A Case of Gastritis

A 75 yrs old lady came with the complaint of burning pain in the abdomen since 18 months. She was diagnosed having chronic gastritis with ulcerations in the stomach. Chronic indigestion always goes with every meal she takes. She had no history of nausea, vomiting, bleeding from the gastrointestinal tract. Her burning pain was relieved by cold milk. She was on antacids which does not relieve her burning pain at all.

Along with this, she suffered from chronic constipation since 15 years. She had to take laxatives. She also had backache radiating to both lower limbs with tingling and numbness. Her backache was aggravated by standing, walking, and was relieved by rest and pressure. Along with this, she had joint pains, was diagnosed having osteoporosis. Patient also suffered from diabetes mellitus. She had itching all over the body without any eruptions, along with dryness of the skin. Her appetite was good.

Endoscopic features showed scattered hemorrhagic erosions, which were compatible with acute gastric mucosal lesion. Although the lesions were rapidly disappeared by continuous administration of roxatidine (150mg/day), chief complaints did not disappeared but were repeatedly worsened. Serum antibody and histologic examination for Helicobacter pylori (H. pylori) showed positive results. Culture and histology were negative for H. pylori and repeated endoscopy showed only chronic gastritis with mild mucosal atrophy. Heart burn also disappeared. Sulphuric Acid 200 was prescribed to her. After about 6 months of regular treatment, patient reports of 75 to 80% relief in her burning pain. She can pass stools with much ease, without the use of laxatives. She has been off antacids since 2 months. She is more comfortable, her mood is more cheerful, is able to do her daily activities independently.

Exercise 25.Complete the table with necessary information from the text.

1. Patient’s complains
2. Data of examination
3. Diagnosis
4. Treatment
5. The course of the disease

TEST:

1. Acute gastritis (catarrhal gastritis) is due … a great variety of causes.

a. from b. to c. on d. in e. off

2. Common varieties in practice are the result of indiscretions in food or alcoholic drinks; but contaminated food, “chill" and scarlet fever in … acute stage may also induce very acute gastric catarrh.

a. its b. it’s c. her d. his e. your

3. The inflammation may … downwards to cause acute gastroenteritis. The cardinal symptom of acute gastritis is vomiting and when enteritis is superadded diarrhea also supervenes.

a. spreads b. spread c. is spreading d. to spread e. to be spread

4. Chronic gastritis is regarded as an important and by no means … disease.

a. frequent b. common c. general d. infrequent e. rare

5. 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…, which may possibly result from it.

a. oleoma b.pappiloma c. myolipoma d. dentinoma e. carcinoma

6. Much of the treatment is essentially prophylactic and consists in … of such well-known causes as alcoholism, oral sepsis (especially pyorrhea) and deficient mastification of food (from bad habits or lack of teeth).

a. the removal b. the insertion c. the resection d. the implantation

e. the grafting

7. The prime causes favoring continuation of the disease… , 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.

a. have been removed b. has been removed

c. having been removed d. to have been removed

e. had been removed

8. Treatment by …is continued until improvement is manifest when its use can be gradually discontinued.

a. lavement b. lavation c. irrigation d. ablution e. lavage

9. If lavage is for any reason impossible, the next best substitute is the administration of a teaspoonful or more of … in a tumblerful of warm water in the morning and again before meals throughout the day.

a. sodium benzoate b. sodium chloride c. sodium fluoride

d. sodium bicarbonate e. sodium sulfate

10. …is so commonly greatly diminished or absent in an untreated case of chronic gastritis that some effort is generally made to remedy the deficiency.

a. Hydrocyanic acid b. Hydrochloric acid

c. Hydroiodic acid d. Hydrosulfuric acid e. Hydroxyacetic acid