Overview

Name: Gastritis and Peptic Ulcer Disease

Description:

This casebook is published and has been read 318 times.

The author of this casebook has identified the following medical topics as being highly relevant to this casebook.

• Peptic Esophagitis -- INFLAMMATION of the ESOPHAGUS that is caused by the reflux of GASTRIC JUICE with contents of the STOMACH and DUODENUM.
  
  
• Gastric ulcer -- Ulceration of the GASTRIC MUCOSA due to contact with GASTRIC JUICE. It is often associated with HELICOBACTER PYLORI infection or consumption of nonsteroidal anti-inflammatory drugs (NSAIDS).
  
  
• Peptic ulcer perforation -- Penetration of a PEPTIC ULCER through the wall of DUODENUM or STOMACH allowing the leakage of luminal contents into the PERITONEAL CAVITY.
  
  
• Peptic Ulcer -- Ulcer that occurs in the regions of the GASTROINTESTINAL TRACT which come into contact with GASTRIC JUICE containing PEPSIN and GASTRIC ACID. It occurs when there are defects in the MUCOSA barrier. The common forms of peptic ulcers are associated with HELICOBACTER PYLORI and the consumption of nonsteroidal anti-inflammatory drugs (NSAIDS).
  
  
• Gastroesophageal reflux disease -- Retrograde flow of gastric juice (GASTRIC ACID) and/or duodenal contents (BILE ACIDS; PANCREATIC JUICE) into the distal ESOPHAGUS, commonly due to incompetence of the LOWER ESOPHAGEAL SPHINCTER. Gastric regurgitation is an extension of this process with retrograde flow into the PHARYNX or MOUTH.
  
  
• PEPTIC ULCER HEMORRHAGE -- Bleeding from a PEPTIC ULCER that can be located in any segment of the GASTROINTESTINAL TRACT.
  
  
• Gastritis -- Inflammation of the GASTRIC MUCOSA, a lesion observed in a number of unrelated disorders.
  
  

Notes

Your stomach makes acid to break down the food you eat. But in some people, the acid can damage the lining of their stomach. This is called gastritis (inflammation of the stomach). Gastritis can be caused by a number of different things. The most common are:

• Alcohol
  
• Infection of the stomach with a germ called Heliobacter pylori
• Medications that can irritate the stomach lining such as aspirin and nonsteroidal anti-inflammatories (NSAIDs) such as ibruprofen and naproxen
• Smoking
• Autoimmune disorders, such as pernicious anemia
• Excess gastric acid secretion (such as from stress)
  

Symptoms include abdominal pain, indigestion, dark stools, loss of appetite, nausea, vomiting, or vomiting blood or coffee-ground like material. If the irritation to the lining is more severe, an ulcer (simply a break in the lining) can form in the stomach (gastric ulcer), or in the upper part of the small intestine leaving the stomach (duodenal or peptic ulcer). Symptoms may last for a short time (acute gastritis) or over many months or years (chronic gastritis). Several tests may be done to make the diagnosis:

• Stomach x-rays - usually done with swallowing a chalky substance called barium to better outline the stomach lining
  
• Upper gastrointestinal (GI) endoscopy - where a long flexible tube with a camera at the end is inserted into the stomach to directly observe the stomach and duodenal lining
• Stool tests - to look for blood and bacteria
• Blood tests - to look for anemia and H. pylori. A positive H. pylori blood test is not definitive for an current infection (it may be a mark of past infection) whereas a positive stool test for H. pylori does indicate current infection.
  

Treatment depends on what is the underlying cause. If irritation from alcohol, smoking or NSAIDs is the cause, discontinuing them will help the problem. This is often paired with medications which reduce or neutralize stomach acid. For mild gastritis, over the counter antacids (such as Maalox or Mylanta) can neutralize the acid and provide relief. If antacids don't provide enough relief, medications called acid blockers may be used to reduce the amount of acid your stomach produces. Examples of this kind of medicine include cimetidine (Tagamet), famotidine (Pepcid) and ranitidine (Zantac). There are also medications that decrease acid production by shutting down acid-secreting cells in the stomach. Omeprazole (Prilosec), lansoprazole (Prevacid) and esomeprazole (Nexium) are examples of these "proton pump inhibitors". In the special case of chronic gastritis or gastic ulcer caused by H. pylori, most doctors use a combination of two antibiotics and a proton pump inhibitor, sometimes with bismuth (such as in Pepto-Bismol) to the regimen.

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