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Emphysematous Gastritis-Causes, Symptoms, Diagnosis and Treatment

What is Emphysematous Gastritis?

Emphysematous gastritis is the inflammation of the stomach that occurs when the gas-producing organism colonizes the stomach and the digestive tract. This condition is also known as gastric pneumonitis.(1) The risk of this condition increases with long-term use of nonsteroidal anti-inflammatory drugs, corticosteroids, and medical conditions including kidney disease, alcoholism, diabetes, and recent stomach surgery.

Emphysematous gastritis is a very dangerous condition and the death rate is 60%.(2) People with this condition require emergency treatment.

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Emphysematous gastritis causes systemic illnesses and can affect the heart, lungs, circulation, and organs including the kidney and liver.

It is different from gastric emphysema as gastric emphysema is a benign condition and occurs when there is gas in the stomach wall. Emphysematous gastritis occurs when infection in the stomach causes gas.

What Causes Emphysematous Gastritis?

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Emphysematous gastritis occurs when the lining of the stomach is colonized by microorganisms that release gas.(1) It occurs when through injury, the organism enters the stomach wall.

Therefore, the major risk factors of emphysematous gastritis are injuries, surgeries, excessive drinking, infections, and ulcers. Drugs that increase the risk of ulcers and stomach bleeding such as non-steroidal anti-inflammatories also elevate the risk.

Symptoms of Emphysematous Gastritis

The symptoms of emphysematous gastritis are non-specific. They occur with other different illnesses. The absence of some of the symptoms does not rule out the existence of the condition.

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The symptoms of emphysematous gastritis include:

  • Signs of systemic illness, including rapid heart rate and low blood pressure
  • Signs of organ failure
  • Vomiting, nausea and diarrhea
  • Feeling of sickness
  • Pain in the stomach that worsens and leads to severe illness

If a person has intense stomach pain that does not get better quickly and further leads to rapid heart rate, should seek help from a doctor. The symptoms of emphysematous gastritis worsen without treatment and can become life-threatening.

How to Diagnose Emphysematous Gastritis?

Emphysematous gastritis cannot be diagnosed with symptoms alone, because the symptoms are nonspecific and could indicate various medical conditions.

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Imaging scans are recommended if the person has an intense stomach ache and the symptoms point toward some serious illness.

A CT scan shows gas in the stomach and also in the surrounding veins and looping or obstruction of the intestine.

A culture done of the fluid from the stomach may reveal the bacteria that release gas.(3) Also, blood work may be performed that might reveal signs of inflammation.

Treatment of Emphysematous Gastritis

There is no targeted treatment for emphysematous gastritis.

Surgery is recommended by the doctors to look for injuries and to remove the blockages and damaged tissues. However, it is known that the surgery in this condition may pose risk as the people experiencing it may be elderly with many other health concerns. A study done in 2020 reported decrease in surgery for emphysematous gastritis is correlated with a decrease in death.(3)

There is newer evidence that suggests, conservative treatment is more effective for emphysematous gastritis as they treat and manage symptoms as they arise.

In 2019 a study was done on 3 people with emphysematous gastritis and a detailed history of the case was noted. These people were given proton pump inhibitors, intravenous fluids, and antibiotics while being monitored in the hospital. All three of them avoided eating or drinking while the treatment was being carried on. All of them survived despite being older adults.(1)

Outlook for Emphysematous Gastritis

The outlook for emphysematous gastritis is not good. A delayed diagnosis can lead to death in 60 percent of cases. There are many underlying conditions associated with it that can make recovery difficult and surgery dangerous.

Emerging studies suggest conservative management of this condition has positive results.

Emphysematous gastritis is a life-threatening condition and requires immediate medical attention. People who get stomach pain after a procedure or experience stomach symptoms with other comorbidities such as diabetes should seek immediate medical help.

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