Gastritis

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Gastritis

Introduction

Chronic diseases are ailments that endure for at least a year, need continuous medical treatment, and either restrict daily life activities or make it difficult to do either daily activities or both (Adegbola et al., 2020). Gastritis is a chronic disease that, when left untreated, may result in stomach bleeding and stomach ulcers (Sierra et al., 2018). Rarely, certain kinds of persistent gastritis may raise your chance of stomach cancer, especially if you have substantial weakening of the stomach lining and alterations in the lining’s cells. This paper discusses the background and significance of gastritis. Specifically, the discussion covers the definition of gastritis, signs and symptoms, description, incidence, and prevalence data. This paper also covers a descriptive epidemiological analysis of gastritis and explains the current mandatory reporting procedures and surveillance methods linked to gastritis. In addition, this paper analyzes the epidemiology of gastritis. The last section of the paper outlines the process of diagnosing gastritis and the current national guidelines and then provides a strategy for how nurses might treat gastritis after graduating.

Background and Significance of Gastritis

Gastritis is among the chronic health diseases characterized by the inflammation of the stomach’s protective lining (Azer & Akhondi, 2019). The stomach’s lining acts as armor against the harsh digestive juices produced throughout the digestive process. Gastritis occurs when the mucosa lining the stomach is injured or weakened. The two types of gastritis are erosive gastritis and non-erosive gastritis. Erosive gastritis, also known as reactive gastritis, leads to corrosion and swelling of the stomach lining. In contrast, non-erosive gastritis leads to inflammation of the stomach lining without erosion or compromise. Acute gastritis contains sudden and severe swelling, while chronic gastritis involves long-lasting inflammation that may persist for years if left unattended. If left untreated, acute gastritis evolves into chronic gastritis. Gastritis’ inflammation is most often caused by long-term use of certain pain relievers such as anti-inflammatory drugs like aspirin or infection with similar bacteria that cause most stomach ulcers. In addition, gastritis can be triggered by chronic vomiting, excessive alcohol intake, and stress. Other causes of gastritis include; helicobacter pylori, a bacterium found in the stomach’s mucous lining, and bile reflux, the backward flow of bile juice from the bile tract into the stomach (Robinson, 2020).

According to Mayo Clinic (2022), due to thinning stomach lining and an increased prevalence of autoimmune disorders and H. pylori infection in the elderly, gastritis is more common in older adults. Besides, gastritis has been linked to other medical conditions such as celiac disease, Crohn’s disease, HIV/AIDS, sarcoidosis, and parasitic infections. Gastritis signs and symptoms often vary among individuals; in many cases, people have no symptoms. However, the signs and symptoms of gastritis include; vomiting blood, nausea, loss of appetite, abdominal bloating, black stool, hiccups, abdominal pain, indigestion, and gnawing or burning feeling in the stomach at night or between meals (Robinson, 2020).

According to Azer & Akhondi (2019), there is an indication of decreasing incidence of contagious gastritis caused by helicobacter pylori in the western population. However, also, there is a rising prevalence of autoimmune gastritis. Women and the elderly are at a greater risk of developing autoimmune gastritis. The prevalence is believed to be between 2% and 5% of the population. In developing countries, chronic gastritis continues to be a relatively common disease. In children living in developed nations such as the western populations, the prevalence of helicobacter pylori infection is approximately 10%. However, the prevalence of H. pylori infection is roughly 50 % in developing countries. In developing countries, the general H. pylori prevalence may vary significantly from one geographical location to another and from one set of socioeconomic circumstances to another. In Africa, it is around 69%, whereas in South America, it is 78%, and in Asia, it is 51%.

According to Feyisa & Woldeamanuel (2021), gastritis is still a significant social and public health issue in developing and developed countries. It is an underlying reason that influences people’s health behavior, socioeconomic status, and living standards, including their living conditions, lifestyles, habits, and behaviors. In developing nations around the world, gastritis affects a population that is 50.8% of the total population. Besides, 34.7% of developed nations’ total population experienced health issues due to gastritis. In developed countries, the prevalence rate of gastritis has fallen significantly compared to that of developing countries. The leading causes of the spread of H. pylori infection are poor environmental and social hygiene.

Surveillance and Reporting of Gastritis

The current surveillance method related to gastritis is endoscopic surveillance. During an endoscopic procedure, a long, pliable tube known as an endoscope is sent down the patient’s throat and into the esophagus. The health care practitioner can check a patient’s stomach, esophagus, and the start of the small intestine through a little camera attached at the end of the endoscope. According to Esposito et al. (2021) patients with autoimmune gastritis or multifocal atrophic gastritis (AG) have an increased likelihood of developing gastric neoplastic lesions. Therefore, the initial endoscopic surveillance should be administered to senior patients at a greater risk for gastric neoplasia. According to European standards, endoscopic surveillance at an exceptionally high degree of care should be performed once every three years. Only via early detection is it possible to lower the death rate associated with stomach cancer. Patients diagnosed with severe atrophic gastritis must undergo endoscopic surveillance of the mucous membrane of the stomach as part of the new diagnostic process for detecting early stomach cancer (Kotelevets & Chekh, 2020). To correctly classify patients with chronic gastritis, it is necessary to investigate them with gastric mucosal biopsy, intrinsic factor antibody, parietal cell antibody, Helicobacter pylori antibody, faecal antigen test, or urea breath test for Helicobacter pylori. Additionally, patients should have their feces tested for Helicobacter pylori.

Epidemiological Analysis

Descriptive epidemiology is concerned with describing the levels of health and sickness that exist within a community as well as how they are distributed. The practice of descriptive epidemiology yields important insights that may be used in the fight against illness, developing effective treatments, and executing subsequent studies. Descriptive epidemiology studies provide the groundwork for more narrowly focused research on the topics posed. Descriptive epidemiology assigns an order to the incidence of illness based on the factors of a person (Who), risk factors, modes of transmission, causes (why), place (where), time (when), and health event (what). Determinants, the causes, and other factors that influence the incidence of disease and other health-related occurrences may also be sought using epidemiology.

Let us start with a descriptive epidemiology analysis of gastritis according to risk factors, modes of transmission, and causes (why). Although gastritis is not contagious, the H. pylori bacteria that cause it may spread through the fecal-to-oral route. Transmission of gastritis viruses occurs via direct contact with infected persons, including sharing eating utensils and food and touching contaminated objects and surfaces. The risk factors associated with gastritis include; bacterial infection, stress, older age, regular use of pain relievers, cancer treatment, and excessive alcohol consumption (Mayo Clinic, 2022). Next, when it comes to time (when), gastritis may develop quickly (acute gastritis) or develop gradually (chronic gastritis). According to place (where), the descriptive epidemiology analysis of gastritis according to place (where) is that the prevalence and incidence rate is much lower in developed countries compared to the rates seen in developing countries (Feyisa & Woldeamanuel, 2021).

Regarding person (who), gastritis affects individuals of all ages; however, those over 60 years are at a greater risk for developing the disease than younger ones. The prevalence of H. pylori infection rises along with advancing years. Lastly, when it comes to diagnosis or health event (what), the commonly used diagnosis for gastritis is the upper GI endoscopy.

Screening and Guidelines

During gastritis diagnosis, doctors usually inquire about the patient’s medical history, symptoms, or any other medications taken by the patient. Even though a doctor wills most likely suspect gastritis after reviewing a patient’s medical history and doing a physical check, the patient may still be asked to undergo one or more of the following tests to determine the root cause of the condition. To start with, medical professionals may use upper GI endoscopy to diagnose gastritis, find out its causes, and manage complications. An upper GI endoscopy is a surgical process in which a doctor views the lining of a patient’s upper gastrointestinal tract, which includes the patient’s stomach, esophagus, and duodenum, with the use of an endoscope, which is a flexible tube equipped with a camera(Botezatu & Bodrug, 2021). In an upper GI endoscopy, the doctor gathers biopsies by inserting a tiny device into the endoscope and using it to remove small samples of tissue from the lining of the patient’s stomach. The doctor can look for signs of inflammation using the endoscope.

In addition, gastritis can be diagnosed using a blood test. Gastritis may have several different causes, and a doctor may order blood tests to investigate those causes and look for signs of complications. When conducting a blood test, a medical expert will transport a blood sample to a laboratory for analysis. Besides, for gastritis diagnosis, some doctors may prefer to use a Stool test which is a standard method for determining whether or not a patient has H. pylori infection and whether or not there is blood in the stool, which is a symptom of bleeding in the stomach. A urea breath test may also be used for gastritis diagnosis by checking for the presence of H. pylori infection. To complete the breath test, a patient is given a tiny glass of a colorless liquid with no flavor and contains radioactive carbon. The patient’s stomach is colonized with H. pylori bacteria, which degrade the test liquid. After some time, the patient will be asked to blow into a bag, which will then be secured. The patient’s breath sample will include the radioactive carbon if it is determined that he is infected with the H. pylori bacteria (Mayo Clinic, 2022).

The current antral biopsy for urease test and history is the national standard for diagnosing H. pylori gastritis. When detecting esophageal cancer, upper endoscopy has a sensitivity of 90.9% with a two-year window and 94.5% with a one-year window in standard clinical practice. Without health insurance, you might wind yourself spending much money on medical treatments like endoscopies. This operation might cost anywhere from $1,250 to $4,800 if you do not have health insurance. In most cases, the charge for the doctor performing the endoscopy, the facility, and the anesthesiologist, is all included in these expenditures (Brooks, 2022). Besides, upper endoscopies costs may range between $787- $3,382 on MD save.

Plan

After graduation, nurse practitioners can address gastritis by encouraging healthy coping mechanisms and providing emotional care such as guided visualization, imagery, progressive relaxation, and deep breathing activities. This method helps redirect attention from the current pain towards more amusing sensations, cultivates a feeling of control, and may increase coping skills for dealing with the stress of severe injury and pain, both of which are likely to endure for a significant amount of time. Besides, informing the patients before carrying out a gastritis diagnosis will enable the patient to be prepared for the results and mentally manage discomfort. This intervention will be helpful when the patient can employ handling methods in stressful situations (Xiao etal., 2021). Besides, the patient will be able to verbally express pain alleviation and easily participate in physical activities with fewer reports of discomfort. It is essential to explain routine patient care to the patient before starting any treatment procedure. When patients are aware of what to expect may lessen worry and enhance comfort (Gulanick & Myers, 2021).

Another intervention that nurse practitioners can use to address gastritis is by considering administering gastritis medicine, such as antacids, before initiating patient treatment, such as assisting the patient in mobilizing. Nurse practitioners should ensure that the patient knows that it is necessary to take their medication before the pain becomes intolerable. This will help ensure that the patient is relaxed and his engagement increases. Another way in which nurse practitioners can address gastritis after graduation is by allowing the patient to utilize no-pharmacological nausea management methods such as guided imagery, deep breathing, music therapy, and relaxation (Gulanick & Myers, 2021). A nurse will be able to know that the intervention is helpful when there are reduced vomiting and nausea severity incidents.

Conclusion

Gastritis is a chronic disease characterized by the inflammation of the stomach’s protective lining and, when left untreated, may result in stomach bleeding and stomach ulcers. There are two types of gastritis, erosive and non-erosive. Gastritis can also be classified as either acute or chronic. Gastritis is caused by the long-term use of certain painkillers such as aspirin, chronic vomiting, bile reflux, helicobacter pylori, excessive alcohol consumption, and stress. Gastritis signs and symptoms are; vomiting blood, nausea, loss of appetite, abdominal bloating, black stool, and hiccups, among others. Gastritis is diagnosed through various screening tests such as upper endoscopy, blood test, stool test, and breath test. The current surveillance method related to gastritis is endoscopic surveillance. In developed countries, such as the western populations, there is a decreasing prevalence of gastritis, while developing countries have an increased prevalence of gastritis. After graduation, nurse practitioners can address gastritis by encouraging healthy coping mechanisms and providing emotional care, administering gastritis medicine such as antacids before initiating patient treatment, and allowing the patient to utilize no-pharmacological nausea management methods.

References

Azer, S. A., & Akhondi, H. (2019). Gastritis.

Botezatu, A., & Bodrug, N. (2021). Chronic atrophic gastritis: an update on a diagnosis. Medicine and Pharmacy Reports, 94(1), 7. doi: 10.15386/mpr-1887Brooks, A. (2022). How Much Does an Endoscopy Cost Without Insurance in 2021? | Mira. Talktomira.com. Retrieved 2 October 2022, from https://www.talktomira.com/post/how-much-does-an-endoscopy-cost-without-insurance.

Esposito, G., Dilaghi, E., Cazzato, M., Pilozzi, E., Conti, L., Carabotti, M., … & Lahner, E. (2021). According to European guidelines, endoscopic surveillance at 3 years after diagnosis seems safe in patients with atrophic gastritis in a low-risk region. Digestive and Liver Disease, 53(4), 467-473 DOI: 10.1016/j.dld.2020.10.038.

Feyisa, Z. T., & Woldeamanuel, B. T. (2021). Prevalence and associated risk factors of gastritis among patients visiting saint paul hospital millennium medical college, Addis Ababa, Ethiopia. Plos one, 16(2), e0246619. DOI: 10.1371/journal.pone.0246619Gulanick, M., & Myers, J. L. (2021). Nursing Care Plans-E-Book: Nursing Diagnosis and Intervention. Elsevier Health Sciences.

Kotelevets, S. M., & Chekh, S. A. (2020). Screening, monitoring, and treatment of precancerous atrophic gastritis in the prospective study for seven years. Asian Pacific Journal of Cancer Prevention: APJCP, 21(2), 331. DOI: 10.31557/APJCP.2020.21.2.331Mayo Clinic (2022). Gastritis – Symptoms and causes. Mayo Clinic. Retrieved 1 October 2022, from https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807#:~:text=Gastritis%20may%20occur%20suddenly%20(acute,and%20improves%20quickly%20with%20treatment.

Mayo Clinic (2022). Gastritis – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. Retrieved 2 October 2022, from https://www.mayoclinic.org/diseases-conditions/gastritis/diagnosis-treatment/drc-20355813#:~:text=Using%20a%20scope%20to%20examine,looks%20for%20signs%20of%20inflammation.

Robinson, J. (2020). Understanding Gastritis. WebMD. Retrieved 1 October 2022, from https://www.webmd.com/digestive-disorders/digestive-diseases-gastritis#:~:text=gradually%20(chronic).-,What%20Causes%20Gastritis%3F,Helicobacter%20pylori%20(H.

Xiao, H., Zhao, Z., Zhang, C., & Wang, J. (2021). Influence of Standardized Nursing Intervention Combined with Mindfulness Stress Reduction Training on the Curative Effect, Negative Emotion, and Quality of Life in Patients with Chronic Gastritis and Gastric Ulcer. Evidence-Based Complementary and Alternative Medicine, 2021.

Sierra, D., Wood, M., Kolli, S., & Felipez, L. M. (2018). Pediatric gastritis, gastropathy, and peptic ulcer disease. Pediatrics in review, 39(11), 542-549.

Adegbola, S. O., Dibley, L., Sahnan, K., Wade, T., Verjee, A., Sawyer, R., … & Hart, A. L. (2020). Burden of disease and adaptation to life in patients with Crohn’s perianal fistula: a qualitative exploration. Health and Quality of Life Outcomes, 18(1), 1-13. https://doi.org/10.1186/s12955-020-01622-7