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Gastritis Oesophagitis

Increased chances of trauma,absorption may produce systemic side effects (excitation of CNS, hypotension, bradycardia and arrhythmia).

Appendicitis severe renal impairment hypophosphataemia

Special Precautions:

1st trimester of pregnancy where symptoms persist, diagnose underlying diseases, especially carcnoma

Gastritis Oesophagitis 5-10ml 4 times daily , 15 minutes before meals and at bedtime

List of entries

1. Indigestion

2. Heartburn

3. Dysphagia

4. Flatulance

5. Anorexia

6. Nausea, Vomiting and Retching

7. Gastritis

8. Diarrhea and Constipation

9. Irritable bowel syndrome

10. Gastrointestinal Reflux

11. Reflux Oesophagitis

12. Peptic Ulcer - Zollinger- Ellison Syndrome

13. Duodenal Ulcer

14. Gastric Ulcer

  1. Indigestion Indigestion is a term frequently used to describe a multitude of symptoms generally appreciated with the distress with the intake of food.To some patients indigestion refers to a feeling that digestion has not proceeded naturally. They may describe a sense of abdominal fullness, pressure or actual pain. Others may use the term to describe heartburn, belching, distention or flatulence. Indigestion may occur as a result of disease of the gastrointestinal tract or in association with pathologic states in other organs

 2. Heartburn Heartburn or pyrosis is a sensation of warmth or burning located substernally or high in the epigastrium. Experimental studies in human beings have shown that esophageal distention or increased motor activity is associated in most subjects with a feeling of fullness and burning in this area. Heartburn may occur with organic disease ofthe intestinal tract and is usually associated with gastroesophageal reflux. This is frequently the case in hiatus hernia

 3. Dysphagia Dysphagia or difficulty in swallowing is a most reliable symptom and indicates the presence of disease or dysfunction Dysphagia should never be dismissed as emotional disturbance or to be confused with globus hystericus, a term used to indicate the sensation of a lump or tightness in the throat independent of swallowing

 4. Flatulance A significant amount of flatus is passed each day by normal persons and the complaint of flatulence often reflects a heightened and embarassing awareness of this natural occurence. Many who complain of gas are in reality experiencing symptoms ascribable to disordered motility. Excessive passage of of intestinal gas may be the result of aerophagia or the formation of increased amounts of gas by intestinal bacteria.

 5. Anorexia Anorexia or loss of the desire to eat is a prominant symptom in a wide variety of intestinal and extraintestinal disorders. Anorexia occurs in many disorders and as a result by itself or of little specific diagnostic value. The mechanism whereby hunger and appetite are modified in variousdiseases are poorly understood. Anorexia is commonly seen in diseases of the gastrointestinal tract and the liver.

 6. Nausea, Vomiting and Retching Nausea and vomiting may occur independently of each other, but generally they are so closely allied that they may conveniently be considered together. Nausea denotes the feeling of imminent desire to vomit,usually referred to the throat or epigastrium. Vomiting refers to the forceful oral expulsion of gastric contents. Retching denotes the labored rhythmic respiratory activity that frequently precedes emesis. Nausea often precedes or accompanies vomiting. It is usually associated with diminished functional activity of the stomach and alterations of the motility of the duodenum and small intestine.

 7. Gastritis Gastritis may be associated with recent alcohol ingestion or with the use of anti-inflammatory drugs, such as aspirin or indomethicin. Another frequent setting is the development of gastric erosions in stressful situations such as following major trauma or surgery or in assocaition with severe systemic disease. The occurence of gastritis in burn victims and patients with increased intracranial pressure is also common.

  8. Diarrhea and Constipation The bowel habits of apparently healthy persons vary widely. For this reasoon, the term diarrhea and constipation have most meaning when viewed as a change from an individuals customary pattern. Reasonably detailed information is important in evaluating either abnormality. When patients complain of diarrhea, it is important to obtain an estimate of the volume as well as frequency of fecal output and in addition, to directly examine a stool for consistency, blood, oilness and malodor. The term constipation may be used by the patient to a variety of changes including reduction in frequency of defecation, a constant sensation of rectal fullness and incomplete evacuation of feces and sometimes painful defecation due to hard stools or perianal pathology

 9. Irritable bowel syndrome The irritable bowel syndrome (also referred to as spastic colon and mucous colitis ) is one of the most frequent gastrointestinal disorders. This condition is chracterized by periodic or chronic symptoms of diarrhea, constipation and abdominal pain. These symptoms are generally associated with psychologic stresses, but the anxiety produced by the bowel disturbance is sometimes regarded by the patient as the fundemental cause of emotional upset. Stools tend to be thin, fragmented or pelletlike and accompanied by excessive mucus and gas.

 10. Gastrointestinal Reflux Reflux of small amounts of gastric juice into the lower part of the esiphagus is a common event. Its frequency is increased by over indulgence.

Whether reflux occurs and whether it produces symptoms are determined by three factors

1. the competency of the lower esophageal sphincter , the primary barrier to reflux

2. the irriatant nature of the refuxed material and

3. the sensitivity of the esophageal mucosa to the refluxed material Although the symptoms of reflux were attributed in the past to inflammation of the esophagus ie esophagitis. It is clear that esophagitis is a complication of severe reflux rather than the cause of the symptoms associated with reflux.

 11. Reflux Oesophagitis Reflux esophagitis is inflammation of the esophageal mucosa caused by reflux of acid gastric or alkaline intestinal juice. Esophagitis is the prcursor of the complications of reflux, namely, bleeding, stricture and change in esophageal epithelium from squamous to columnar. Bleeding is slow and chronic. Acute massive bleeding occassionally occurs with esophagitis but is usually due to an associated peptic ulcer of the esophagus.

12. Peptic Ulcer - Zollinger- Ellison Syndrome Peptic ulcer is a term used to refer to a group of ulceratrive disorders of the upper gastrointestinal tract,which appears to have in common the participation of acid pepsin in their pathogensis. The major forms are chronic duodenal and gastric ulcer. The Zollinger-Ellison syndrome gastrinome may also be considered a form of peptic ulcer.

 13. Duodenal Ulcer Duodenal ulcer is a chronic and recurrent disease. The ulcer is usally deep and sharply demarcated. It tends to penetrate through the submucosa and often into the muscularis propria. The ulcer floor contains no intact epithelium and usually consists of a zone of eosinophilic necrosis resting on a base of granulation tissue surrounded by variable amounts of fibrosis. The ulcer bed may be clear or contain either blood or a proteinaceous exudate with entrapped erythrocytes and acute and chronic inflammatory cells.

 14. Gastric Ulcer Gastric ulcers, just like as duodenal ulcers, are more common in males. They are also histologically similar to duodenal ulcers. Gastric ulcers are characterstically deep, extending beyond the mucosa of the stomach. Almost all benign gastric ulcers are located in the antrum, in a zone immediaterly distal to the junction of the antral mucosa with the acid-secreting mucosa of the body of the stomach.

Use contraindicated . Observe caution