Introduction
Gastritis is the medical term for stomach lining inflammation. Several conditions can bring it on, but it is also treated with drugs, dietary modifications, and other therapies. Gastritis can develop unexpectedly, resulting in obvious symptoms that may disappear fast without medical intervention (Feyisa & Woldeamanuel, 2021). However, chronic gastritis could go unnoticed. It can eventually cause difficulties if left untreated. This paper will cover the background of gastritis, the various types, causes, diagnoses, and treatment methods applicable. In particular, emphasis is placed on the home state of Florida. The paper also highlights the steps adhered to when diagnosing and surveilling gastritis in the United States. Subsequently, an epidemiological analysis is provided on the predisposing factors that lead to various forms of gastritis. Finally, the paper discusses the scenario of a nursing student who has to care for individuals diagnosed with gastritis.
Background and Significance
The condition of chronic gastritis is typical. In fact, according to some sources, it affects well over 50 percent of individuals globally (Feyisa & Woldeamanuel, 2021). The illness is associated with problems like stomach cancer and ulcers and is a significant public health issue (Feyisa & Woldeamanuel, 2021). An individual affected by gastritis could not exhibit symptoms, while another person might experience severe symptoms (Azer, 2021). Most frequently, persons complain of an upper center or upper left abdominal discomfort that is acute, stabbing, or burning (Feyisa & Woldeamanuel, 2021). The back is mostly affected by the pain. The symptoms of bloating and nausea are also common (Azer, 2021). Vomiting brought on by gastritis might be transparent, yellow, or green (Azer, 2021). Indigestion symptoms can resemble those of gastropathy. Indigestion is a stomach ache or discomfort brought on by trouble digesting food and a burning sensation between an individual’s lower ribs (Azer, 2021). One may hear the medical term dyspepsia used to describe indigestion. As one becomes older, their risk of developing gastritis increases.
The stomach linings of older people are thinner, their circulation is reduced, and their metabolism and mucosal regeneration are slower. Additionally, older persons are more likely to take medications like NSAIDs and nonsteroidal anti-inflammatory drugs that can lead to gastritis (Azer, 2021). The prevalence of H. pylori infection is about two-thirds of the global population. However, it is less frequent in the US. In the US, elderly persons and members of lower socioeconomic categories are more likely to have H. pylori (Azer, 2021). The H. pylori bacteria are the most common cause of gastritis. In the US, these bacteria are present in the body of around 35% of the population (Azer, 2021). A medical professional may conduct a physical exam and inquire about a patient’s symptoms and medical background.
A doctor may request one or more different tests. Patients ingest a pill or liquid containing the radioactive urea when in an H. pylori breathalyzer test. Then the patient exhales into a bag that resembles a balloon. Urea is converted into carbon dioxide by H. pylori bacteria. The breathalyzer test will reveal a rise in carbon dioxide when a patient has the bacteria. Checking for antibodies that combat the H. pylori bacteria through a blood test (Azer, 2021). The medical professional might advise Antibiotics: The bacterial infection can be treated with antibiotics. For a few weeks, one might need to take several different antibiotics. Antacids: Medication containing calcium carbonate lessens exposure to stomach acid (Feyisa & Woldeamanuel, 2021). After continuous research on the issue of gastritis in Florida, no data was found regarding the number of gastritis incidences reported. Nevertheless, Florida is progressing on research concerning a digestive-related illness.
Table 1. Research on digestive illness in Florida
Surveillance and Reporting
There are various ways through which gastritis is identified in the United States. Hematological disorders, such as anemia found during a routine physical, positive histological result of gastric biopsies, medical suspicion based on the existence of many other autoimmune conditions, neurological symptoms associated with vitamin B12 deficiency, or good family history are the most frequent preliminary observations for chronic as well as autoimmune gastritis (Azer, 2021). In the early phases of autoimmune gastritis, iron-deficiency anemia frequently manifests based on blood film demonstrating microscopic hypochromic alterations and iron tests (Azer, 2021). The primary cause is achlorhydria, which impairs iron absorption in the early jejunum and duodenum. Other forms of chronic gastritis could potentially result in iron deficiency anemia.
In addition to Diabetes type 1, Addison disease, myasthenia gravis, vitiligo, chronic spontaneous urticarial and perioral cutaneous autoimmune illnesses, particularly erosive oral lichen planus, autoimmune gastritis, is linked to various autoimmune disorders, mostly thyroid diseases. Early in the 1960s, “hypogastric syndrome” was used to describe the relationship between autoimmune thyroid illness and chronic atrophic autoimmune gastritis. The county health department and personnel utilizing the ‘Merlin Reportable Diseases Data’ should better understand how to interpret Florida’s reportable disease data (Shah et al., 2021). Some restrictions and presumptions related to Florida’s reportable disease data analysis are discussed.
- Case identification: A documented set of monitoring case definitions is used to categorize cases at the local level as verified, probable, or suspected (Shah et al., 2021). These classifications are assessed at the state level for specific disease cases.
- Under-reporting: According to evaluations of communicable disease reporting systems, reporting accuracy varies with the disease. More thoroughly reported than more prevalent but less dangerous illnesses like hepatitis A or campylobacteriosis are the less common but more dangerous diseases like bacterial meningitis, diphtheria, polio, botulism, and anthrax (Shah et al., 2021). Variation in the recorded disease occurrence at the community scale reflects, to variable degrees, both variations in the actual disease incidence and variations in the zeal with which monitoring is carried out.
- Insufficient Case Information: Because of insufficient case information, some studies may not contain all reportable cases of a particular condition (Shah et al., 2021). For instance, only reported cases with an inception date will be considered in the results if the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) user chooses the inception date as the data type for analysis.
Epidemiological Analysis
As determined by medical examination, individuals’ health includes social and psychological components in addition to the physical absence of sickness. Different factors might cause any physiological, mental, or social well-being to deteriorate. However, not all contributing factors have an equal impact on disease (Feyisa & Woldeamanuel, 2021). Three hundred sixty-four patients who visited Saint Paul Hospital Millennium Medical College (SPHMMC) as part of the trial were the subject of a cross-sectional study. Through a structured interview tool and an exit strategy, primary data were gathered by validating inquiries about sociocultural and personal behavioral aspects. The presence of a Helicobacter Pylori infection, indications and signs of gastritis that appeared and lasted for less than four weeks, greater than a month, or none at all were used to determine a patient’s gastritis status (Feyisa & Woldeamanuel, 2021). The determinants of gastritis severity were found using descriptive statistical analysis, bivariate analysis, and a multivariate ordinal logistic regression model.
In the research area, gastritis was prevalent in 78.8% of people. Particularly, gastritis was present in 48.9% and 29.9% of the population. The study discovered that younger age was somewhat substantially associated with lower gastritis levels, while low income and prescription medicines were marginally significantly associated with greater gastritis status (Feyisa & Woldeamanuel, 2021). Additionally, the findings showed that eating spicy meals Adjusted Odds Ratio (AOR) of 1.508; 95% Confidence Interval (CI): 1.046, 2.174), distress (AOR = 2.168; 95% CI: 1.379, 3.4066), not exercising consistently (AOR = 1.780; 95% CI: 1.001, 3.168), as well as drug use (AOR = 1.478; 95% CI: 1.093, 1.999)
5 W’s: What, Who, Where, When, Why
According to the current study’s findings, factors that led to acute gastritis included being a man, being younger, and skipping or delaying meals. While consuming spicy foods, not getting enough exercise, and having a low monthly income are all related to chronic gastritis. Social pressures, using prescription medications for therapy, and engaging in substance use all led to chronic gastritis (Feyisa & Woldeamanuel, 2021). Men should refrain from engaging in risky actions that cause stress, while women should get enough sleep and rest. People, especially the young and those with low incomes, should be educated on how to practice healthy habits. They should eat their meals at the appropriate times, such as breakfast, lunch, or dinner, avoid eating spicy food frequently, engage in regular physical activity, and take their medications after each meal or along with other medications that lessen gastric mucosa irritation (Feyisa & Woldeamanuel, 2021). Another conclusion from this study is that people require healthcare information on the elements that contribute to every type of gastritis to raise their awareness and equip them with knowledge.
Screening and Guidelines
Histopathological analysis of gastric biopsy tissues serves as the foundation for diagnosing gastritis. Even though health history and laboratory investigations are useful for diagnosing and determining its spread, severity, and origin, endoscopy, and biopsy are the gold standards for diagnosing and determining its spread, severity, and origin (Passman et al., 2013). Two primary categories for the tests used to identify H. pylori-associated gastritis exist.
- Invasive techniques that call for a gastroscopy and biopsies. These include culture, a quick urease test, the Alcian blue histological staining, a refined silver stain, and atomic detection (PCR DNA).
- Non-invasive methods -biopsies and gastroscopy are part of invasive techniques. Non-invasive techniques include serology, fecal antigen testing, and urease breath testing (13C-UBT). However, concurrent use of proton-pump inhibitors causes both non-invasive and invasive tests to produce false-negative results (Azer, 2022). Additionally, individuals using proton-pump inhibitors frequently exhibit negative histology H. pylori staining.
Serological assays cannot distinguish active and previous infections of H. pylori for the presence of antibodies. Laboratory and histological examinations are the main components of the diagnosis of autoimmune gastritis. These conditions include atrophic gastritis of the stomach’s fundus and corpus, autoantibodies against the fundamental factor and parietal cells, elevated serum gastrin levels, and elevated pepsinogen one and two ratios (Azer, 2022). Parietal cell antibodies, as opposed to intrinsic factor antibodies, are the most effective serum indicator in autoimmune gastritis.
Nursing Care Plan
Acute Pain
Acute pain nursing diagnosis is demonstrated by complaints of discomfort and changes in muscular tone; pain, particularly in the abdomen, is associated with muscle tension secondary to gastritis. The patient is expected to gain the ability to verbally communicate pain relief and be able to engage in activities with fewer reports of discomfort as a result (Al Baihaqi, 2021). The nurse should strive to provide emotional support and good coping strategies through deep-breathing exercises, progressive relaxation, guided imagery, and visualization. Outcomes will be measured by reduced acute pain intensity and lower frequencies of acute pain incidences.
Comfort Alterations
Pain, tiredness, and mental exhaustion are signs of altered comfort caused by emotional or physical distress due to gastritis, according to the nursing diagnosis. The goal is for the individual to express a pain level lower than three on the pain scale and demonstrate how to use coping mechanisms in trying circumstances (Al Baihaqi, 2021). A nurse should figure out ways to help the patient escape their discomfort. Such techniques may include breathing exercises, meditation, and therapeutic music. The effectiveness of this nursing care plan will be assessed on the level of activeness of the patient. When the patient is comfortable, they are most likely to engage in more activities considering that they will be less tired.
Vomiting and Nausea
Acid reflux, a symptom of gastritis, is linked to an overactive gag reflex in nursing diagnoses for nausea and vomiting. The patient should suffer less severe nausea and vomiting, which is the anticipated result (Al Baihaqi, 2021). The nurse should ensure that the patient is provided with a basin that is easily accessible. The patient should also be encouraged to use nausea management techniques that do not require drugs. They include guided imagery, deep breathing, music therapy, and relaxation. Success will be attained for this nursing care plan if the patient can hold down food after consumption.
Ineffective Coping
Nursing diagnosis involves identifying how incapacity to adapt, dissatisfaction, and worry are linked to the unpredictability of the illness development secondary to gastritis. The patient can accurately assess their current situation and distinguish inadequate coping mechanisms and outcomes as desired (Yang et al., 2021). The nurse should identify external stressors from the community, workplace, family, and relationships. Stress can alter the autonomous nervous system, affecting immune response and escalating sickness. Therefore, even the dependent patient’s wish for freedom could cause further stress. This nursing care plan is focused on the stress of the patient. Effectiveness will be measured regarding how well the patient feels regarding their future recovery.
Conclusion
The term “gastritis” refers to various ailments that share the same physical symptom, which is the swelling of the stomach lining. The pathogen responsible for most gastrointestinal issues, including stomach ulcers, is the same bacteria that often causes gastritis. Regular use of certain painkillers and binge drinking both considerably increase the risk of gastritis. Florida does not provide statistics on the incidences of gastritis reported. Drug abusers and the elderly present some of the most vulnerable people that can contract gastritis. Diagnoses and testing for gastritis can be done through invasive or non-invasive techniques. Care for patients diagnosed with gastritis requires an individual to identify the varying signs and symptoms expressed by patients. Some general recommendations for gastritis patients include breathing exercises, guided imagery, therapy, and meditation.
References
Al Baihaqi, R. (2021). Nursing care for acute pain related to gastritis at Anggrek Room Rsi Nashrul Ummah Lamongan. Journal of Vocational Nursing, 2(1), 10-12.
Azer SA, Akhondi H. Gastritis. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.
Feyisa, Z. T., & Woldeamanuel, B. T. (2021). Prevalence and associated risk factors of gastritis among patients visiting Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia. PloS one, 16(2), e0246619.
Passman, D. B., Kite-Powell, A., Spector, D., Loschen, W., Harp, B., Chern, A.,… & Lombardo, J. (2013). Establishing a federal and state data exchange pilot for public health situational awareness. Online Journal of Public Health Informatics, 5(1).
Shah, S. C., Piazuelo, M. B., Kuipers, E. J., & Li, D. (2021). AGA clinical practice update on the diagnosis and management of atrophic gastritis: an expert review. Gastroenterology, 161(4), 1325-1332.
Yang, X., Chen, Y., Chen, S., & Pan, L. (2021). Observation on clinical application effect of psychological nursing intervention in nursing care of elderly patients with chronic gastritis and analysis of nursing satisfaction. Minerva Gastroenterology.