GASTRITIS

Dr DEEPAN P SHAH (MD)

Gastritis is a condition in which mucosa(stomach lining)is inflammed or swollen.
The mucousa consists of gastric glands that secrete digestive juices.
They are covered by layer of columnar epithelial tissues.
It produces acid and pepsin that helps in breakdown of food and digestion of protein
When stomach lining is inflammed it produces less acid and enzymes.

Types

Acute Gastritis -starts suddenly and appears with noticeable symptoms that resolves without treatment within few days.
Chronic Gastritis -It is long lasting and stays in body unnoticeable and can cause complications.
Other classification-
Atrophic/autoimmune
Non atrophic mainly caused due to H pylori
Multifocal atrophic caused due to H pylori and environmental causes
Radiation-caused due to radiation injury.
Non inflammatory granulomatous

Gastritis can also be classified as

Erosive Gastritis -The acids residing with in stomach erode and wear away the stomach lining causing ulcers and deep sores.
Non Erosive Gastritis – It causes inflammation of stomach lining.it does not cause erosion or ulcers.

Risk factors –

Helicopter pylori-The bacteria that resides in mucosa.
Alcohol consumption – excessive alcohol consumption can cause irritation of the mucosal lining.
Stress-stress due to major surgery or injury can lead to gastritis.
Age– older adult people are more prone to this Condition due to thinning of mucosal lining and they are more likely to have Helicobacter Pylori infections.
Bile reflux– regurgitation of bile into stomach from bile tract.
Certain medications.

Pathology

Chronic Gastritis – it can be divided into two

  • Autoimmune Atrophic Gastritis
  • H Pylori Associated Gastritis

Autoimmune Atrophic Gastritis 

It is a chronic condition that results in replacement of parietal cell by metaplastic mucosa.
The interaction of autoantibodies against parietal cell proton pump leads to destruction of parietal cells.
It in turn causes imparied absorption of vitamin B12 and pernicious anaemia.

H. Pylori Associated Gastritis

H Pylori Bacteria enters the body and resides in stomach
It attacks the Lining of the stomach that protects it from acid that digest the food.
Once bacteria damage the lining acid can enter through the lining easily causing ulcers.
H pylori produces its virulence through motility,urease activity and association with mucosal cells.
Urease activity create ammonia that neutralizes the activity of acid
Motility allows the bacteria to penetrate the mucus layer and promote association of bacteria and epithelial cells.

Symptoms-

Pain in upper abdomen.
Feeling of fullness in upper abdomen.
Belching and heartburn.
Hiccups
Indigestion
Nausea
Vomitting
Faltulence
Weight loss
Early satiety

Diagnosis-

Breath test – for H. Pylori
Blood test– pernicious anemia and H pylori infections can be ruled out with blood test.
Stool test-For presence of blood in stools.
Endoscopy-for stomach lining inflammation and erosion
Stomach biopsy
Liver, kidney and pancreas function test.

HOMOEOPATHIC MEDICINES

ARSENICUM ALBUM

Intense burning and heat in stomach and pit of stomach.violent burning pain. Vomiting after eating and drinking.

NUX VOMICA

Spasmodic pain in abdomen. Colickly pain with urge to stool and urinate. Cutting Pains causing patient to bend. Reversed peristalsis.

ARGENTUM NITRICUM

Belching, vomiting, nausea. Ulcerative pain in Left side.gastritis especially of drunkards. Trembling and throbbing pain In stomach.enormous distension.

KALIUM BICHROMICUM

Cutting pain in abdomen soon after eating.dilatation in stomach, round ulcer of stomach, cannot digest meat, vomiting of bright yellow water.painful retraction, burning.

ARGENTUM NITRICUM

Abdominal colic with flatulent distension.stitchy ulcerative pain in left side of abdomen.nausea, retching vomitting of mucus.great craving for sweets.painful spot over stomach that radiates to all over abdomen.

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