What are the approach considerations in the treatment of acute gastritis?

Updated: Jul 12, 2020
  • Author: Sarah El-Nakeep, MD; Chief Editor: BS Anand, MD  more...
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Surgical intervention is not necessary for gastritis, except in the case of phlegmonous gastritis or acute necrotizing gastritis. With the latter entity, surgical intervention with resection of the affected area may be the most effective form of treatment.

Consult a gastroenterologist in complicated cases.

In cases of suspected upper gastrointestinal (GI) bleeding (decreased hemoglobin, melena, hematemesis), diagnostic endoscopy is mandatory to exclude bleeding ulcers, angiomatous malformations, erosions and malignant transformation. Severe cases with upper GI bleeding can be treated by cautery, hemoclips, local epinephrine injection, or hemostatic spraying of the bleeding area [9] along with an intravenous (IV) proton-pump inhibitor (PPI) bolus, then continuous infusion for 72 hours to stabilize the bleeding. [10]

Over-the-counter (OTC) drugs such as mucosal coating (sucralfate, antacids) agents or short-term histamine-2 antagonists can stabilize mild to moderate cases in the short term. [11] In the long term, treatment of the underlying cause (ie, avoid nonsteroidal anti-inflammatory drugs, caffeine, smoking; H Pylori eradication; etc.) is the most satisfactory course of action.

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