Gastritis (to be) ____ inflammation of the gastric mucosa.

The following (to be) ____ known causes of gastritis:

Bacterial infection (most often by Helicobacter pylori and other Helicobacter bacteria)

Fungal infection (most often in people with AIDS)

Parasitic infection (most often from poorly cooked seafood)

Viral infection

Bile reflux

NSAIDs

Cigarette smoke

Autoimmune disorders

Excessive alcohol consumption

Certain allergens

Certain types of radiation

The following symptoms can (to be) ____ a result of gastritis or can (to relate) _______________to the underlying cause:

Upper abdominal pain or discomfort

Gastric hemorrhage

Appetite loss

Belching

Nausea

Vomiting

Fever

Fatigue

Diagnosis. A doctor may (to order) _________ a gastroscopy or, less frequently, a barium meal to investigate suspected gastritis and related conditions such as peptic ulcer disease and gastric cancer. The appearances at endoscopy, with or without histological examination of biopsy specimens, can (to use) ___________ to determine the cause of the gastritis. However, a relevant patient history (to be) _____ also very important, particularly with regard to smoking, alcohol intake and medication use. In most cases, a biopsy from the gastric antrum (to take) ______________ to detect the presence of Helicobacter pylori. Alternatively, a non-invasive method to detect Helicobacter such as a urea breath test or stool antigen test may (to consider) ____________________, particularly in younger patients and those without more worrying symptoms such as weight loss or bleeding.

Treatment usually (to consist) _____________ of removing the irritant or the infection. In the case of Helicobacter infection, a doctor may (to prescribe) ______________ antibiotics.

Peptic ulcer (to be) ______ usually a non-malignant ulcer of the stomach (called gastric ulcer) or duodenum (called duodenal ulcer). About 4 % of gastric ulcers (to cause) __________ by malignant tumour. Duodenal ulcers (to be) _______ non-malignant. Most instances (to know) _______________ to be associated with Helicobacter pylori. It (to be) ________ a spiral-shaped bacterium. It (to live) ___________ in the acid environment of the stomach. These ulcers can also (to cause) ___________________ or (to worsen) ______________ by drugs such as Aspirin and other NSAIDs.

Symptoms of a peptic ulcer can (to be) ________:

• Abdominal pain;

• Vomiting blood;

• Tarry stool;

• Weight loss;

• Rarely, an ulcer can (to lead) _____________ to a gastric or duodenal perforation. This (to be) _________ extremely painful and (to require) ___________ immediate surgery.

A history of heartburn, gastroesophageal reflux disease (GERD) and use of certain forms of medication can (to raise) ________________ the suspicion for peptic ulcer. Medicines associated with peptic ulcer (to be) _________ NSAID (non-steroid anti-inflammatory drugs).

The timing of the symptoms in relation to the meal may differentiate between gastric and duodenal

The diagnosis of Helicobacter pylori can (to be) _____ by:

• Biopsy;

• Breath testing;

• Direct culture from a biopsy specimen;

• Measurement of antibody levels in blood.

A major causative factor (90% of gastric and 75% of duodenal ulcers) (to be) ______ chronic inflammation due to Helicobacter pylori.

Another major cause (to be) ______ the use of NSAIDs.

Stress in the psychological sense (not to influence) _________________ the development of peptic ulcers. Burns and head trauma, however, can (to lead) ___________ to "stress ulcers".

Smoking (to lead) ___________ to atherosclerosis and vascular spasms. It (to cause) ___________ vascular insufficiency and (to promote) _________________the development of ulcers through ischemia.

A family history (to be) ________ often present in duodenal ulcers, especially when blood group O (to be) ______ also present. Inheritance (to appear) ____________ to be unimportant in gastric ulcers.

When H. pylori infection (to be) ______ present, the most effective treatments (to be) ________ antibiotics.

Appendicitis (to be) ______ a condition characterized by inflammation of the appendix. Most (to require) ____________ removal of the inflamed appendix, either by laparotomy or laparoscopy. If untreated, mortality (to be) ____ high, mainly due to peritonitis and shock.

The causes of appendicitis (to be) _______ generally unknown. The leading theory (to be) _____ that obstruction of the appendix (to be) _______ the risk factor. Viral infections, which can (to cause) _________ ulceration of the lining, can also (to lead) _________ to obstruction of the appendix

Appendicitis can (to classify) __________________ into two types, typical and atypical. There (to be) ____ typically pain and tenderness in the right iliac fossa in both typical and atypical appendicitis.

Diagnosis (to base) _______________ on history and physical examination. Diagnosis (to back) ___________________ by blood tests and imaging.

The classical physical finding in appendicitis (to be) __________ diffuse pain in the umbilical [, mbi’laikel] region. This point (to locate) ________________ on the right-hand side of the abdomen.

Other physical findings (to include) ______________ right-side tenderness on a digital rectal exam.

Ultrasonography and Doppler sonography also (to provide) _____________ useful means to detect appendicitis, especially in children.

In places where it (to be) ______ readily available, CT scan (to become) ___________ the diagnostic test of choice, especially in adults. A properly performed CT scan with modern equipment (to have) ___________ a detection rate (sensitivity) of over 95%.

Appendicitis can (to treat) ______________ by removal of the appendix through a surgical procedure. This procedure (to call) __________________ an appendectomy. Traditionally, appendectomy (to involve) __________ an open laparotomy incision.

Often now the operation can (to perform) ____________________ via a laparoscopic approach, or via small incisions with a camera to visualize the area of interest in the abdomen. Antibiotics (to give) ______________ often intravenously to help kill remaining bacteria and thus reduce the inflammation.

Most appendicitis patients (to recover) _________________ easily with treatment, but complications can (to occur) _______________ if treatment (to delay) ________________ or if peritonitis (to occur) __________.

Recovery time (to depend) _________________ on age, condition, complications, and other circumstances but usually (to be) _______ between 10 and 28 days.

Gastroenteritis (to be) ________ an inflammation of the gastrointestinal tract. It (to be) _______ an illness of fever, diarrhea and vomiting. Gastroenteritis (to cause) _______________ by an infectious virus, bacterium or parasite [‘paeresait]. It usually (to be) __________ of acute onset, normally lasting less than 10 days and self-limiting. It (to call) ________________ often the stomach flu or gastric flu even though it (not to relate ) ____________ to influenza.

The most common viral causes of acute gastroenteritis (AGE) in children <5 years of age in both developed countries as well as developing countries (to be) ________ rotavirus group A (up to 50% of the cases), noroviruses (the most common cause of outbreaks of AGE in all age groups), adenoviruses type 40 and 41, astrovirus, and sapovirus. Bacterial causes (to be) ________ less common in developed countries.