Acute gastritis

CHIEF COMPLAINT: Constant abdominal pain with N/V for 4 days HISTORY OF PRESENT ILLNESS: The patient is a 24-year-old African American female who presents to the clinic with abdominal pain, nausea, as well as vomiting. According to the patient, she has not experienced fever and she has not noticed any blood in her stool or vomit. ASSESSMENT: A 24-year-old African American woman presents to the clinic complaining of abdominal pain, nausea and vomiting. Upon enquiry, she denies any blood in the stool or vomit. She also denies any fever.

Patient medical history is not available. Although acute gastritis is suspected, there will be need to conduct a few tests to ascertain the exact cause of the symptoms the patient presents. It is important to note that acute gastritis could be caused by many factors. These, according to Emergency Nurses Association – ENA (2007) include, but they are not limited to, “ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, salicylates, steroids, caustic ingestion (acids, alkalis, or food with excessive seasoning), or indigestion of infected foods” (163).

As ENA further points out, other causes could in this case be inclusive of viral or bacterial infections, tobacco, or emotional/physical stress. It is important to note that one of the key culprits as far as bacterial infections are concerned is H. pylori. According to LeMone, Burke, Dwyer, Levett-Jones, Moxham, and Reid-Seari (2015), “manifestations of acute gastritis may range from asymptomatic to mild heartburn to severe gastric distress, vomiting and bleeding with hematemesis…” (691). The patient in this case presents with severe abdominal pain and vomiting.

Other symptoms in this case could include, but they are not necessarily limited to, indigestion and loss of appetite. Acute gastritis can be diagnosed in several ways. In addition to endoscopy to examine the patient’s upper digestive system, H. pylori tests may also be conducted. The patient’s upper digestive system may also be X-rayed to identify abnormalities. PLAN: An endoscopy will come in handy in seeking for signs of inflammation in the patient’s upper digestive system.

In instances whereby an area that appears suspicious is identified, biopsy will be necessary after which samples will be taken for examination in the laboratory. It is important to note that biopsy could help in the detection H. pylori in the lining of the patient’s stomach. Upon an assessment of what caused acute gastritis, the appropriate treatment plan can be instituted. For instance, “hemorrhagic and erosive changes can be seen in biopsy specimens…” (Hauser, 2011, p. 56).

Acute injury in most patients’ gastric mucosa has been known to be produced by NSAIDs and aspirin (Hauser, 2011). There are various differential diagnoses for acute gastritis. These include nonulcer dyspepsia. In nonulcer dyspepsia however, endoscopy happens to be normal. Essentially, “in the absence of bleeding, removal of the causative agent and treatment with frequent antacids may be the only requirement” in the treatment of acute gastritis (Taylor, p. 626). It is important to note that the patient in this case denies any blood in the vomit or stool.

Towards this end, the goal will to be the neutralization of stomach acid. Pepto-Bismol will be prescribed so as to provide rapid pain relief – with a dose taken as needed, but at intervals of not less than 30 minutes. Cimetidine (Tagamet HB), which is a histamine (H-2) blocker, will also be prescribed. It should, however, be noted that where hemorrhage is evident, hospitalization ought to.