Gastritis - Definition, Classification, Pathophysiology and Prevention

Gastritis - Definition, Classification, Pathophysiology and Prevention

Gastritis   November 19, 2013

Definition of Gastritis

Gastritis is an inflammation localized or diffuse, in the gastric mucosa that develops when the mucosal protective mechanisms are filled with bacteria or irritants. (J. Reves, 1999).


Classification of Gastritis

Gastritis by type divided into 2 (two), namely :

1. Acute gastritis
Gastritis (inflammation of the gastric mucosa) is most often caused by carelessness diet, such as eating too much, too fast, eating food too much seasoning or infected food. Other causes include alcohol, aspirin, bile fefluks and radiation therapy. Gastritis can also be the first sign of acute systemic infection. Form a more severe acute gastritis caused by strong acid or alkali, which can lead to gangrene or perforation of the mucosa.

2. Chronic gastritis
Prolonged inflammation caused by both benign and malignant gastric ulcers, by the bacteria H. Pylori. Chronic gastritis may be classified as Type A or Type B. Type A occurs in gastric fundus or corpus. Type B (H. Pylori) the antrum and pylorus. May be related to the bacteria H. Pylori. Dietary factors such as hot drinks, seasonings, use of drugs, alcohol, smoking or reflux of intestinal contents into the stomach.


Pathophysiology of Gastritis

Foodstuffs, drinks, drugs and chemicals that go into the stomach causing irritation or erosion of the gastric mucosa to lose barrier (protective). Furthermore an increase in diffusion of hydrogen ions. Diffusion in mucosal disruption and increased gastric acid secretion is increased / lot. Stomach acid and digestive enzymes. Then invades the gastric mucosa and inflammatory reaction occurs. This is called gastritis. Response of the gastric mucosa against irritants are mostly with mucosal regeneration, therefore such disturbances often disappears by itself.

With the constant irritation, tissue become inflamed and can bleed.
The introduction of substances such as strong acids and bases are corrosive resulting in inflammation and necrosis of the stomach wall (gastritis corrosive). Necrosis can result in perforation of the stomach wall to the next due to bleeding and peritonitis.
Chronic gastritis can lead to a state of atrophy of the gastric glands and the state of mucosal thickening patches are gray or greenish gray (gastitis atrophic). The loss of the gastric mucosa will ultimately result in reduced gastric secretion and the onset of pernicious anemia. Atrophic gastritis may be a precursor to gastric carcinoma. Chronic Gastritis may also occur in conjunction with peptic ulcer or may occur after the action gastroyeyunostomía.


Prevention of Gastritis

Although infection of H. pylori can not always be prevented, here are some suggestions to reduce the risk of gastritis:

1. Eating correctly. Avoid foods that can irritate especially spicy foods, acidic, fried or fatty. Which is just as important as the selection of the right foods for health is how to eat it. Eat a sufficient amount, on time and done with ease.

2. Avoid alcohol. The use of alcohol can irritate and erode the mucous lining of the stomach and can cause inflammation and bleeding.

3. Do not smoke. Smoking affect the protective stomach lining, making the stomach more susceptible to gastritis and ulcers. Smoking also increases stomach acid, thereby delaying the healing of the stomach and is a major cause of gastric cancer. However, to be able to quit smoking is not easy, especially for heavy smokers. Consult with your doctor about methods that can help to stop smoking.

4. Do exercise regularly. Aerobic exercise can increase heart rate and breathing, also can stimulate bowel muscle activity that helps remove food waste from the intestines more quickly.

5. Control stress. Stress increases the risk of heart attack and stroke, lowers the immune system and can lead to skin problems. Stress also increases the production of stomach acid and slow down the speed of digestion. Because stress for some people can not be avoided, then the key is to control it effectively by way of a nutritious diet, adequate rest, regular exercise and adequate relaxation.

6. Replace pain medication. If possible, avoid the use of NSAIDs, this class of drugs will cause inflammation and will make existing inflammation worse. Replace with pain relievers containing acetaminophen.

7. Follow the doctor's recommendations.

Nursing Care Plan for Gastritis

Acute Pain related to Gastritis

Acute Pain related to Gastritis

Nursing Diagnosis and Interventions   September 08, 2013

Nursing Care Plan for gastritis - Nursing Diagnosis : Acute Pain

Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori, chronic bile reflux, and stress; certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. (wikipedia)

Acute Pain

Pain is whatever the experiencing person says it is, existing whenever the person says it does (McCaffery, 1968); an unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain) sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than less than 6 months.

Defining Characteristics:

Subjective

Pain is always subjective and cannot be proved or disproved. A client's report of pain is the most reliable indicator of pain (Acute Pain Management Guideline Panel, 1992). A client with cognitive ability who can speak or point should use a pain rating scale (e.g., 0 to 10) to identify the current level of pain intensity (self-report) and determine a comfort/function goal (McCaffery, Pasero, 1999).

Objective

Expressions of pain are extremely variable and cannot be used in lieu of self-report. Neither behavior nor vital signs can substitute for the client's self-report (McCaffery, Ferrell, 1991, 1992; McCaffery, Pasero, 1999). However, observable responses to pain are helpful in clients who cannot or will not use a self-report pain rating scale. Observable responses may be loss of appetite and inability to deep breathe, ambulate, sleep, or perform activities of daily living (ADLs). Clients may show guarding, self-protective behavior, self-focusing or narrowed focus, distraction behavior ranging from crying to laughing, and muscle tension or rigidity. In sudden and severe pain, autonomic responses such as diaphoresis, blood pressure and pulse changes, pupillary dilation, or increases or decreases in respiratory rate and depth may be present.


Nursing Diagnosis for Gastritis : Acute Pain related to inflammation of the mucosal lining of the stomach (gastric)

Goal: Pain is reduced with no inflammation or irritation of the gastric mucosa

Outcomes:

• Pain scale is reduced
• Do not feel pain in the epigastric.
• Not grimace (no abdominal tenderness)

Gastritis Nursing Interventions and Rational:

1. Record complaints of pain, including the location, duration, intensity (scale of 0-10)
R /: Pain is not always there, but if there is to be compared with the previous patient's symptoms of pain, which can help diagnose the etiology and occurrence of bleeding complications.

2. Review the factors that increase or decrease pain.
R /: Assist in making diagnoses and treatment needs.

3. Give food a little but often as an indication for patients.
R /: Food has the effect of neutralizing acid, also destroy the gastric contents. Eating little to prevent distension.

4. Assistive range of motion exercises active / passive.
R /: Reduce joint stiffness, pain minimize discomfort.

5. Provide frequent oral care and comfort measures (back massage, change of positions).
R /: Bad breath due to retained secretions, causing no appetite and can increase nausea. Gingivitis and dental problems can be improved.

6. Give medications as indicated.
R /: Lowering the acidity of gastric absorption or by neutralizing chemical.

Gastritis - Definition, Classification, Pathophysiology and Prevention