Management of Stress Gastritis

Abstract

Management of stress gastritis is primarily directed toward prevention of gastrointestinal bleeding. Antacids and H2 blockers have been the standard agents used for prophylactic therapy in critically ill patients. However, growing evidence that gastric alkalization leads to an increased incidence of nosocomial pneumonias has led to the development of other prophylactic agents that do not decrease gastric acidity. These cytoprotective agents presumably enhance gastric mucosal defenses and stimulate mucosal repair. Approximately 3% of patients bleed despite prophylactic therapy. Bleeding is usually controlled with intensive medical management, and the need for surgical intervention is rare.