Is this acute or chronic gastritis?
The 50-year-old man is suffering from chronic gastritis. Due to his excessive alcohol ingestion, the subject exposes the gastric mucosa to an irritant, and this causes epigastric pain that would explain his substernal pain. Specifically, the man suffers from “Acute Gastritis Without Bleeding” whose primary cause is alcohol. Croft (1967) says that while the symptoms of alcoholic gastritis may occur within hours of ingestion, they are most notably the following morning, and this symptom is evident in the subject.
What factors may lead to the development of gastritis?
The main factors that may lead to the development of gastritis include the clinically evaluated staphylococcal endotoxin and alcohol (Croft 1967). The ingestion of these toxins causes the damaging of the surface epithelium but does not affect the glandular epithelium that is left intact. Likewise, the ingestion of aspirin causes irritation that may contribute to gastritis.
What investigation should be performed?
Several ways can be used to investigate chronic gastritis. The patients/subjects can be investigated through gastric mucosal biopsy, an evaluation of the intrinsic factor antibody, urea or the fecal antigen test to accurately classify it. In addition, parietal cell antibody and Helicobacter pylori antibody analysis would be useful for classification (Desai 2007). This is important since Helicobacter pylori (HP) bacterial infection is prevalent and common in such cases and the results of the tests will indicate its presence.
How can the patient be treated?
Chronic gastritis can be treated using several ways that balance the acidic conditions in the stomach. They include the use of proton pump inhibitors, antacids, and H2 antagonists. In addition, gastritis can be eliminated by the avoidance of aspirin and similar medication, fried foods, coffee, and alcohol. The patient recovering from the condition should otherwise prefer to ingest vegetables and fruits with the exception of citrus.
Croft, D. N. “Gastritis”. Br Med J. 1967 Oct 21; 4(5572): 164–166. PMCID: PMC1750051
Desai H. G. “Investigations proposed to accurately classify chronic gastritis”. J Assoc Physicians India. 2007 Apr; 55: …