Question

A 50-year-old man has been suffering from substernal pain for the last 5 months, particularly on waking up in the morning. He lost his job a year ago and was suffering from depression. He consumes about 12–16 cans of beer every day. He has lost his appetite too and says that eating aggravates pain.

• Is this acute or chronic gastritis?
• What factors may lead to the development of gastritis?
• What investigation should be performed?
• How can the patient be treated?

Answer 1

This is a chronic gastritis because any sort of discomfort or pain lasting more than twelve weeks or 3 to 6 months is categorized into chronic status.

The major factors which could have led to the development of gastritis in this patient are

• Alcohol (long term consumption or daily conception can erode the gastric lining and cause pain secondary to inflammation)
• Feeling low ,stressed, depression (This psychological state can make an individual to avoid eating food as a result the gastric secretion can irritate its lining causing inflammation and pain.

The most important investigations which is required to be done in thus patient are

• Biopsy to rule out any abnormal growth of tissues
• Helicobacter antibody (major cause for gastritis)
• Urea breath test
• Intrinsic factor antibody (to rule put in case of any genetic origin)
• Stool test to assess the presence of any blood in it .This is a typical indicator for gastrointestinal problems like gastritis
• CBC:especially RBC level will be done to rule out anemia
• Vitamin A ,vitamin B6, thiamine can decrease if one consume alcohol in any form

The patient will be treated in the following way are

• Proton pump inhibitor to reduce the gastric secretion
• Antacids to balance and neutralize the acid secretion
• Antibiotics to treat infection
• Multivitamins to meet ant deficiency
• Intravenous fluid to maintain fluid status
• General:
  • Encourage oral intake
  • Provide preferred food
  • Provide psychological support