Stress-Induced Gastritis Workup

  • Author: Rohan C Clarke, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jul 22, 2011
 

Laboratory Studies

  • A high degree of clinical awareness is the key to early diagnosis. The presence of any of the previously discussed clinical features should alert the clinician to the presence of stress gastritis.
  • Useful investigations and diagnostic tools include the following:
    • Hematocrit
    • Coagulation profile
Next

Procedures

  • Nasogastric tube and lavage: Gastric lavage is a useful test to confirm whether blood is present in the upper GI tract and to quantify the amount of blood if found. This is roughly assessed by how much normal saline it takes before the aspirate becomes clear.
  • Endoscopy is useful only in the diagnosis of stress-induced gastritis.
Previous
Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Rohan C Clarke, MD  Consulting Staff, Department of Gastroenterology, JPS Health Systems Hospital

Rohan C Clarke, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society of Gastrointestinal Endoscopy

Disclosure: Salix Honoraria Round table feedback group

Coauthor(s)

Rachael M Ferraro, DO  Internal Medicine Hospitalist, Torrance Memorial Medical Center, Little Company of Mary Hospital

Rachael M Ferraro, DO is a member of the following medical societies: American College of Osteopathic Internists, American College of Physicians, and American Osteopathic Association

Disclosure: Nothing to disclose.

Emmanuel Gbadehan, MD  Instructor in Clinical Medicine, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Gastroenterology, Harlem Hospital Center, North General Hospital

Emmanuel Gbadehan, MD is a member of the following medical societies: American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Uzodinma R Dim, MD  Clinical Cardiac Electrophysiology Fellow, Division of Cardiovascular Medicine, University of Iowa Hospital and Clinics

Uzodinma R Dim, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, and Association of Black Cardiologists

Disclosure: Nothing to disclose.

Specialty Editor Board

Ann Ouyang, MBBS  Professor, Department of Internal Medicine, Pennsylvania State University College of Medicine; Attending Physician, Division of Gastroenterology and Hepatology, Milton S Hershey Medical Center

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Simmy Bank, MD  Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

  1. Feldman M. Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 7th ed. Philadelphia, Pa: WB Saunders Co; 2002:587-603.

  2. Constantin VD, Paun S, Ciofoaia VV, Budu V, Socea B. Multimodal management of upper gastrointestinal bleeding caused by stress gastropathy. J Gastrointestin Liver Dis. Sep 2009;18(3):279-84. [Medline].

  3. Reveiz L, Guerrero-Lozano R, Camacho A, Yara L, Mosquera PA. Stress ulcer, gastritis, and gastrointestinal bleeding prophylaxis in critically ill pediatric patients: A systematic review*. Pediatr Crit Care Med. Sep 15 2009;epub ahead of print. [Medline].

  4. Herzig SJ, Vaughn BP, Howell MD, Ngo LH, Marcantonio ER. Acid-suppressive medication use and the risk for nosocomial gastrointestinal tract bleeding. Arch Intern Med. Jun 13 2011;171(11):991-7. [Medline].

  5. Fiddian-Green RG, McGough E, Pittenger G. Predictive value of intramural pH and other risk factors for massive bleeding from stress ulceration. Gastroenterology. Sep 1983;85(3):613-20.

  6. Irwin R, Rippe J. Manual of Intensive Care Medicine. Philadelphia, Pa: JB Lippincott Co; 2001.

  7. Khuroo MS, Yattoo GN, Javid G. A comparison of omeprazole and placebo for bleeding peptic ulcer. N Engl J Med. Apr 10 1997;336(15):1054-8.

  8. Laine L. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 6th ed. Philadelphia: WB Saunders;. 2000:198-219.

  9. Lin HJ, Lo WC, Lee FY. A prospective randomized comparative trial showing that omeprazole prevents rebleeding in patients with bleeding peptic ulcer after successful endoscopic therapy. Arch Intern Med. Jan 12 1998;158(1):54-8. [Medline].

  10. Petronilho F, Araujo JH, Steckert AV, et al. Effect of a gastrin-releasing peptide receptor antagonist and a proton pump inhibitor association in an animal model of gastritis. Peptides. Aug 2009;30(8):1460-5. [Medline].

  11. van Mark A, Spallek M, Groneberg DA, Kessel R, Weiler SW. Correlates shift work with increased risk of gastrointestinal complaints or frequency of gastritis or peptic ulcer in H. pylori-infected shift workers?. Int Arch Occup Environ Health. Dec 11 2009;epub ahead of print. [Medline].

  12. Wolfe M. Stress-related erosive syndrome. In: Bayless T, ed. Current Therapy in Gastroenterology and Liver Disease. 4th ed. St Louis, Mo: Mosby; 1994:139-43.

  13. Wolfe MM, Sachs G. Acid suppression: optimizing therapy for gastroduodenal ulcer healing, gastroesophageal reflux disease, and stress-related erosive syndrome. Gastroenterology. Feb 2000;118(2 Suppl 1):S9-31.

  14. Yardley JH, Hendrix TR. Textbook of Gastroenterology. 2nd ed. Philadelphia, Pa: JB Lippincott Co; 2001:1456-93.

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.