Question | Answer |
Acute and Chronic gastritis (Pg. 559) | Inflammation of the lining of the stomach
acute: sudden onset, short duration, bleeding if severe
chronic; slow onset, may result in pernicious anemia
*ulcers can be formed |
Risks; infection, meds, drinks, reflux, age | H.pylori, etc.
fam hx, NSAIDs/corticosteroids
excessive alcohol use, smoking, caffeine, stress
bile reflux disease
autoimmune disorders
older age
radiation |
S/S of gastritis:
dys__, pain, appetite/wt, abdominal, vomit like? | dyspepsia, general abdominal discomfort/indigestion
-upper abdominal pain, increase/decrease w/ eating
-nausea, low appetite, bloating (wt loss)
-hematemesis |
S/S of erosive gastritis: | Black, tarry stools; coffee-ground emesis
-acute abdominal pain |
Labs;
CBC
serum & stool antigen
C 13 urea breath test | CBC- anemia? bleeding?
-->others testing for H.pylori |
What is anemia in women and in men? | Women; hgb <12, rbc <4.2
Men; hgb<14, rbc <4.7 |
How do you dx gastritis? | Upper endoscopy (through mouth into esophagus, stomach, duodenum) |
Upper endoscopy:
NPO? Anesthetic?
perforation? | NPO 6-8 hrs before
-local anesthetic sprayed into back of throat
-perforation is a risk |
Medications you can give? | H2 antagonists(dine's), antacids (hydroxides), PPI's (zoles)
-prostaglandins, anti-ulcer/mucosal barriers, antibiotics |
Surgery? | Prescribed when ulcerations or significant bleeding
- |
Surgery:
Vagotomy | nerve fibers only responsible for gastric production
-laproscopically common |
surgery:
Pyloroplasty | usually done at the same time as the vagotomy |
Surgery:
Partial gastrectomy | Removal of the involved portion of the stomach |
Methods for stopping gastric bleeding: | Insert a NG tube for gastric lavage (irrigate w/ NS or water to stop active gastric bleeding) |
Complications to gastritis;
gastric bleeding, outlet obstruction, dehydration, pernicious anemia, dumping syndrome
--> why pernicious anemia? | Chronic gastritis may damage the parietal cells. leads to a reduced production of intrinsic factor= (necessary to absorption of vitamin b12)
-insufficient vit b12 can lead to pernicious anemia |
Pernicious anemia you need monthly ___? | Injections of vit b12 |