Stress-Induced Gastritis Clinical Presentation

Updated: Aug 26, 2018
  • Author: Rohan C Clarke, MD; Chief Editor: BS Anand, MD  more...
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Presentation

History

The most common presenting sign/symptom of stress-induced gastritis is bleeding (hematemesis, melena) in a patient with an acute critical illness. [2, 1]

Patients who may have an increased risk of stress gastritis are those with severe illness, [1] major surgery, [1] massive burn injury, head injury associated with raised intracranial pressure, sepsis and positive blood culture results, severe polytrauma, [1] and multiple system organ failure. [2] The clinician should have a high index of suspicion in patients in these settings who are noted to have decreased hematocrit values and who are not receiving prophylaxis for stress gastritis.

Some types of psychiatric stressors (eg, major, untreated depression) can cause stress gastritis. [1]

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Physical Examination

The clinical presentation in patients with stress-induced gastritis is varied, but the following clues should raise the level of clinical suspicion for this entity:

  • Coffee ground vomitus

  • Melena

  • Hematemesis (in extreme cases)

  • Orthostasis (unusual)

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