GASTRITIS

Acute or chronic inflammation of the gastric mucosa.

Causes

Acute gastritis

  • Non-steroidal anti-inflammatory drugs (NSAIDS), e.g. acetylsalicylic acid, diclofenac, ibuprofen
  • Alcohol
  • Regurgitation of bile into the stomach

Chronic gastritis

  • Autoimmune gastric ulceration
  • Bacterial infection (Helicobacter pylori)

Clinical features

  • May be asymptomatic or have associated anorexia, nausea,
    epigastric pain, and heartburn

Differential diagnosis

  • Pancreatitis, cholecystitis
  • Peptic and duodenal ulcers, cancer of the stomach
  • Epigastric hernia

Investigations

  • Gastroscopy
  • Stool for occult blood
  • Barium meal for chronic gastritis

Management

  • Modify diet: Avoid precipitating causes and increase milk intake
  • Give an antacid Magnesium trisilicate compound 2 tablets every 8 hours as required

If no response

  • Omeprazole 20 mg in the evening for 4 weeks

If vomiting

  • Metoclopramide 10 mg IM repeated when necessary up to 3 times daily
  • Or chlorpromazine 25 mg deep IM or oral (if tolerated) repeated prn every 4 hours
Caution
  • Acetylsalicylic acid and other NSAIDS are contraindicated in patients with gastritis

Prevention

  • Avoid spices, tobacco, alcohol, and carbonated drinks
  • Encourage regular, small, and frequent meals
  • Encourage milk intake