Overview
Gastritis refers to inflammation of the gastric mucosa, categorized into acute and chronic forms, often caused by infection (e.g., Helicobacter pylori), nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, or other irritants 1.Diagnosis
Clinical Presentation: Epigastric pain, nausea, vomiting, dyspepsia 1.
Diagnostic Tests:
- Endoscopy: Visualizes mucosal changes, biopsies for histology and H. pylori testing 1.
- Urea Breath Test or Serology: For H. pylori detection 1.
Grading: Histologic grading based on severity of mucosal inflammation and atrophy 1.Management
First-Line Treatments:
- Helicobacter pylori eradication therapy: Triple therapy (proton pump inhibitor + two antibiotics) 1.
- Discontinue NSAIDs or alcohol if applicable 1.
Adjunctive Treatments:
- Symptomatic relief with antacids or H2 receptor antagonists 1.
- Proton pump inhibitors (PPIs) for severe cases or complications 1.Special Populations
Pediatrics: Limited data; adult emergency department visits by minors may present with varied diagnoses including gastrointestinal issues 1.
Elderly: Increased risk of complications; careful monitoring and management of comorbidities 1.
Comorbidities: Management tailored to underlying conditions; caution with NSAID use in those with peptic ulcer disease 1.Key Recommendations
Diagnose H. pylori infection using urea breath test or serology for accurate identification and guide eradication therapy (Evidence: Strong 1).
Initiate PPI therapy for severe gastritis or complications, alongside appropriate antibiotic therapy if H. pylori is confirmed (Evidence: Moderate 1).
Avoid NSAIDs and alcohol in patients with gastritis to prevent exacerbation and recurrence (Evidence: Expert opinion 1).References
1 Baker MD, Schwartz GR, Ludwig S. The adult patient in the pediatric emergency department. Annals of emergency medicine 1993. link80978-3)