Indication

Gastritis is an inflammatory condition of the stomach and can be described as any clinical condition with upper abdominal discomfort like indigestion or dyspepsia. Antaj reduces the excess acid and inhibits the secretion of the excess acid thereby protecting the gastric mucosa from damage due to the same.

There are 2 types- 1) Acute and 2) Chronic

1) Acute gastritis also known as heamorrhagic or erosive gastritis, is a transient acute inflammatory involvement of the stomach, mainly mucosa.

Etiological factors are as follows

  • Diet and personal habits- highly spiced food, excessive alcohol consumption, malnutrition, heavy smoking and excessive coffee intake.
  • Infection- Bacterial(Helicobacter pylori, Diphtheria, Salmonellosis, Staphyloccocal food poisoning), Viral(Viral hepatitis, influenza, infectious mononucleosis)
  • Drugs- Aspirin, cortisone, indomethacin, preparation of iron, chemotherapeutic agents.
  • Chemical & Physiological agents- Intake of corrosive chemicals such as caustic soda, phenol, Lysol, gastric irradiation, freezing.
  • Severe stress- Emotional factors like shock, anger, resentment etc., extensive burns etc.

Sign and Symptoms

  • Mucosal damage results in either slow upper gastro-intestinal bleeding which can be detected as positive feacal occult blood test or can manifest as massive upper gastro-intestinal bleeding.
  • In some patients, epigastric discomfort anorexia, nausea may be seen.

Pathogenesis

  • Reduced blood flow- resulting in mucosal hypoperfusion due to ischeamia.
  • Increased acid secretion& its accumulation due to H.pylori infection resulting in damage to epithelial barrier.
  • Decreased production of bicarbonate buffer.

2) Chronic Gastritis-is the condition occurs more frequently with advancing age, average age for symptomatic chronic gastritis being 45 years which corresponds well with the age incidence of gastric ulcer.

Etiopathogensis

  • Reflux of duodenal contents into the stomach, especially in case who have undergone surgical intervention in the region of pylorus.
  • Associated disease of stomach & duodenum, such as gastric and duodenal ulcer, gastric carcinoma.
  • Chronic hypochromic anemia, especially associated with atrophic gastritis.
  • Immunological factors such as autoantibodies to gastric parietal cells in a trophic gastritis and auto antibodies against intrinsic factor.
  • Cytotoxic effect of the injurious agents on the gastric mucosal epithelium thus breaking the barrier and the inciting the inflammatory response.

Sign and Symptoms

Patient present with pernicious aneamia& Vit.B12deficiency. Complications if not treated on time- Peptic ulcer and in case of autoimmune chronic gastritis as it is a pre-malignant condition, it can progress to cancer. Dosage of Antaj in Gastritis(general and special conditions)

  • Gastritis - 2tsp. (10ml) or 1 tablet, three times a day (morning, afternoon, night) after meals.
  • Gastritis induced by insomnia and indigestion - 2tsp.(10ml) or 1 tablet, three times a day (morning, afternoon, night) before meals.
  • Fasting induced gastritis - 3tsp. (15ml) or 2 tablets, two times a day (morning before breakfast and night before dinner).

Peptic Ulcer are the areas of degeneration and necrosis of gastro-intestinal mucosa exposed to acid-peptic secretion.They most commonly occur in either the duodenum or stomach in the ratio of 4:1. Antaj protects the gastric mucosa from harmful effects of the gastric acid and promotes healing of damaged tissues.

1) Acute peptic ulcer(Stress ulcer) commonly multiple small mucosal erosions.

Etiology

  • Psychological stress
  • Physiological stress as in shock, severe trauma, septicemia, extensive burns(Curling’s ulcer), Intracranial lesions, drug intake(aspirin, steroids etc.)
  • Local irritants(alcohol, smoking, coffee etc.)

Pathogenesis(possible hypothesis for genesis of stress ulcers are)

  • Ischemic hypoxic injury to the mucosal cells.
  • Depletion of the gastric mucous “barrier” rendering the mucosa susceptible to attack by acid –peptic secretions.

2) Chronic peptic ulcer(Gastric & Duodenal ulcers) If not specified , Chronic peptic ulcers would mean gastric and duodenal ulcers, more frequently in middle-aged adults. The peak incidence for duodenal ulcer is 5th decade, while the gastric ulcer it is a decade later D.U. &G.U. are more common in males than in females, D.U. is 4 times more common than G.U.

Etiological factor

  • Helicobacter pylori gastritis
  • NSAID’s induced mucosal injury leading to direct toxicity, endothelial damage and epithelial injury to both gastric as well as duodenal mucosa.
  • Increased Acid-pepsin secretions, causes disturbance in normal protective mucosal barrier.
  • Gastritis
  • Other local irritants-heavily spiced foods, alcohol, cigarette smoking, unbuffered aspirin.
  • Dietary factors- G.U. is seen commonly in poor-economic strata, D.U. has increased incidence in south India.
  • Psychological factors- stress, anxiety, fatigue and ulcer type personality.
  • Genetic factor- blood group O are prone to peptic ulcer. D.U. has association with HLAB5 antigen.
  • Hormonal factor- secretions of certain hormones by tumors are associated with peptic ulceration eg. Elaboration of gastrin by islet-cell tumor in Zollinger-Ellison syndrome.
  • Miscellaneous- D.U. observed in association with alcoholic cirrhosis, CRF, hyper-parathyroidism, COPD and chronic pancreatitis.

Pathogenesis

  • Exposure to mucosa to gastric acid and pepsin secretion,
  • strong etiologic association with H.pyloris infection.

Sign and Symptoms of Peptic Ulcer

  • The clinical features of peptic ulcer vary considerably from complete absence of symptoms to life threatening hemorrhage.
  • Acid dyspepsia- gastric acid manifest as a burning pain or discomfort in the upper abdomen, usually the epigastrium, during empty stomach and relieved by food or alkalis. Pain occurs after 2 to 3 hrs. after food induced acid secretion persists but the buffering action of the food is gone.
  • Post prandial abdominal discomfort characterized by bloating, fullness or even nausea. Half of the cases show acid eruptions and heart burn.
  • D.U. classical characteristic pain so called periodicity or clustering of pain; manifest as periods of pain followed by days or weeks of symptoms of relief.
  • Increased in severity of pain radiation of the pain to theback,pallor, vomiting or bleeding should point to the development of complication.

Complications

  • Bleeding
  • Perforation (a hole through the wall of the stomach)
  • Gastric outlet obstruction from swelling or scarring that blocks the passageway leading from the stomach to the small intestine.

Dosage of Antaj in Peptic Ulcer- 2tsp. (10ml) or 1 tablet, three times a day (morning, afternoon, night) before meals.

Hyperacidity-is a condition in which the level of acid in the gastric juices is excessive, causing discomfort or excessive acidity of the gastrointestinal tract especially the stomach, producing a burning sensation. Antaj helps to alleviate this condition.

Dosage of Antaj in Hyperacidity- 2tsp. (10ml) or 1 tablet, twice a day (morning, night) after meals.

Flatulence is the accumulation of gas in the alimentary canal. It causes indigestion, constipation and IBS. Antaj releases gases downwards thus helps to release it.

Dosage of Antaj in Flatulence- 2tsp. (10ml) or 1 tablet, two times a day (morning, night) before meals.

Heart burn is the burning sensation felt in the chest, caused by acid regurgitation into the oesophagus. Antaj being coolant helps to reduce burning and gives a cooling effect.

Dosing of Antaj in Heart burn- 2tsp. (10ml) or 1 tablet, twice a day (morning, night) after meals.

Dyspepsia is disturbed digestion, which may be accompanied by symptoms such as nausea and vomiting, heartburn, bloating and stomach discomfort. With the help of digestive herbs present in Antaj, it works for indigestion.

Dosing of Antaj in Dyspepsia- 2tsp. (10ml) or 1 tablet, three times a day (morning, afternoon, night) after meals.

Excess and long term consumption of alcohol causes gastric irritation, mucosal damage, heartburn etc. that lead to gastritis.

There is the long-term increase in UK alcohol consumption since 1975, when average consumption per capita was 9 litres for the UK population older than 15 years and 6.9 litres on average as a whole whereas 10 litres per capita for those aged 15 years and older and 8.3 litres per capita on average throughout the entire population in 2011. General Lifestyle Survey (GLS), which provides a snapshot of the habits and attitudes of nearly 8,000 families and people living in private households in Great Britain states that

“Obtaining reliable information about drinking behavior is difficult, and social surveys consistently record lower levels of consumption than would be expected from data on alcohol sales. This is partly because people may consciously or unconsciously underestimate how much alcohol they consume. Drinking at home is particularly likely to be underestimated because the quantities consumed are not measured and are likely to be larger than those dispensed in licensed premises.”

Reference

1. Alcohol consumption factsheet, Updated August 2013, Institute of Alcohol Study, www.ias.org.uk

Dosage- Alcohol induced gastritis - 3tsp. (15ml) or 2 tablets, two times a day (morning empty stomach and night before dinner).

With more than 98 million prescriptions in 2012 in the U.S., according to IMS Health, a healthcare technology and information company, NSAIDs are one of the most commonly used classes of medications. The Arthritis, Rheumatism, and Aging Medical Information System estimates that adverse effects due to NSAIDs are responsible for more than 100,000 hospitalizations and more than 16,000 deaths in the U.S. each year1. Gastritis is the most common side effect of NASIDs.

Serious Risks Associated With NSAIDs2

Age Risk of GI bleeding each year Risk of dying from GI Bleeding each year

Risk in any one year is

16-44 1 in 2,100 1 in 12,353
45-64 1 in 646 1 in 3,800
65-74 1 in 570 1 in 3,353
>75 1 in 110 1 in 647
>G I stands for gastrointestinal.

Reference

1. Consumer Reports Best Buy Drugs, The Nonsteroidal Anti-Inflammatory Drugs: Treating Osteoarthritis and Pain.

2. Source: Blower A, Brooks A, Fenn G, Hill A, Pearce M, Morant S. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharm Ther. 1997(11):283291.

Dosage- Adjuvant with anti-inflammatory and analgesic medications for the gastritis side-effect - 2tsp. (10ml) or 1 tablet, two times a day, before meals.

Eating fast food has become a trend now, not only young stars but childrens and adults are too crazy for these foods! Excess and continuous habit of fast food leads to gastritis.

Roberto De Vogli et al., carried study between 1999 and 2008, and found that the average number of annual fast food transactions per capita had been increased from 26.61 to 32.76. During the same period, age-standardized mean BMI increased from 25.8 to 26.4 kg/m2. There was a strong and positive association between fast food consumption and age-standardized mean BMI (unadjusted r = 0.658; P < 0.001). When considering changes between 1999 and 2008 (Fig. 1), the average annual number of fast food transactions per capita was positively associated with age-standardized mean BMI (unadjusted r = 0.503; P < 0.01). The highest increases in the average number of annual fast food transactions per capita were observed in Canada (16.6), Australia (14.7), Ireland (12.3) and New Zealand (10.1), while the lowest increases occurred in Italy (1.5), Greece (1.9), the Netherlands (1.8) and Belgium (2.1)1.

Reference

1. Roberto De Vogli et al., The influence of market deregulation on fast food consumption and body mass index: a cross-national time series analysis

Dosage- Gastritis induced by Fast food consumption habit- 2tsp. (10ml) or 1 tablet, two times a day, after meals.

GERD is the most common oesophageal disorder, accounting for nearly 75% of all patients with oesophageal disorders. In Western studies, 15% to 20% of the general population suffers from GORD. The prevalence of GORD in Asia is lower (2.3% to 8%), probably due to higher prevalence of Helicobacter pylori, lower body mass index, low fat consumption in diet and genetic diversity1.

Following findings show the trend of GERD in United States over the period

  • Sixty percent of the adult population will experience some type of gastroesophageal reflux disease (GERD) within a 12 month period and 20 to 30 percent will have weekly symptoms3.
  • Approximately seven million people in the United States have some symptoms of GERD4.
  • In 2004, approximately 20 percent of the United States population reported reflux symptoms that occurred at least weekly5.
  • Yearly hospitalizations with obesity diagnoses increased in the United States by 112 percent between 1996 and 2004. Obesity is linked to the development of GERD and frequency of symptoms3.
  • Primary or secondary GERD diagnosis increased by an unprecedented 216 percent or from a total of 995,402 individuals diagnosed in 1998 to 3,141,965 in 20053.
  • Hospital stays for people with Primary GERD diagnoses and below median income levels rose by approximately 31 percent between 1998 and 20053.

References

  1. API Text book of Medicine, editor in chief-Y.P.Munjal, 9th edition.
  2. Shobna J. Bhatia et al., Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: Report of the Indian Society of Gastroenterology Task Force. Indian J Gastroenterol (May–June 2011) 30(3):118–127 DOI 10.1007/s12664-011-0112-x.
  3. Gastroesophageal Reflux Disease (GERD) Hospitalizations in 1998 and 2005 - HCUP-US Home Page. Retrieved March 5, 2012, from: http://www.hcup-us.ahrq.gov/reports/statbriefs/sb44.jsp
  4. Gastroesophageal Reflux Disease (GERD). (n.d.). Office of Medical Informatics - College of Medicine – University of Florida. Retrieved March 5, 2012, from: http://medinfo.ufl.edu/~gec/coa1/gerdfaq.html
  5. Digestive Diseases Statistics for the United States - National Digestive Diseases Information Clearninghouse. (n.d.). Home - National Digestive Diseases Information Clearninghouse.

Dosage in GERD- 3tsp. (15ml) or 2 tablets, two times a day (morning before breakfast and night before dinner).

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