Treatment of acute gastritis

The treatment will slightly vary depending on the cause of the acute gastritis:

• Alcohol and food poisoning (and ingestion of other mildly toxic foods and liquids). In order to cleanse the stomach, the patient is asked to drink a couple of glasses of water, and then vomiting is induced. In mild cases this is the only method used; however, if the person is suffering from severe alcohol poisoning, a thick tube is used to thoroughly clean the stomach using warm water. It is also essential to cleanse the stomach as soon as possible, since after just two hours most of the alcohol would pass farther into duodenum, making the cleansing process pretty much useless.
• Bacterial infection. If the acute gastritis was caused by a bacterial infection, first of all the stomach has to be cleansed as soon as possible, by making the patient drink water and vomit it back, or, preferably, by using a thick tube. Next, the patient is treated using broad-spectrum antibiotics (to combat the bacteria) and detox therapy (which is aimed at the toxins produced by bacteria). It is important to note that a thick tube is much more preferable than the vomiting method, not only because it is easier to cleanse the stomach using a thick tube, but also because inducing vomiting can damage the mucous layer of the esophagus. This damage to the esophagus ranges from mild to very severe; thus, it is important keep in mind this side effect of self-induced vomiting.
• Ingestion of highly toxic substances. If the acute gastritis was caused by a highly toxic chemical agent (especially strong acids and bases), then a thick tube is inserted into the stomach (if it is not contraindicated to do so) through the mouth of the patient in order to thoroughly clean the stomach using warm water. Simultaneously, the patient is given analgesics and is treated to prevent acute circulatory collapse (which often happens in such cases). It is still debated whether it is wise to use light bases if the patient has ingested a strong acid, and light acids if the patients has ingested a strong base, in order to neutralize it. Studies show that this tactic often leads to perforation of the stomach’s wall, greatly worsening the condition of the patient.

Other recommendations

• The first few days the patient should rest in bed and avoid moving too much. If needed, bismuth subsalicylate can be prescribed to the patient for the course of 10 to 14 days.
• During severe cases of acute gastritis, if the vomiting does not subside, intravenous or subcutaneous infusions of isotonic solutions of sodium chloride are recommended.
• Surgical treatment in a form of gastrotomy (removal of a part of a stomach) and even gastrectomy (removal of a whole stomach) is the only method of treating suppurative (phlegmonous) gastritis, since the necrotic process cannot be reversed.

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.