GASTRITIS

The term gastritis is commonly employed for any clinical condition with upper abdominal discomfort like indigestion or dyspepsia in which the specific clinical signs and radiological abnormalities are present.

The condition is of great importance due to its relation with peptic ulcers and gastric carcinoma.

There are two types of gastritis –

1) Acute gastritis

2) Chronic gastritis

1) Acute gastritis –

Acute gastritis is a transient acute inflammatory involvement of stomach, mainly mucosa.

Etiopathogenesis –

The various etiological factors which play an important role in causation of acute gastritis are as fallows –

1) Diet and personal habits –

- Highly spiced food

- Excessive consumption of alcohol

- Malnutrition

- Heavy smoking.

2) Infection –

- Bacterial infection –

a) Helicobactor pylori

b) Diptheria

c) Salmonellas

d) Pneumonia

e) Staphylococcal food poisoning.

- Viral infection –

a) Viral hepatitis

b) Influenza

c) Infectious mononucleosis.

3) Chemical and physical agents –

I) Intake of corrosive chemical such as

Caustic soda, phenol, Lysol.

ii) Gastric irradiation.

iii) Freezing.

4) Sever stress –

i) Emotional factor like –

a) Shock

b) Anger

c) Extensive burns.

ii) Trauma.

iii) Surgery.

5) Drugs –

In take of drugs like non steroids anti

Inflammatory drugs.

Mechanism –

Gastritis occurs by one of the following mechanism –

1) Reduced blood flow resulting in mucosal

Hypo perfusion due to ischemia.

2) Increased acid secretion and its

accumulation due to H. pylori infection

resulting in damage to epithelial barriers.

Clinical features –

- Abdominal pain

- Discomfort dyspepsia

- Heart burn

- Vomiting may be persist for 1 or 2 days.

- Haematemesis.

- Melaena.

- Tenderness in the epigastric region.

Investigation –

- Gastroscopy

- Mucosal biopsy.

Management –

Antacid therapy is given oral or parenteral

H2 receptor blockers.

2) Chronic gastritis

This is a disease of unknown etiology, usually progressing very slowly over years and ultimately irreversibly damaging the gastric mucosa. The disease occurs usually in middle aged and elderly subjects but verily in young. In chronic gastritis, glandular damage is observed on histological examination.

Etiology–

The incidence of chronic gastritis increased with each decade of life and is frequent over the age of 50 yrs. It is common with-

- Prolonged ingestion of alcohol.

- Tobacco

- Salicylates or very hot liquid

- Gastro-jejunostomy

- Iron deficiency anaemia

- Gastric freezing

Are associated with chronic gastritis.

Classification –

It based on the type of mucosa affected (i.e. cardiac, body, pyloric antral) .

1) Type A (Autoimmune) – Body fundic predominant.

2) Type B (H.pylori related) – Antral predominant.

3) Type AB (Environmental) – Antral and body gastritis.

4) Chemical (Reflux gastritis).

5) Uncommon forms of gastritis.

Clinical feature –

Chronic gastritis is suspected when dull aching pain is experience in the upper abdomen, within 15 min. after taking spicy or large meal and there is no pain even if a meal is delayed or omitted.

Iron deficiency or megaloblastic anaemia may be present. Vomiting and tenderness are always absent.

Investigations –

- Gastroscopy

- Biopsy.

Treatment or management –

Avoid very hot tea or cold water. Avoiding tobacco and spices. Mechanical, chemical or thermal irritation of the gastric mucosa is prevented by taking small feeds with very little liquid, by vomiting spices in diet.

GASTRITIS and homopathic medicine

Aconitum Napellus

Inflammatory fever with great pain, stitch like, burning and pressing pain in the pit of stomach, with anguish and fear of death, great thirst and vomiting after taking cold or having taken of cold drink while heated.

Aescullus hippocastanum

Subacute gastritis, the burning aching distress in the stomach is almost unbearable, with weakness and faintness, retching and violent vomitting.

Antimonum Crudum

There is total loss of appetite, tongue thickly coated yellow or white, great thirst at night nausea belching with taste of what had been eaten, vomiting after sour wine, from bathing.

Antimonium Tartarricum

Persistent nausea and vomiting loss of energy, oppression and tightness in epigastrium heaviness of head distaste for food, putrid eructation, violent spasmodic vomiting, followed by great drowsiness and weary feeling, loathing of food, pale and sunken countenance, unpleasant sensation of warmth and burning.

Apis Mellifica

Erysipelas of stomach, painful sensitiveness in pit of stomach with burning, great thirst drinks little but often painless yellow diarrhea.

Argentum Nitricum

Incessant vomiting of food with a smooth, dry tongue as it were destitute of papillae. Pain radiating in all directions, acid vomiting. Pain in left side of stomach. Ulcerative pain in stomach after eating.

Arnica Montana

Pressive, cutting pains in epigastricum with nausea and retching, after blows on stomach. Vomiting of dark red coagula, mouth bitter. General soreness sense of fullness in pit of stomach.

Arsenicum Album

Sub acute gastritis burning periodical pains, with sour acrid vomiting, violent thirst but vomits the water. Extreme tenderness in pit of stomach. Tongue is red with red papillae. After abuse of ices, spoiled sauces, sour beer, alcoholic excesses, chewing tobacco.

Euphorbia corollata

Sudden nausea, vomiting and diarrhea of watery fluids with sinking, anxious feeling in the stomach, faintness, slow and weak pulse, cool skin, cold feet and hands, cold sweat on body and extremities, spasm of legs and feet, from fright. Overindulgence in ices, fruits etc.

Titanium

Excessively severe pain and distress, only relieved by vomiting, great weakness and emaciation, during pains constant eructations of foetid gas from the stomach, bowel much distended, constipated.