Presentation Of Gastritis

Case
47

A 52 year old man presents to the office with approximatally

2 weeks of upper abdominal pain. His symptoms are difficult
for him to describe, but include some discomfort in the
epigastric region that comes and goes. He has had some
heartburn and nausea, but no vomiting or diarrhea. He
has noticed that his stool looks darker than it used to, but
he has not seen any blood. He feels full quickly after eating.
He tried taking some over the counter antacid, which helps
a little bit. His only other medication is an over the counter
nonsteroidal anti-inflammatory drug (NSAID) that he takes
once or twice a day because of arthritis in his knees. He
does not smoke cigarettes or drink alcohol. On examination,
he is pale appearing, but in no acute discomfort. He is
afebrile, his blood pressure is 120/80 mmHg, his pulse is 95
beats/min, and his respiratory rate is 14 breaths/min. Head,
ears, eyes, nose, and throat (HEENT) examinations is
notable only for pale conjictiva. Cardiac and pulmonary
examinations are normal. His abdomen has normoactive
bowel sounds and tenderness in tyhe epigastrium. There is
no mass, rebound, or guarding. Rectal examination reveals
normal tone, no masses, and dark black stool that is stongly
fecal occult blood test (FOBT) positive. The remainder of his

Keyword
A 52 years old man
2 week upper abdominal pain
Discomfort in the epigastric region that comes
and goes
Heartburn and nausea, but no vomiting or diarrhea
He feels full quickly after eating
Other medication is an over the counter
nonsteroidal anti-inflammatory drug (NSAID)
He does not smoke cigarettes or drink alcohol

Problem
A 52 year old man with
upper abdominal pain

Hypotesa
A 52 year old man with
upper abdominal pain
because gastritis

Point Papper
Presentation
Case explanation
All about gastritis

Case explanation
SURNAME
FIRST NAME
AGE: 52
SEX: Male
MARITAL STATUS: M
OCCUPATION : office worker
PRESENT COMPLAINT: upper abdominal pain
O/E
General condition
ENT
RS
CVS
BP 120/80 mmHg, pulse 95 beats/min, RR 14 breaths/min
GIS
Discomport in the epigastric region that comes and goes, heartburn and
nausea, but no vomiting or diarrhea. Abdomen has normoactive bowel sound
and tenderness in the epigastrium
GUS
CNS
IMMEDIATE PAST HISTORY
POINTS OF NOTE
Tried taking some antacid, other medication is NSAID
INVESTIGATIONS
Strongly fecal occult blood test (FOBT) positive.
DIAGNOSIS
Gastritis
MANAGEMENT

Definition
Gastritis is a term used to describe a
group of condition characterized by
inflammation of the lining of your
stomach.
Commonly,
the
inflammation of gastritis result from
infection with the some bacterium
that causes most stomach ulcers.

Etiology
The following are known causes and
factors related to gastritis
Bacterial infection (most often by
helicobacter pylori)
Fungal infection (most often in people
with immunodeficiency)
Parasitic infection
Bile reflux

Continue...
NSAIDs ( nonsteroidal anti inflammatory
drugs )
Sigarette smoke
Autoimmun disorders
Excessive alcohol consumption
Excessive caffeine consumption
Certain types of radiation
Sress and allergic

Epidemiology
Data for the incidence and prevalence of gastritis
are not available. Dyspeptic symptoms affect up to
25% of the population of the US nonulcer
dyspepsia (including gastritis) contributes to the
diagnosis in about 50% of patients referred for
upper endoscopy. Dyspeptic symptoms are
reported in 10% to 20% of patients taking NSAIDS,
although the prevalance may range from 5% to
50%. North european or scandinavian ancestry is
a recognized risk factor for autoimmune gastritis.

Symtoms
Many people with gastritis do not have
any symptoms, but some people
experience symptoms such as :
Upper abdominal discomfort or pain
Nausea
Vomiting
These symptoms are also called
dyspepsia

Continue...
Erosive gastritis may cause ulcers or
erosions in the stomach lining that
can bleed. Signs of bleeding in the
stomach include :
Blood in vomit
Black, tarry stools
Red blood in the stool

Risk Factors
Factors thats may increase your risk
of gastritis include :
H. Pylori infection
Regular use of aspirin or other
NSAIDs
Older age

Complication
Left untreated, gastritis may leatd to
stomach ulcers and stomach bleeding. some
forms of chronic gasrtitis may increase your
risk of stomach cancer, espesially if you
have extensive thinning of the stomach
lining and changes in the lining cells.
Tell your doctor if you signs and symptoms
aret improving despite treatment for
gastritis.

Treatment Of Gastritis
Antacids, such as aspirin, sodium bicarbonate,
and citric acid; alumina and magnesia; and
calcium bicarbonate and magnesia.
Histamine 2 (H2) blocker, such as famotidine
(Pepcid AC) and ranitidine (Zantac 75).
Proton pump inhibitor (PPIs), such as
omeprazole (Prilosec, Zegerid), lansoprazole
(Prevacid), pantoprazole (protonix), rabeprazole
(Aciphex) and dexlansoprazole (kapidex).

How is gastritis
diagnosed?

Other tests used to identify the cause of gastritis or

any complications include the following :
Upper gastrointestinal (GI) series. The patient
swallows barium, a liquid contrast material that
makes the digestive tract visible in an x ray. X-ray
images may show changes in the stomach lining,
such as erosions or ulcers.
Blood test. The doctor may check for anemia, a
condition in which the bloods iron-rich substance,
anemia may be a sign of chronic bleeding in the
stomach.

Continue...
Stool test. This test checjs for the
presence of blood in the stool, another
sign of bleeding in the stomach.
Test for H. Pylori infection. The doctor may
test a patients breath, blood, or stool for
signs of infection. H. Pylori infection can
also be confirmed with biopsies taken
from the stomach during endoscopy.

Education
Degestive problem ranging from simple
stomach upset to stomach cancer can occur
for many reasons, including life style choices
you can control. In general, to keep your
degestive
system
healthy,
doctors
recommend that you :
Practice good eating habits. Just as important
as what you eat is the manner in which you
eat, in moderate proportion, eat at regular
times an relax while you eat.

Continue...
Maintain a healthy weight. Degestive problem can occur
no matter what your weight but heartburn, bloating and
constipation tend to be more common in people who are
over wight. Maintaining a healthy wight can often help
prevent or reduce these symtoms
Get plenty of exercise. Aerobic exercise that increases
your breathing and heart rate also stimulates the activity
of intestinal muscles helping to move food waste
through your intestines more quickly. Its best to aim for
as least 30 minutes of aerobic activity avery day. Check
with your doctor before you begin an exercise program
Manage stress.

Prognosis
Once your doctor identifies the
cause of your gastritis and begins
treatment, the outlook for a full
recovery is very good. However, if
your gastritis is related to smoking
or alkohol use, you must be willing
to changes your lifestyle to eliminate
these irritans.

Bibliography
U.S Departement of health and
human service. National
institute of Health