Gastric gastritis

Alterations in other gastric secretions, such as pepsinogens and blood group substances also take place in chronic atrophic gastritis. The secretion of pepsinogen I has been used as an indicator of intestinal metaplasia and gastric cancer (21, 22). 

The nitrite results from reduction of nitrate by bacteria abnormally present in the gastric mucosa and the gastric cavity. The bacteria grow situ because the pH is elevated as a result of loss of HCl secretion secondary to the loss of parietal cells and their replacement by intestinal-type epithelium. Parietal cells are lost as a result of chronic atrophic gastritis. What... 

Helicobacter pylori is associated with chronic gastritis, peptic ulceration and possibly involved in the pathogenesis of gastric carcinoma (Correa and Ruiz, 1992 Dixon,... 

Salim, A.S. (1992a). Role of sulfhydryl-containing agents in the healing of erosive gastritis and chronic gastric ulceration in the rat. J. Pharm. Sci. 81, 70-73. 

Prolonged hypergastrinemia leading to the development of colonic polyps and potentially adenocarcinoma in rats was a concern that has proven to be unfounded with long-term use in humans.19 The FDA has stated that there is insufficient evidence linking PPI use to atrophic gastritis, intestinal metaplasia, or gastric cancer.20... 

Dietary factors such as coffee, tea, cola, beer, and a highly-spiced diet may cause dyspepsia, but they have not been shown to independently increase PUD risk. Although caffeine increases gastric acid secretion and alcohol ingestion causes acute gastritis, there is inconclusive evidence to confirm that either of these substances are independent risk factors for peptic ulcers. 

In another subpopulation, the Helicobacter gastritis extends into the corpus resulting in atrophy of the oxyntic mucosa and reduced acid secretion. It is not yet clear to which extent these manifestations reflect different stages or different courses of Helicobacter-induced gastritis [41, 45], H. pylori thus emerges as the main cause of acquired gastric hypochlorhydria [46-48],... 

Gram-negative bacilli are in general not recovered or only occasionally and at low counts in studies of healthy individuals on acid inhibitors [34, 40, 43, 44] (table 2). This pattern has also been shown in healthy old people with hypochlorhydria secondary to chronic gastritis, of whom the great majority only harbored URT flora despite gastric pH >6 [32],... 

Selective failure of the gastric acid barrier, as seen in otherwise healthy individuals on proton pump inhibitors or with H. pylori-induced corpus gastritis, results in gastric colonization of swallowed oropharyngeal bacteria. In otherwise healthy subjects this will be mainly Gram-positive bacteria belonging to the URT flora and strict anaerobic bacteria of oral origin. 

McColl KE, el-Omar E, Gillen D Helicobacter pylori gastritis and gastric physiology. Gastroenterol Clin North Am 2000 29 687-703, viii. 

Feldman M, Cryer B, McArthur KE, Huet BA, Lee E Effects of aging and gastritis on gastric acid and pepsin secretion in humans A prospective study. Gastroenterology 1996,110 1043-1052. 

Gastric ulcers, chronic gastritis and hiatus hernia are increasingly common conditions in old age. Both morbidity and mortality from bleeding stomach ulcers have increased in persons over 75 and this is in contrast to the lowered incidence in other... 

H. pylori is one of the main causes of human chronic gastritis, resulting in various diseases including peptic ulcers, gastric adenocarcinomas, and mucosa-associated lymphoid tissue (MALT) lymphomas (Williams... 

Goodwin CS. (1997) Helicobacter pylori gastritis, peptic ulcer, and gastric cancer Clinical and molecular aspects. Clin Infect Dis 25 1017-1019. 

Abdominal pain, constipation, diarrhea, dry mouth, dyspepsia, flatulence, gastric ulcer, gastritis, glossitis, hemorrhagic gastric ulcer, hemorrhoids, loose stools, melena, nausea, vomiting. 

Gl Gastric/epigastric pain flatulence gastritis constipation nausea diarrhea dry mouth vomiting heartburn appetite disorder anorexia bloating abdominal discomfort/pain dyspepsia taste distortion. 

Possible adverse reactions include cramping diarrhea gastric bleeding ulceration gastritis vomiting drowsiness lethargy headache mental confusion ataxia irregular menses carcinoma of the breast. 

Gl effects Use caution in those intolerant to salicylate because of Gl irritation, and in gastric ulcers, peptic ulcer, mild diabetes, gout, erosive gastritis, or bleeding tendencies. Salsalate and choline salicylate may cause less Gl irritation than aspirin. 

Gastritis Atrophic gastritis has been noted occasionally in gastric corpus biopsies from patients treated long-term with omeprazole and esomeprazole. 

Helicobacter pylori H. pylori is found in approximately 100% of chronic active antral gastritis cases, 90% to 95% of duodenal ulcer patients, and 50% to 80% of gastric ulcer patients. The treatment of documented H. pylori infection in patients with confirmed peptic ulcer on first presentation or recurrence has been recommended by the National Institutes for Health in a 1994 Consensus Conference. Once H. py/on eradication has been achieved, reinfection rates are less than 0.5% per year, and ulcer recurrence rates are dramatically reduced. 

Adverse reactions may also include tachycardia hypertension palpitations syncope cerebrovascular accident vasodilation vasculitis gingivitis dyspepsia oral ulcer/abscess gastritis gastric ulcer hypersalivation dry mouth splenomegaly melena hematochezia esophagitis colitis pancreatitis pancytopenia neutropenia eosinophilia thrombocytopenia hepatitis hepatomegaly hepatic dysfunction renal... 

Esomeprazole (Nexium) [Gastric Acid Inhibitor/Proton Pump Inhibitor] Uses Short-term (4-8 wk) for erosive esophagitis/GERD H. pylori Infxn in combo w/ antibiotics Action Proton pump inhibitor, gastric acid Dose Adults. GERD/erosive gastritis 20 0 mg/d PO x 4-8 wk 20 0 mg IV 10-30 min inf or >3 min IV push, 10 d max Maint 20 mg/d... 

Pantoprazole (Protonix) [Gastric Acid Suppressant/Proton Pump Inhibitor] Uses GERD, erosive gastritis, ZE synd, PUD Action Proton pump inhibitor Dose 40 mg/d PO do not crush/chew tabs 40 mg IV/d (not >3 mg/min, use Protonix filter) Caution [B, /-] Disp Tabs, inj SE Chest pain, anxiety, GI upset Interactions t Effects OF warfarin t effects of photosensitivity W/ St. John s wort X effects OF ketoconazole EMS t Effects of anticoagulants may affect glucose (hypoglycemia) OD Unlikely to cause life-threatening Sxs... 

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