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What is Gastritis/ dyspepsia and how can relief from it ??

What is Gastritis/ dyspepsia and how can relief from it ??

Gastritis/ dyspepsia

Gastric acid secretion from the parietal cell of the stomach is a common reason. Gastric acid is required for food digestion.  

Excess production of gastric acid in stomach is called gastritis.  Dyspepsia as persistent abdominal pain for discomfort entered in upper abdomen.

Gastritis

 Causes

  • Irregular lifestyle
  • sudden  withdraw  of   gastric   suppression drugs
  • Stress
  • Zollinger Ellinson syndrome
  • Barrett esophagus
  • Crohn’s disease.
  • Genetic factors
  • Drug-induced gastritis (eg. antibiotics,  NSAIDs ,Corticosteroid,  bisphosphonate,Calcium channel blockers, antidepressants,  iron,  nitrates,   theophyline etc.

Sign and symptoms gastritis or acidity

  • Heartburn
  • Belching
  • Water brash
  • Esophageal pain
  • Upper abdominal discomfort
  • Postprandial discomfort
  • Bloating in the upper abdomen
  • Nausea
  • Vomiting

 Treatment of gastritis

  • First  choice  use antacid preparation (eg. aluminum hydroxide and magnesium hydroxide) if patient is not  a chronic renal disease patient.
  • It should be taken 1-1.5 hours after meal .
  • Liquid dosage form is more  potent than solid doses form.
  • I suggest that Sodium Bicarbonate preparation  should avoid in hypertensive patient. Calcium carbonate and magnesium Hydroxide preparation should also be avoid.
    • If antacid can’t relieve the symptoms alone should use  H2 receptor blocker drugs (eg.  famotidine or Nizatidine.) or PPI ( eg.  esomeprazole, pantoprazole or  lansoprazole).

Dose adjustment

Nizatidine

150 mg  two times daily  for 4 weeks 30 minutes before the meal,  then once daily at night for two weeks,  if symptoms not relief extend the the treatment time for  two weeks.

Famotidine

20 mg  two times daily  for 4 weeks 30 minutes before the meal,  then once daily at night for two weeks,  if symptoms not relief extend the the treatment time for  two weeks.

PPI ( Proton Pump Inhibitor)

Esomeprazole 20 mg or prantoprazole 40 mg may be given 2  times a day  30 minutes before of meal for 3 weeks. Last 1 weeks once a day at night before the 30 minutes of meal. Dexlansoprazole is better to use 30 mg 1 or 2 times a day for 4 weeks. First 20 days  2 times a day 30 minutes before the meal and then 10 days a single dose for withdrawing the drug at night before the 30 minutes of meal.

With added a antacid preparation (eg. aluminum hydroxide and magnesium hydroxide) 1-1.5 hours after meal .

Advice

 It is very important for all gastritis,Peptic ulcer disease, duodenal ulcer disease , gastroesophageal reflux disease, gastric ulcer disease patients .

Diet

  • Patient should concern about his meal.
  • Should be less spicy less oily .
  • Less consume free sugar or sugar containing in food
  • Try to avoid heavy fiber food
  • Avoid  coffee
  • Alcohol
  • Avoid milk
  • Cigarette are  prohibited strongly.

Lifestyle

Patient  should obey the following guideline for better feel and withdrawal the medication .

Daily activities
  • Wake up at morning 6 a.m take a glass of fresh water
  • Then take100- 150 gram green papaya
  • Then take breakfast at 8 a.m.
  • At 11 a.m. take a sugar free toast biscuit with a glass of fresh water, then chewing a chewing gum for 40 to 50 minutes.
  • Take your lunch within 2 p.m.
  • At 5 p.m. take a sugar free toast biscuit with a glass of fresh water.
  • Then chewing a chewing gum for 40 to 50 minutes.
  • Take your dinner within 8 to 9 p.m.
  • Go to bed within 10:00 to 10:30 p.m.

Note

zollinger-ellison syndrome,  Barrett oesophagus, Genetic factors for hyposecretion may not be control in this case it is better by vagotomy or an antrectomy.

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