Gastritis

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Background

  • Inflammation of the stomach lining
  • May occur acutely or chronically
  • May lead to peptic ulcer disease
  • Causes
    • H. pylori
    • NSAIDs
    • ETOH
    • Critical Illness (Cushing ulcer)
      • Increased ICP, stimulation of vagal nuclei, increased secretion of gastric acid

Clinical Features

  • Gnawing or burning pain in epigastric area
  • Nausea, vomiting
  • Early satiety, bloating
  • Heartburn

Differential Diagnosis

Epigastric Pain

Evaluation

  • CBC (to rule out anemia)
  • BMP, LFTs
  • Lipase
  • Consider:
    • Acute abdominal series
    • ?Barium swallow (upper GI series)
    • endoscopy (most will be done as outpatient)
    • RUQ US
    • ECG/troponin

Management

  • Cessation of NSAIDs and Etoh
  • Eradicate H. pylori if identified in symptomatic patient

Disposition

  • Normally outpatient management, unless complication (see below)

Red Flags

Any of the following suggest need for endoscopy referral:

  • Age >55yr
  • Unexplained weight loss
  • Early satiety
  • Persistent vomiting
  • Dysphagia
  • Anemia or GI bleeding
  • Abdominal mass
  • Persistent anorexia
  • Jaundice

See Also

PUD

References