- J- shaped enlargement of the GIT inferior to the diaphragm
- Regions of the stomach: cardia, fundus, body,antrum, pylorus
- Pyloric sphincter – connects stomach to small intestines
- Rugae – folds in the lining of stomach when empty
- Gastric glands cells
- Mucous neck cells - secretes mucous that serves as the protection of the stomach from HCl
- Chief cells- Pepsinogen and gastric lipase
- Parietal cells - Intrinsic factor and HCL
- G cells- Gastrin – stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen; contracts lower esophageal sphincter, increase motility of stomach and relaxes pyloric sphincter
- Functions:
- Form chyme by mixing saliva, food and gastric juices
- Temporary reservoir of food
- Secretes gastric juice which is composed of HCl, gastric lipase, pepsin, intrinsic factor
- Chemically digests protein by pepsinogen, lipids by lipase
- Aids in absorption of Vit B12 by intrinsic factor
- Killing of some bacteria from food
- Secretion of gastrin
Gastritis
- Inflammation of the gastric mucosa caused by an irritant and/or impairment of protective mechanism
- Can be acute or chronic
- Acute – results from ingestion of chemicals, alcohol, or contaminated foods
- Chronic – diffuse inflammation results from aging, chronic alcohol consumption, chronic use of NSAIDS
- Risk factors
- Smoking
- Diet
- Heavy alcohol consumption
- Infection
- Excessive use of NSAID
- Etiology
- Helicobacter Pylori
- Gram negative bacteria that produces an enzyme called urease which divides into ammonia and CO2
- Ammonia protects H. pylori from acidity of stomach and damages protective lining of stomach and cells
- Produces catalase which protects them from phagocytosis
- Clinical manifestations
- Abdominal discomfort and pain
- Nausea and vomiting
- Hypersalivation
- Bleeding – hematemesis, melena
- Anorexia
- Diagnostics
- History
- Gastroscopy barium swallow
- Gastric analysis
- Hgb and Hct
- Management
- Antacids
- H2 receptor antagonist
- Antibiotics – amoxicillin or metronidazole
- Antiemetics
- NGT decompression and suction in severe gastritis
- Nursing management
- Maintain fluid and electrolytes balance
- NPO if unable to tolerate foods then bland diet
- Avoidance of precipitating factors like spicy foods, coffee, alcohol, smoking, NSAID
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