Gastritis

Gastritis refers to inflammation of the stomach mucosa (lining), which can result in considerable abdominal pain and discomfort.
There are several different types:
Acute Gastritis - This develops rapidly and affects the superficial layers of the stomach. There are several different causes such as non-steroidal anti-inflammatory drugs (aspirin for example), Helicobacter pylor infection, alcohol, stress injury as caused by burns or central nervous system insult.
Chronic Gastritis - this develops more gradually and is divided into two subtypes -
Type A (10%) - This occurs in the upper part of the stomach (fundus) and is caused by antibodies to stomach cells called pariteal cells. This results in reduced gastric acid production and is associated with other diseases such as pernicious anaemia and thyroiditis and increases the risk of gastric cancer.
Type B (90%) - This occurs in the lower part of the stomach (antrum) and is caused by non-steroidal anti-inflammatory drugs and Helicobacter pylori infection. This presents an increased risk of peptic ulcer disease and gastric cancer.

Symptoms
The major symptom of gastritis is abdominal pain which is usually burning or gnawing. Patients may also complain of indigestion, belching, abdominal bloating, burning, nausea, vomiting (with or without blood in the vomitus), or darkened stools.
However most patients are asymtomatic (have no symptoms).

Diagnosis
A detailed history is taken and a careful examination is performed, to aid diagnosis and eliminate possible causes of symptoms. Upper gastrointestinal endoscopy allows the physician to visualise the stomach lining by directing a thin tube with a camera into the stomach. This also allows the opportunity for a biopsy (tissue sample) to be taken.
Exposure to Helicobacter pylori may be detected by a blood test which detects antibodies against the infection. Blood tests may also be taken to test for anaemia, which may result from gastric bleeding or vomiting blood. Another test, called a urease breath tests allows detection of active infection. Stool may be analysed for blood or antigen, a sign of infection.

Treatment
Patients may be advised to avoid offending agents (alcohol, aspirin) to promote healing.
Antacids help to neutralise the gastric acid, and sucralfate allows the lining of the stomach to repair itself. H2 blockers and Proton Pump Inhibitors are medications which reduce acid production in the stomach.
Triple therapy is used to combat Helicobacter Pylori infection - this involves combining a medication to reduce acid production (such as H2 blockers or Proton Pump Inhibitors) with two antibiotic treatments.
Intensive care patients, patients who have suffered burn injuries, central nervous system injuries may be given prophylactic (preventative) H2 blockers to prevent stress gastritis