04 September 2020 Friday
Nursing Care in Gastritis
The incidence of gastritis, which is a nonspecific inflammation caused by the gastric mucosa in response to infection or irritation, is gradually increasing.
The causes of gastritis are drugs, autoimmunity, hypersensitivity reactions and agents that cause infection.
In addition, heavy meals, dry and hard foods, bitter-spicy foods, alcohol, smoking, excessively consumed tea, coffee, eating irregularly, eating without chewing, excessive drug use, inflammatory diseases and gall bladder, heart, liver, rheumatic diseases are risk factors.
In gastritis, edema and hyperemia are seen in the gastric mucosa, and it causes superficial erosion in the mucosa over time. Gastritis is divided into acute and chronic.
Chronic gastritis is also classified as superficial and atrophic. Helicobacter Pyolori (H.Pyolori) is one of the most important causes of gastritis. H.Pyolor is the causative agent of 70-90% of chronic gastritis. The disease mostly involves in the fundus and antrum of the stomach. In the regions with poor sanitation (low socioeconomic level, undeveloped countries), the rate of oral or fecal contamination with contaminated water and food is quite high. Chronic gastritis is more common in the elderly, chronic alcoholists and smokers.
Acute gastritis can be asymptomatic and also can give symptoms of severe gastritis such as nausea, vomiting or hematemesis.
In chronic gastritis, no symptoms are seen until atrophy develops. Afterwards, symptoms similar to ulcer symptoms such as pain and burning in the stomach that do not alleviate with antacid intake are observed. Also, symptoms of fatigue and pernicious anemia may occur. Malabsorption of vitamin B12, bleeding, gastric perforation and cancer are possible complications.
Since gastritis is usually asymptomatic, gastroscopy or biopsy is required for diagnosis. In addition to these, stool antigen tests, serological tests and urea tests are also taking.
The main approach in the treatment of gastritis is directed to the cause. H. Pylori eradication is one of the most important points in the treatment of chronic gastritis, and triple combinations (antacids, H2-receptor antagonists, proton pump inhibitors) are the most effective treatment methods.
If pernicious anemia has developed, vitamin B12 should be added to the treatment. Factors that can cause bleeding (aspirin and corticosteroids) should be used with caution. Use of alcohol and tobacco should be avoided, and light and frequent diet should be adopted.
Surgical intervention may be required in case of bleeding, also subtotal gastrectomy, pyoloroplasty, vagatomy or total gastrectomy may be applied in severe erosive gastritis.
The diet of the individual has priority in nursing care in gastritis. For example; irritant and solid food intake is avoided, and a light diet should be given less and often. The patient should be avoided from alcohol and tobacco. Stress should be reduced as much as possible. The patient should be informed about the regular use of drugs. Pain, bleeding findings, fluid and electrolyte balance are should be monitored. Also weight tracking should be done.