How is acute gastritis treated?

Updated: Jun 13, 2019
  • Author: Mohammad Wehbi, MD; Chief Editor: BS Anand, MD  more...
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Answer

Administer fluids and electrolytes as required, particularly if the patient is vomiting.

Discontinue the use of drugs known to cause gastritis (eg, NSAIDs, alcohol). A long-term prospective study found that patients with arthritis who were older than 65 years and regularly took low-dose aspirin were at an increased risk for dyspepsia severe enough to necessitate the discontinuation of NSAIDs. [11] This suggests that better management of NSAID use should be discussed with older patients in order to reduce NSAID-associated upper GI events.

There has been a growing concern in recent years regarding the interaction between PPIs and clopidogrel. A decrease in the antiplatelet activity of clopidogrel with a possible increase in adverse cardiac events is postulated. Pharmacokinetically it has been shown that omeprazole and lansoprazole interact significantly with clopidogrel, and that omeprazole, rabeprazole, and esomeprazole interact with prasugrel. Pantoprazole has been shown to have the least interaction and thus, pantoprazole with low CYP2C19-inhibiting properties appears to be the safest PPI to be used with clopidogrel until more concrete evidence is available. [7, 12]


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