Gastritis

Acute gastritis. Acute gastritis (catarrhal gastritis) is due to a great variety of causes. Common varieties in practice are the result of indiscretions in food or alcoholic drinks; but contaminated food, "chill" and scarlet fever in its acute stage may also induce very acute gastric catarrh. The inflammation may spread downwards to cause acute gastroenteritis. The cardinal symptom of acute gastritis is vomiting and when enteritis is superadded diarrhea also supervenes.

Chronic gastritis. Chronic gastritis, is regarded as an important and by no means infrequent disease. Accurate diagnosis is essential. It is important to treat this disease in as early a stage as possible, not only for the immediate disabilities which arise but still more for the serious consequences such as carcinoma, which may possibly result from it. Much of the treatment is essentially prophylactic and consists in the removal of such well-known causes as alcoholism, oral sepsis (especially pyorrhea) and deficient mastification of food (from bad habits or lack of teeth). The cardinal symptoms and signs of an established case which demand treatment are:

1. Vomiting, especially, in the morning and associated always with an excessive secretion of mucus into the stomach.

2. Diminution or frequently complete absence of hydrochloric acid in the gastric juice.

The prime causes favoring continuation of the disease having been removed, the first essential in treatment is gastric lavage carried out always before breakfast and in the severe cases at intervals during the day, before meals. Treatment by lavage is continued until improve­ment is manifest when its use can be gradually discontinued. If lavage is for any reason impossible, the next best substitute is the administration of a teaspoonful or more of sodium bicarbonate in a tumblerful of warm water in the morning and again before meals throughout the day.

Hydrochloric acid is so commonly greatly diminished or absent in an untreated case of chronic gastritis that some effort is generally made to remedy the deficiency. It is known that after gastric lavage for some weeks the secretion of hydrochloric acid frequently returns in adequate amount.

Anorexia is common in chronic patients especially in the morn­ing when there is a great excess of mucus in the stomach. Later in the day the appetite generally improves. Bad dietary habits are common in these patients. The prescribed diet should be arranged so that attractive small meals are provided at frequent intervals.

Дата добавления: 2015-07-08