Under an erosive gastritis refers gastric erosions as a result of damage to the mucosal defense. They typically occurs acutely with bleeding in appearance, but can also run subacute or chronic, with no or few symptoms. The diagnosis is made endoscopically. Treatment is supportive, with the elimination of the underlying cause. Patients certain intensive medical treated (eg. As ventilated patients, traumatic brain injury, burns, multiple trauma) benefit from prophylaxis with säuresupprimierenden substances.
are common causes erosive gastritis
Under an erosive gastritis refers gastric erosions as a result of damage to the mucosal defense. They typically occurs acutely with bleeding in appearance, but can also run subacute or chronic, with no or few symptoms. The diagnosis is made endoscopically. Treatment is supportive, with the elimination of the underlying cause. Patients certain intensive medical treated (eg. As ventilated patients, traumatic brain injury, burns, multiple trauma) benefit from prophylaxis with säuresupprimierenden substances. Common causes of erosive gastritis are NSAIDs alcohol Stress Less common causes include exposure Viral infection (eg. As cytomegalovirus) vascular injury Direct trauma (eg. As feeding tubes) Superficial erosions and tiny mucosal lesions occur. This can already 12 hours after the initial injury occur. In severe or untreated cases, one sees deep erosions, ulcers and sometimes perforations. These lesions typically occur in the body, but in principle, the antrum can be affected. The acute stress gastritis, a form of erosive gastritis, occurs in about 5% of all critically ill patients. The incidence increases with the length of stay in an intensive care unit and with the time in which the patient receives enteral nutrition, too. Pathogenetically significant is probably a hypoperfusion of the gastrointestinal mucosa, leading to disruption of the mucosal defense mechanisms. Patients with traumatic brain injury or burns additionally have a reinforcing acid secretion. Symptoms and discomfort patients with minor erosive gastritis are often asymptomatic, although some among dyspepsia, nausea and vomiting are suffering. Often the first sign is a hematemesis, melena or blood in gastric aspirate, usually within 2-5 days after initial injury. Bleeding is light or moderate in severity generally, in some cases it can if there is a deep ulceration, v. a. acute stress gastritis, be massive. Diagnosis Both the acute and chronic erosive gastritis are diagnosed endoscopically. Therapy For bleeding: endoscopic hemostasis to acid suppression: proton pump inhibitors or H2 blockers In severe gastritis bleeding with iv is Fluid replacement and if necessary treated with blood transfusions. An endoscopic hemostasis should be attempted, possibly also as a bridging measure to surgery (total gastrectomy). With angiographic measures can be a serious gastrointestinal bleeding because of the pronounced collateral circulation of the stomach probably not breastfeed. An acid suppression treatment is started when the patient is not already receiving this. In milder forms of gastritis the elimination of the causative agent and the use of gastric acid reducing drugs (Pharmacological gastric acid treatment) can be sufficient. Prevention Prophylaxis with säurersupprimierenden drugs reduces the incidence of acute stress gastritis. but have the advantage primarily intensive care treated high-risk patients, incl. those with severe burns, head injury, coagulation disorders, sepsis, shock, trauma, h with mechanical ventilation for more than 48, have liver or kidney failure, multiple organ failure or a history of peptic ulcers or gastrointestinal bleeding. Prophylaxis is the i.v. Administration of H2 blockers, proton pump inhibitors or oral antacids to raise the intragastric pH> 4.0. Repeated pH measurements and a corresponding titration of therapy is not required. Early enteral nutrition can reduce the incidence of bleeding. In patients during therapy with NSAIDs no prophylactic suppression of acid production is recommended, unless they have an ulcer in prehistory.