1. References
   1. Huether, S.E. & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
   2. Jensen, E., Martin, C., Kappelman, Dellon, E., (2016). Prevalence of eosinophilic gastritis, gastroenteritis, and colitis: estimates from a national administrative database. Journal of Pediatric Gastroenterol Nutrition. 62(1):36-42. doi: 10.1097/MPG.0000000000000865.
   3. Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology, 62(6), 591-599. Retrieved from http://jpp.krakow.pl/journal/archive/12_11/pdf/591_12_11_article.pdf
   4. Mahvi-Shirazi, M., Fathi-Ashtiani, A., Rasoolzade-Tabatabaei, S.-K., & Amini, M. (2012). Irritable bowel syndrome treatment: cognitive behavioral therapy versus medical treatment. Archives of Medical Science : AMS, 8(1), 123–129. Retrieved from http://doi.org/10.5114/aoms.2012.27292
   5. Marcus, A. J., (2016). Chronic Gastritis - Epidemiology. Medscape. Retrieved from http://emedicine.medscape.com/article/176156-overview#a6
   6. Mayo Clinic Staff (2014). Lifestyle and Home Remedies. Gastritis. Retrieved from http://www.mayoclinic.org/diseases-conditions/gastritis/basics/lifestyle-home-remedies/con- 20021032
   7. Mayo Clinic Staff (2014). Symptoms. Gastritis. Retrieved from http://www.mayoclinic.org/diseases-conditions/gastritis/basics/symptoms/con-20021032
   8. Mayo Clinic Staff (2014). Tests and diagnosis. Gastritis. Retrieved from http://www.mayoclinic.org/diseases-conditions/gastritis/basics/tests-diagnosis/con-20021032
   9. Mayo Clinic Staff (2014). Treatments and Drugs. Gastritis. Retrieved from http://www.mayoclinic.org/diseases-conditions/gastritis/basics/treatment/con-20021032
   10. McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.
   11. U.S. Department of Health and Human Services, (2014). Digestive Diseases Statistics for the United States. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/health-statistics/Pages/digestive-diseases-statistics-for-the-united-states.aspx
2. Pathophysiology
   1. Acute
      1. Diffuse erosion of lining
      2. Localized erosion of lining
      3. Prostaglandins are inhibited as the mucosal protective layer is damaged. This damage is most frequently caused by drugs or chemicals.
   2. Chronic
      1. Type A (Fundal)
         1. Degenerates gastric stomach mucosa and fundus of stomach
         2. Diminishes acid secretions
         3. Elevated plasma levels of gastrin
         4. Intrinsic factor limited suggesting autoimmune response
         5. Increase risk for stomach cancer.
      2. Type B (Antral)
         1. Involves antrum only
         2. More frequent than Type A
         3. Associated with H. Pylori
         4. Elevated levels of hydrochloric acid secretions
         5. Greater risk for gastric cancinoma
      3. Type AB or pangastritis
         1. Both Type A and B involved
         2. Antrum is extremely involved
   3. Gastritis predisposed the lining of your stomach to develop ulcers with the epithelial cells breaking down barriers and as prostaglandins are reduced causing diminished acid secretions.
3. Epidemiology
   1. Chronic
      1. U.S.A. Adults - approximately 30-35% infected
         1. Hispanics - 52%
         2. Black - 54%
         3. White - 21%
      2. Age - increasing rate of prevalence with age
      3. Children aged 2-8 years
         1. Developing nation - around 10%
         2. U.S.A - 1%
      4. Socioeconomic differences
         1. Better sanitation leads to lower prevalence
         2. Crowed living environments increases prevalence
      5. Internationally
         1. Developing countries and Asia more common
         2. Around 50% prevalence of H. Pylori equally effecting men and women
         3. Autoimmune gastritis - rare
            1. More common in black
            2. More common in northern European
            3. More common in women 3:1
   2. Acute
      1. Eosinophlic Gastritis - 6.3 per 100,000
      2. Eosinophilic Colitis - 3.3 per 100,000
      3. Women more often affected
      4. Affects all age groups
4. Treatment
   1. Medications
      1. Antibiotics - to destroy H. Pylori
         1. Clarithromycin
         2. Flagyl
         3. Amoxicillin
      2. Acid production reduction
         1. Prilosec
         2. Protonix
         3. Dexilant
         4. Nexium
         5. Aciphex
         6. Prevacid
      3. Block acid production and promote healing
         1. Pepcid
         2. Tagemet
         3. Axid
         4. Zantac
      4. Antacids to neutralize stomach
   2. Lifestyle
      1. Manage stress
      2. Switch pain killer to Tylenol if you use regularly
   3. Diet
      1. Small frequent meals
      2. Low acid content in foods
      3. Avoid Alcohol
5. Clinical Presentation
   1. Chronic
      1. Nausea
      2. Vomiting
      3. Burning/ Aching/ Indigestion
         1. May become worse with eating
         2. May become better with eating
      4. Full feeling after eating in your upper abdomen
      5. Anorexia
      6. Epigastric pain
   2. Acute
      1. Vague abdominal discomfort
      2. Bleeding
         1. Vomiting
         2. Stool
      3. Tenderness in stomach
      4. Epigastric pain
6. Diagnosis
   1. Endoscope
      1. Passage of a scope down into stomach to visualize stomach lining and take samples of tissue if needed.
   2. H. Pylori
      1. Blood
      2. Stool
      3. Breath Test
   3. X-ray of Upper Digestive system
      1. Barrium study
      2. Upper gastrointestinal series
   4. Consider assessment findings, clinical presentation, socioeconomic differences, age, race, physical history, family history when formulating diagnosis.