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Diagnosis of acute gastritis

Diagnosis is mainly based on the clinical picture and anamnesis. The latter plays a very important role since acute gastritis can often be diagnosed in a group of people that, for example, ate the same food; or in case of an acute corrosive gastritis, the members of the family can be asked whether they have any poisonous substances, strong bases or acids in their house.

It is also important to find out whether the patient has suffered from angina pectoris in the past, so as not to confuse heart attack with acute gastritis (since a heart attack is often accompanied by the pain in the epigastric region, nausea and vomiting).

Other methods for making a diagnosis

Examination of the oral cavity

  • Examination of the oral cavity – this is important since the cause of the acute gastritis can sometimes be identified judging by its state. For example, the ingestion of hydrochloric acid leads to a formation of white incrustation on the base of the tongue; nitric acid causes a yellow incrustation, while sulfuric acid creates a black incrustation. Ingestion of strong bases leads to a necrosis of the mucous layer, substantial swelling and brownish/greyish incrustation.
  • Gastroscopy – during this procedure an endoscope is passed down through the esophagus into the stomach in order to assess the magnitude of damage. This is done to find out if there is any bleeding, figure out the type of gastritis and the type of therapy that the condition of the patient calls for.
  • Electrocardiography – due to the fact that the clinical picture of a heart attack and acute gastritis can often be identical, it is essential to conduct an electrocardiography in order to differentiate between the two.
  • Stool test for bleeding – this test is also called guaiac fecal occult blood test. This test can detect blood in fecal matter, even if it cannot be seen. It uses a special paper surface with a phenolic compound. This test is usually used after the treatment of acute gastritis to detect any hidden (occult) bleeding.
  • Complete blood count – this test is used to determine the concentration of white blood cells, red blood cells, and platelets that are circulating in patient’s blood stream. This test allows to detect anemia (red blood cell count is lower than normal), or an inflammatory process (raised levels of leucocytes). It can also detect an allergic reaction (raised levels of eosinophil granulocytes).

Prognosis

In most cases prognosis for acute gastritis is good if the stomach was cleansed in time and the right treatment was prescribed. However, acute gastritis caused by ingestion of highly toxic substances can often lead to irreversible effects not only in the stomach itself by also in the esophagus. Most commonly in such cases a vast amount of scar tissue develops, creating strictures and making it hard or impossible for the food to pass through. Prognosis for suppurative (phlegmonous) gastritis is not good and calls for a surgical removal of a part or of the whole stomach.