechanisms against irritation, namely by replacing gastric mucosal
cells, for example, with stronger desquamosa cells. Because desquamosa cells are
stronger, their elasticity is also reduced. When digesting food, the stomach performs
peristaltic movements but because the replacement cells are not elastic, stiffness will occur
which in turn causes pain. This metaplasia also causes the loss of mucosal cells in the
stomach lining, which will cause damage to the mucosal lining of the blood vessels. This
blood vessel damage will cause bleeding (Price, Sylvia and Wilson, Lorraine, 1999: 162).
 Clinical Manifestations

a. Acute gastritis
Pain in the epigastrium which may be accompanied by nausea. Pain can come back on an
empty stomach. When the pain is the patient is sweating, restless, abdominal pain and may be
accompanied by an increase in body temperature, tachycardia, cyanosis, a burning sensation
in the epigastrium, cramps and weakness.

b. Chronic gastritis
Signs and symptoms han almost with acute gastrritis, accompanied only by weight loss,
chest pain, pain enemia, such as peptic ulcer and can occur aklohydration, high serum gastric
level.
 Complication
Complications that arise in acute gastritis, namely upper gastrointestinal bleeding (SCBA) in
the form of hemothemesis and melena, ends with hemorrhagic shock, ulcers occur, if the
process is severe and perforation rarely occurs. Fluid disturbances when there is severe
vomiting.

• Complications that arise Chronic Gastritis, namely impaired absorption of vitamin B 12,
due to lack of absorption, B 12 causes pernicious anemia, impaired iron absorption and
narrowing of the antrum pylorus area. Peptic ulcers are also gastric malignancies.
 Treatment
In general, it is eliminating the main factors, namely the etiology, gastric diet with small and
frequent portions, and drugs.Specifically distinguished
Acute Gastritis:
1. Abstain from drinking alcohol and eating until the symptoms disappear; change to a non-
irritating diet.
2. If symptoms persist, IV fluids may be required.
3. If there is bleeding, management is similar to hemorrhage that occurs in the upper
gastrointestinal tract.
4. Emergency surgery may be needed to remove gangrene or perforation.
5. If gastritis occurs as a result of ingesting strong acids or alkalis, dilute and neutralize the
acid with a common antacid
6. If gastritis occurs as a result of ingesting strong alkalis, use diluted orange juice or diluted
vinegar.
7. If corrosion is severe, avoid emetic and flush the stomach because of danger of perforation.
 Chronic Gastritis:

a. Diet modification, stress reduction, and

pharmacotherapy.
b. H. phylory may be treated with antibiotics
(egtetracycline or amoxicillin) and bismuth salt
(peptobismol).