GASTRITIS
Wet gangrene develops when an area of
dry gangrene, or a wound, becomes
infected by
bacteria
.
Redness, swelling,
and oozing pus may occur around the
blackened tissues. The gangrene spreads,
and the area gives off an unpleasant
smell. A virulent type called
gas gangrene
is due to a bacterium that destroys mus-
cles and produces a foul-smelling gas.
TREATMENT
Treatment of dry gangrene involves at-
tempting to improve the circulation to
the affected area before the tissues die.
Antibiotic drugs
can prevent wet gan-
grene from setting in.
To treat wet gangrene,
amputation
of
the affected part and the surrounding
tissue may be necessary.
Ganser’s syndrome
A rare
factitious disorder
in w hich an
individual seeks, either consciously or
unconsciously, to mislead others about
his or her mental state and may sim u-
late symptoms of
psychosis
.
Gardnerella vaginalis
A
bacterium
that
is
often
found
in
the vaginal discharge of women with
bacterial vaginosis
.
gargle
A liquid preparation to wash and freshen
the mouth and throat. Some gargles
contain
antiseptics
or local
anaesthetics
to relieve sore throats.
gargoylism
Another name for
Hurler’s syndrome
,
in
w hich the facial features are coarsened.
gas-and-air
A mixture of
nitrous oxide
and
oxygen
that is mainly used for temporary pain
relief in emergencies or during
labour
.
gas gangrene
A rare but life-threatening
form
of
gangrene
(tissue death), usually due to
infection by the bacterium C
i o s t r i d i u m
p e r f r i n g e n s
. This
organism
thrives
in
anaerobic
environments, where there is
little or no oxygen, such as dying tissue.
Gas gangrene develops suddenly and
normally occurs at the site of a recent,
serious wound. The bacteria multiply in
the damaged tissue, producing toxins
that release a gas, and spread incredibly
rapidly to healthy tissue.
The affected area is swollen and pain-
ful,
and
pale
or
reddish-brown
in
colour.
Gas
collects
in
the
tissues,
causing a crackling sensation if the area
is pressed. Other symptoms that develop
early in the infection include sweating,
fever, and anxiety. If left untreated, the
condition may lead to
shock
(failure of
blood circulation),
kidney failure
,
coma
,
and even death.
Penicillin drugs
destroy the bacteria at
the edges of the gangrene, but all of the
diseased tissue needs to be surgically
removed.
Amputation
of an affected limb
may be required, in some cases, to con-
trol the spread of infection.
Hyperbaric
oxygen treatment
,
in w hich the patient is
exposed to oxygen at high pressure,
may help to kill the bacteria.
gastrectomy
Removal of the whole
stomach
(total
gastrectomy) or of part of the stomach
(partial gastrectomy). Total gastrectomy
is used to treat some
stomach cancers
.
Partial gastrectomy used to be a treat-
ment for
peptic ulcers
(ulcers of the
stomach or duodenum) but has largely
been replaced by drug treatment.
A person who has had a gastrectomy
may experience fullness and discomfort
after meals. Possible postoperative com-
plications include the regurgitation or
vomiting of
bile
,
w hich may lead to
inflammation of the stomach or the
oesophagus;
diarrhoea; and
dumping
syndrome
(sweating, nausea, dizziness,
and weakness after meals, due to food
leaving the stomach too quickly). Other
complications include
malabsorption
(a
reduced ability to absorb nutrients),
w hich may lead to
anaemia
or
osteoporo-
sis
(loss of bone density). After a total
gastrectomy, patients cannot absorb vit-
amin B
12
and need injections of the
vitamin for the rest of their lives.
gastric erosion
A break in the surface layer of the mem-
brane that lines the
stomach
.
Gastric
erosions occur in some cases of
gastritis
(inflammation of the stomach lining).
Many result from ingestion of irritants
such as
alcohol
,
iron
tablets, or
aspirin
.
The physical stress of serious illness,
injuries such as
burns
,
or major surgery
may also cause erosions to develop.
Often there are no symptoms, but
erosions may bleed, causing
vomiting of
blood
or blood in the faeces. Persistent
loss of blood may lead to
anaemia
.
Gastric erosions
are
diagnosed by
gastroscopy
(inspection and examination
of the stomach via a flexible viewing
instrument; an endoscope).
They usually heal in a few days when
treated with antacid drugs, H 2-receptor
antagonists, or proton pump inhibitors
(see
ulcer-healing drugs
) .
Drugs
that
block the production of stomach acid
are often given to people who are at
high risk of developing erosions, such
as those receiving
intensive care
.
gastric lavage
See
lavage, gastric
.
gastric ulcer
A raw area in the
stomach
wall caused
by a breach of the lining (see
gastric ero-
sion
) that penetrates into the tissues. A
gastric ulcer is a type of
peptic ulcer
(ulcer of the stomach or duodenum).
gastrin
A
hormone
produced by cells in the
stomach
lining. Gastrin causes the stom-
ach to produce more acid and helps to
propel food through the digestive tract.
(See also
gastrointestinal hormones
. )
gastritis
Inflammation
of the
stomach
lining due
to irritation of the tissues. The condition
may be
acute
or
chronic
.
Acute gastritis may be due to infection
w ith the H
e e i c o b a c t e r
p y e o r i
bacterium.
It may also be caused by drugs, usually
nonsteroidal anti-inflammatory drugs
such
as
aspirin
;
alcohol
;
or severe physical
stress, such as
burns
or major surgery.
Chronic gastritis is most often due to
H.
p y e o r i
infection but may be due to
prolonged irritation by
smoking
,
alco-
hol, or
bile
;
by an
autoimmune disorder
that damages the stomach lining (see
anaemia, megaloblastic
) ;
or by degenera-
tion of the lining with age.
Symptoms include discomfort in the
upper abdomen, nausea, and vomiting.
In acute gastritis, the faeces may be
blackened by blood lost from the stom-
ach (see
melaena
) ;
in chronic gastritis,
slow blood loss may lead to anaemia
(see
anaemia, iron-deficiency
) ,
resulting
in symptoms such as pallor, tiredness
and breathlessness.
Diagnosis of gastritis is made through
gastroscopy
(examination of the stomach
lining with a flexible viewing instru-
ment), during w hich a
biopsy
(removal
of a tissue sample for analysis) may be
performed.
Ulcer-healing drugs
and
anti-
biotics
may be prescribed to treat H.
p y e o r i
infection. Anaemia w ill be treated.
There is no treatment for gastritis due
to an autoimmune disorder, however.
G
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