Gastritis (Nursing Notes)

 Definition

It is the inflammation of the gastric mucosa (stomach lining). It can be scattered or localized.

Acute Gastritis: Sudden onset, lasts for a short time (usually due to food poisoning or alcohol).

Chronic Gastritis: Long-term inflammation (usually due to H. Pylori infection).

2. Causes (Etiology)

H. Pylori Infection: The most common cause of chronic gastritis.

NSAIDs: Overuse of painkillers like Aspirin, Ibuprofen, Diclofenac (they damage the stomach lining).

Diet: Excessive alcohol, spicy food, or caffeine.

Stress: Physical stress (burns, trauma, surgery) causes "Stress Ulcers."

Smoking: Increases acid secretion.

3. Pathophysiology (How it happens)

The protective mucosal barrier of the stomach is damaged.

HCL (Acid) and Pepsin come in contact with stomach tissue.

Inflammation and edema (swelling) occur.

If not treated, it can lead to ulceration or bleeding.

4. Clinical Manifestations (Signs & Symptoms)

Epigastric Pain: Burning sensation or discomfort in the upper abdomen.

Nausea and Vomiting: Very common.

Anorexia: Loss of appetite.

Sour Taste: In the mouth.

Fullness: Feeling full quickly after eating a little.

Hematemesis: Blood in vomit (if severe/erosive).

Melena: Black tarry stools (if bleeding is present).

5. Diagnostic Evaluation

Endoscopy (EGD): The gold standard test. The doctor puts a camera to see the lining and takes a biopsy.

Urea Breath Test: To check for H. Pylori bacteria.

Stool Test: To check for occult blood.

CBC: To check for anemia (low Hb) due to bleeding.

6. Medical Management

Antibiotics: (Clarithromycin, Amoxicillin, Metronidazole) to kill H. Pylori.

PPIs (Proton Pump Inhibitors): To stop acid production (e.g., Pantoprazole, Omeprazole).

H2 Blockers: To reduce acid (e.g., Ranitidine, Famotidine).

Antacids: To neutralize acid immediately (e.g., Digene, Sucralfate).

7. Nursing Management & Care

NPO Status: Keep patient NPO (Nil Per Oral) if nausea/vomiting is severe to rest the stomach.

IV Fluids: To prevent dehydration (RL or NS).

Diet Progression:

Start with clear liquids (water, juice).

Then full liquids.

Then Bland Diet (boiled food, khichdi, curd).

Avoid Irritants: Strictly NO alcohol, smoking, caffeine (coffee/tea), and spicy/oily food.

Monitor for Bleeding: Watch for tachycardia (high pulse) or hypotension (low BP), which indicates internal bleeding.

Education: Tell the patient not to take NSAIDs (painkillers) on an empty stomach.