GASTRITIS Pathophysiology Nursing Notes

GASTRITIS Pathophysiology Nursing Notes
GASTRITIS Pathophysiology Nursing Notes


  • It is an inflammation of the gastric mucosa. ( inner lining of the stomach)
  • It is one of the most common GI problems.
  • It refers to diffuse localized responses of the gastric mucosa to injury or infection.

Layers in stomach

  • Mucosa
  • Submucosa
  • Muscle layer
  • serosa

Types of Gastritis

  • Acute Gastritis
  • Chronic Gastritis

According to the position

  • Antral gastritis
  • Gastritis body of the stomach
  • Pangastritis

acute gastritis

  • It is short term inflammatory process that can be initiated by numerous factors in stomach
  •  may last several hours to a few days.

Acute Gastritis Etiology and Risk Factors

  • Dietary indication
  • Overuse of aspirin and other NSAIDs
  • Excessive alcohol intake
  • Bile reflux disease
  • Stress
  • Bacterial and fungal infection
  • Old age
  • Radiation therapy, chemotherapeutic damages, steroids, and digitalis.
  • Excessive intake of tea, coffee, mustard, pepper, etc.
  • Other disease

Pathophysiology of gastritis

  • The mucosal lining of the stomach normally protects it from the action of gastric acid. This mucosal barrier is composed of prostaglandins.
  • If this barrier is penetratedà gastritis occurs leading to injury to mucosa and small vessels causing edema, hemorrhage, and possible ulcer formation.

Clinical features of acute gastritis

  • Abdominal epigastric discomfort, tenderness, headache, severe nausea, anorexia, vomiting and hiccupping.
  • Sometimes no symptoms may occur.
  • Cramping, belching, reflux, sometimes hematemesis and GI bleeding.

Chronic Gastritis

  • It is a prolonged inflammation of the gastric mucosa or the stomach.
  • It can result from repeated episodes of acute gastritis.


Etiology of chronic gastritis

  • Helicobacter pylori (H-pylori) cause chronic atrophic gastritis 
  • Gastric surgery
  • Acute recurrent gastritis
  • More common in older adults
  • Benign or malignant ulcers of the stomach
  • Autoimmune diseases
  • Pernicious anemia,
  • caffeine,
  •  NSAIDs, alcohol,
  • smoking,
  • reflux of intestinal content into the stomach

Pathophysiology of chronic gastritis


Clinical features

  • Anorexia
  • Heart burn after eating
  • Sour taste on mouth
  • Feeling of fullness
  • Dyspepsia
  • Epigastric pain
  • Vomiting
  • Intolerance of spicy or fatty foods
  • Mal-absorption
  • Weight loss

Peptic Ulcer

  • A peptic ulcer may be referred to as a gastric, duodenal, or esophageal ulcer, depending on its location.
  • A peptic ulcer is an excavation (hollowed-out area) that forms in different parts of the stomach
  •  mucosal wall of the stomach,
  •  pylorus (the opening between the stomach and duodenum),
  • duodenum (the first part of the small intestine), or in the esophagus.
  • Erosion of a circumscribed area of mucous membrane is the cause.
  • This erosion may extend as deeply as the muscle layers or through the muscle to the peritoneum.
  • Peptic ulcers are more likely to occur in the duodenum than in the stomach.
  • As a rule they occur alone, but they may occur in multiples.



  • Greatest frequency in people between 40 and 60 years of age.
  • It is relatively uncommon in women of childbearing age, but it has been observed in children and even in infants.
  • After menopause, the incidence of peptic ulcers in women is almost equal to that in men.
  • Etiology
  • H. pylori infection (90% has this bacterium)
  • The ingestion of milk and caffeinated beverages, smoking, and alcohol also may increase HCl secretion.
  • Stress and eating spicy foods may make peptic ulcers worse.
  • Familial tendency also may be a significant predisposing factor.


Zollinger Ellison syndrome. 

Chronic use of NSAIDs, alcohol ingestion, and excessive smoking.

Types of peptic ulcer disease

  • Gastric peptic ulcer
  • Duodenal peptic ulcer

Stomach function

Digestion of food

  • Storage of food
  • Secretion of  gastric juices
  • Secretion of digestive enzymes
  • Secretion of HCL
  • Secretion of Gastric hormones
  • Secretion of intrinsic factor
  • Absorption of water

Gastric Ulcers and Duodenal Ulcers

  • DUs occur most often in the first portion of duodenum (>95%), with ~90% located within 3 cm of the pylorus.
  • Malignant DUs are extremely rare.
  • In contrast to DUs, GUs can represent a malignancy.
  • Benign GUs are most often found along the lesser curvature in the region of pyloric antrum.


  • Duodenal Ulcer by H. Pylori Infection

Clinical manifestations

  • Typical symptoms
  • Epigastric pain
  • Fullness
  • Nausea
  • Bloating
  • Nocturnal pain


Alarm symptoms

  • Anemia (bleeding)
  • Hematemesis
  • Melena
  • Pyrosis (heartburn)
  • Weight loss
  • Persisting abdominal pain often radiating to the back


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