Nursing Care Plan for Elderly with (Acute / Chronic) Gastritis

Gastritis is a common disease in the community, but once the disease is often underestimated and overlooked by the sufferer. In fact, gastritis disease can not be underestimated. Gastritis is a digestive disease of the stomach are caused by excessive stomach acid production. This resulted imflamasi or inflammation of the gastric mucosa. Sufferers feel will feel sore stomach and heartburn in the area around the solar plexus. If this is allowed and ignored protracted it will lead to erosion of the gastric mucosa. In some cases, gastritis can lead to ulcers in the stomach and an increase in stomach cancer.

Gastritis (dyspepsia / heartburn) is a disease caused by excess stomach acid or stomach acid resulting in increased inflammation of the gastric mucosa such as cut, or pain in the gut. Symptoms occurred, ie, the stomach was sore and heartburn. Mechanisms of gastric damage caused by an imbalance of digestive factors such as gastric acid and pepsin to the production of mucus bicarbonate blood flow.

There are two types of gastritis are:

Acute Gastritis

Acute Gatritis (inflammation of the gastric mucosa) is most often caused by faulty diet, eg. eating too much, too fast, eating too much food seasoning, or infected food. Other causes include alcohol, aspirin, bile reflux or radiation therapy. Gastritis can also be the first sign of acute systemic infection. Form a more severe acute gastritis caused by strong acid or alkali which can lead to gangrene or perforation of the mucosa.

Chronic Gastritis

Prolonged gastric inflammation caused by benign and malignant gastric ulcers or bacteria Helicobacter pylori. These bacteria colonize the place with the concentrated gastric acid. Chronic gastritis is classified as type A or type B. Type A disease associated with autoimunmis, pernicious anemia. Type A occurs in gastric fundus or corpus. Type B (H. pylori) on the antrum and pylorus. Associated with H. pylori. dietary factors like-iminum heat, seasoning, use of drugs, alcohol, smoking, or refluksisi intestine into the stomach.


Etiology

• Gastritis is an inflammation of the gastric mucosa.
• Acute erosive gastritis: irritants that can heal itself caused by irritants (eg, NSAIDs, alcohol), severe physiological stress (eg, major surgery, burns, ventilator), or local trauma (eg NG tube).
• A type of chronic gastritis: inflammation of the proximal stomach as a result of pernicious anemia, atrophic gastritis, aclorhidria, autoimmune disorders, or radiation.
• Type B chronic gastritis: inflammation of the distal stomach or antrum as a result of Helicobacter pylori infection.
• Reflux gastritis: inflammation as a result of the bile and pancreatic lymph in the secondary hull as a result there is no pyloric or pyloric are nonfunctional (eg after partial gastrectomy).
• Hemorrhagic gastritis: gastritis with significant inflammation as a reaction to severe stress (eg ICU patients, hypoxia, ischemia, uremia).

Clinical Manifestations

• Epigastric pain or burning in bad taste that gain weight by eating.
• Dyspepsia
• Anorexia
• Nausea / vomiting
• Bleeding can occur resulting in hematemesis, melena.

Acute Gastritis

• Superficial ulceration may occur and lead to hemorrhage.
• Discomfort in the abdomen with headache, lethargy, nausea, and anorexia. Possible vomiting and hiccups.
• Some patients showed asymptomatic.
• Colic and diarrhea can occur if foods that irritate not vomited but instead reaches the intestine.
• Patients usually recover about a day, although the appetite may be lost for 2 to 3 days.

Chronic Gastritis

• Gastritis type A: essentially asymptomatic except for the symptoms of vitamin B12 deficiency.
• Gastritis type B: patients complain of anorexia, heartburn after eating, belching, a sour taste in the mouth or nausea and vomiting.

Treatment

Treatment of gastritis in general is to eliminate the main factor etiology, gastric diet with small portions and often, as well as drugs. However, the specifics can be distinguished as follows:

Acute Gastritis

1. Reduce drinking alcohol and eating regular and healthy until the symptoms disappear; transformed into a diet that does not irritate.
2. If symptoms persist, IV fluids may be required.
3. If gastritis caused by ingesting strong acidic or alkaline, dilute and neutralize the acid with common antacids, such as aluminum hydroxide, H2 receptor antagonists, proton pump inhibitors, anticholinergics and sucralfate.
4. If gastritis caused by ingesting a strong base, use citrus juice or vinegar diluted in dilute.
5. If severe corrosion, avoid emetic and rinse the stomach because of the danger of perforation.
6. Antacids: Antacids are drugs that can be liquid or tablet form and is a common drug used to treat mild gastritis. Antacids neutralize stomach acid and can relieve pain caused by stomach acid quickly.
7. Acid inhibitors: When antacids are no longer able to cope with the pain, the doctor may recommend medications.

Chronic Gastritis

1. Diet modification, stress reduction, and pharmacotherapy.
2. Cytoprotective agents: Drugs of this class helps to protect the tissues that line the stomach and small intestine.
3. Proton pump inhibitors: A more effective way to reduce stomach acid is to close the "pumps" within acid-producing cells of the stomach acid. Proton pump inhibitors reduce acid by covering the work of the "pumps" it.
4. H. pylori may be treated with antibiotics. There are several regimens in overcoming the infection of H. pylori. The most commonly used is a combination of antibiotics and proton pump inhibitors. Sometimes also added bismuth subsalycilate. Antibiotics used to kill bacteria, proton pump inhibitor works to relieve pain, nausea, heals inflammation and improve the effectiveness of antibiotics. Treatment of infection of H. pylori is not always successful, the speed to kill H. pylori is extremely diverse, depending on the regimen used. However, a combination of three drugs seem more effective than a combination of two drugs. Therapy in the long term (for 2 weeks of therapy compared with 10 days) also seem to increase effectiveness. To ensure H. pylori is gone, it can be re-examined after the treatment carried out. Respiratory examination and stool examination were two types of checks are often used to ensure the absence of H. pylori. Blood tests will show positive results for several months or even more despite the fact that the bacteria is gone.