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Gastritis
Gastritis
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Gastritis

  1. 1. Gastritis Dr. Sami
  2. 2. Definition:  Gastritis is an inflammation or irritation of the lining of the stomach (Gastric Mucosa). That can Cause Stomach pain, indigestion (dyspepsia), bloating and nausea.  It can occur suddenly (acute) or gradually (chronic).
  3. 3. Gastric Mucosa:  Gastric: Related Stomach  Mucosa: The moist, inner lining of some organs and body cavities (such as the nose, mouth, lungs, and stomach). Protective Layer.
  4. 4.  Gastric mucosa  is the mucous membrane layer of the stomach, which contains the glands and the gastric pits. (Gastric pits are indentations in the stomach which denote entrances to the tubular shaped gastric glands. )  There are approximately 90 to 100 gastric pits per square millimetre (58,000 to 65,000 per square inch) of surface epithelium.  In humans, it is about 1 mm thick, and its surface is smooth, soft, and velvety.  It consists of simple columnar epithelium, lamina propria, and the muscularis mucosae.
  5. 5.  Gastric mucus  The mucosa is always covered by a layer of thick mucus that is secreted by tall columnar epithelial cells.  Gastric mucus is a glycoprotein that serves two purposes:  1: the lubrication of food masses in order to facilitate movement within the stomach  2: the formation of a protective layer over the lining epithelium of the stomach cavity.  This protective layer is a defense mechanism. the stomach has against being digested by its own protein-lyzing enzymes,  The acidity, or hydrogen ion concentration, of the mucous layer measures pH7 (neutral)
  6. 6. Types of Cells In Gastric Mucosa:  The gastric mucosa contains six different types of cells.  Epithelial Cells  Mucoid cells  Zymogenic, or chief, cells  Gastrin cells  Parietal, or oxyntic, cells  Endocrine cells
  7. 7.  Mucoid cells  secrete gastric mucus and are common to all types of gastric glands. Mucoid cells are the main cell type found in the gastric glands in the cardiac and pyloric areas of the stomach.  Zymogenic, or chief, cells  These cells secrete pepsinogen, from which the proteolytic (protein-digesting) enzyme pepsin is formed. There are two varieties of pepsinogen, known as pepsinogen I and pepsinogen II.  These cells cells are located predominantly in gastric glands in the body and fundic portions of the stomach.
  8. 8.  Gastrin cells,  also called G cells, are located throughout the antrum. These endocrine cells secrete the acid-stimulating hormone gastrin Gastrin has two principal biological effects: stimulation of acid secretion from gastric parietal cells and stimulation of mucosal growth in the acid-secreting part of the stomach. Circulating gastrin regulates the increase in acid secretion that occurs during and after meals.  Parietal, or oxyntic, cells,  found in the glands of the body and fundic portions of the stomach, secrete hydrogen ions that combine with chloride ions to form hydrochloric acid (HCl). The acid that is produced drains into the lumen of the gland and then passes through to the stomach.  Hydrochloric acid helps to digest, breakdown and absorb protein.  Elimination of Bacteria n Viruses  Prevent from Infections.
  9. 9.  Endocrine cells or Enterochromaffin  secrete several substances, including the hormone serotonin.  It appears to stimulate the production and release of gastric and colonic mucus.
  10. 10. Gastric Secretions:  The gastric mucosa secretes 1.2 to 1.5 litres of gastric juice per day.  Gastric juice renders food particles soluble, initiates digestion (particularly of proteins), and converts the gastric contents to a semiliquid mass called chyme, thus preparing it for further digestion in the small intestine
  11. 11. Gastritis:  Gastritis is an inflammation of the protective lining of the stomach
  12. 12. Causes:  The stomach has a protective lining of mucus called the mucosa. This lining protects your stomach from the strong stomach acid that digests food. When something damages or weakens this protective lining, the mucosa becomes inflamed, causing gastritis. A type of bacteria called Helicobacter pylori (H. pylori) is the most common bacterial cause of gastritis.  Alcohol abuse: Chronic alcohol use can irritate and erode the stomach lining.  Autoimmune disease: In some people, the body’s immune system attacks healthy cells in the stomach lining.  Bacterial infection: H. pylori bacteria are the main cause of chronic gastritis and peptic ulcer disease (stomach ulcers). The bacteria break down the stomach’s protective lining and cause inflammation.
  13. 13.  Bile reflux: The liver Produce bile to help digest fatty foods. “Reflux” means flowing back. Bile reflux occurs when bile flows back into the stomach instead of moving through the small intestine.  Medications: Steady use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to manage chronic pain can irritate the stomach lining.  Physical stress: A sudden, severe illness or injury can bring on gastritis. Often, gastritis develops even after a trauma that doesn’t involve the stomach. Severe burns and brain injuries are two common causes.
  14. 14. Types:  Acute  Acute erosive gastritis typically involves surface necrosis due to damage to mucosal defenses.  NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the maintenance of the normal lining of the stomach and intestines.  COX-1 produce Prostaglandins: a group of lipids made at the site of tissue damage of infection,  Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach called prostaglandin.
  15. 15.  These drugs used in a short period are not typically dangerous.  However, regular use can lead to gastritis.  Additionally, severe physiologic stress ("stress ulcers") from sepsis, hypoxia, trauma, or surgery is also a common etiology for acute erosive gastritis.  This form of gastritis can occur in more than 5% of hospitalized patients.
  16. 16.  Chronic  Chronic gastritis refers to a wide range of problems of the gastric tissues.  The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining.  Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn's disease, certain connective tissue disorders, and liver or kidney failure.
  17. 17. Other Types:  We can also divide gastritis as:  Erosive (reactive):  Erosive gastritis causes both inflammation and erosion (wearing away or abrasion) of the stomach lining. This condition is also known as reactive gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or bacterial infections and stress from illnesses or injuries.  Non-erosive:  Inflammation of the stomach lining without erosion or compromising the stomach lining.
  18. 18. Sings and Symptoms:  Black, tarry stool.  Bloating.  Nausea and vomiting.  Feeling extra full during or after a meal.  Loss of appetite.  Stomach ulcers.  Losing weight without meaning to.  Upper abdominal (belly) pain or discomfort.  Vomiting blood.  Indigestion
  19. 19. Complications:  Anemia: Erosive gastritis can cause chronic bleeding which, in turn, can lead to anemia  Atrophic gastritis: Chronic inflammation in the stomach can cause the loss of both the stomach lining and glands  Peptic ulcers: Ulcers can form in the lining of the stomach and duodenum  Growths in the stomach lining: The risk of both benign and malignant growths increases in people with gastritis. If Helicobacter pylori (H. pylori) bacteria cause gastritis, they also increase the risk of a specific form of cancer known as gastric mucosa-associated lymphoid tissue (MALT) lymphoma.
  20. 20.  deficiencies in vitamin B12, vitamin D, folic acid, vitamin C, zinc, calcium, and magnesium  bleeding in the stomach  perforation inside the stomach  Weakness  Weight loss
  21. 21. Diagnose:  Blood tests:  CBC  Presence of H. pylori.  Urinalysis  Stool sample, to look for blood in the stool  X-rays  Endoscopy, to check for stomach lining inflammation and mucous erosion  Stomach biopsy, to test for gastritis and other conditions
  22. 22.  Breath test:  During an H. pylori breath test, you swallow a capsule or liquid containing urea, a harmless radioactive material. You then exhale into a balloon-like bag. H. pylori bacteria change urea into carbon dioxide. If you have the bacteria, the breath test will show an increase in carbon dioxide.
  23. 23. Prevention  Maintaining good hygiene habits. Habits like handwashing may help you reduceTrusted Source the risk of having a H. pylori infection.  Taking good care of your mental health. Self-care and de-stressing practices may reduce your risk of developing Trusted Source stress-induced gastritis.  Eating smaller meals more slowly and regularly. Also, avoiding or limiting fried, salty, sugary and spicy foods (these are things that research shows could trigger gastritis symptoms).  Quitting smoking, if you smoke.  Avoiding or limiting alcohol and caffeine.
  24. 24. Treatment  Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances.  Medications used to treat gastritis include:  Antibiotic medications to kill H. pylori.  For H. pylori in your digestive tract, doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days.
  25. 25.  Medications that block acid production and promote healing.  Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix).
  26. 26.  Medications to reduce acid production.  Acid blockers — also called histamine (H-2) blockers — reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR).
  27. 27.  Antacids that neutralize stomach acid.  Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients.  Aluminum hydroxide gel (Alternagel, Amphojel) Calcium carbonate (Alka- Seltzer, Tums) Magnesium hydroxide (Milk of Magnesia)

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