Case report of acute gastritis

Dr Nidhi H Dave

A 21 year old male patient , presented with 7 days history of low grade fever with severe profuse vomiting; epigastric & lt hypochondriac pain which was < by touch, < after eating and drinking warm liquids; & generalized weakness, aversion to food, milk.

7 days ago, prior coming to hospital, patient was presented with same complaints to general practitioner & was maltreated with antibiotics. ( the exact component of antibiotic is unknown as it was given in loose packing)

All complaints were > after Eructation, Vomiting. Desire for fanning distantly. Cannot bear tight bandage around waist with or without pains.

Rapid antigen test for Covid-19 was negative.

Even though taken medicines for 5 days, patient didn’t improved. The complaints were standstill.

Patient came to Sainath hospital on 7^th day of onset of his complaints.

On Physical Examination,

• Pulse- 110/min
• BP- 100/70 mmHg
• Temprature-101.1 F
• sPO2- 96% on air
• Ill Look++
• No cyanosis/ No pallor/ No icterus
• P/A:- soft; Tender++ on epigastric, lt hypochondriac region
• RS/ CVS- clear

Lab Investigation:- (on admission)

Leucocytosis with PMN prominence seen. 

Patient was asked for USG-abdomen to confirm the diagnosis of acute gastriis. But patient refused for USG due to some financial issues.

Thus, patient was diagnosed as Acute gastritis clinically & he was advised to hospitalized for 24-48 hours.

He was given IV fluids (1 lit) on the day of admission.

(i.e. 500 ml NS & 500 ml RL) in order to maintain hydration, along with homoeopathic medication.

On the day of admission,

A stat dose of PSORAINUM 1M was given in a cup of warm water;

Which was followed by CARBO VEG 30, QDS ; 4 pills in a cup of warm water, for 1 day.

After medication,

4PM On same day (after an hour of admission 27/10/2020):	Pulse-90/min BP-110/70 mmHg Temprature-99.1 F sPO2- 98% on air No vomiting after administration of medicines; Abdominal pain reduced by 10%, as per patient; but still pain + Patient took half cup of tea with parle g biscuits. Weakness+
8 PM On same day (after an hour of admission 27/10/2020):	Pulse- 84/min BP-110/70 mmHg Temprature-98.7 F sPO2- 98% on air No Vomiting/ no pain in abdomen even after taking food. Stool passed once; semi solid in consistency. Weakness+ No fresh complaints.

28/10/2020:

8 AM:	Pulse-74/min BP-110/70 mmHg Temprature- 98.1 F sPO2- 99% on air No vomiting since last night No epigastric tenderness/ pain. Stool has passed once, semi solid in consistency, satisfactory. In general, patient feels better. No fresh complaints. I/O- 1500/1000 Adv- repeat CBC at 3 PM (after 24 hours of admission)
12 PM:	Pulse-82/min BP-110/70 mmHg Temprature- 98 F sPO2- 99% on air No vomiting after admission. No epigastric tenderness/ pain. In general, patient feels better. No fresh complaints. Adv- repeat CBC at 3 PM (after 24 hours of admission)
4PM:	Pulse-88/min BP-122/80 mmHg Temprature- 98.2 F sPO2- 99% on air No vomiting after admission. No epigastric tenderness/ pain. In general, patient feels better. No fresh complaints.
8 PM:	Pulse-86/min BP-110/80 mmHg Temprature- 98 F sPO2- 99% on air No vomiting after admission. No epigastric tenderness/ pain. In general, patient feels better. No fresh complaints.

29/10/2020:

8 AM:	Pulse-88/min BP-120/70 mmHg Temprature- 98.7 F sPO2- 99% on air No vomiting after admission. No epigastric tenderness/ pain. In general, patient feels better. No fresh complaints.
12PM:	Pulse-90/min BP-120/80 mmHg Temprature- 98.4 F sPO2- 99% on air In general, patient feels better. No fresh complaints.
4 PM:	Pulse-78/min BP-120/80 mmHg Temprature- 98.1 F sPO2- 99% on air In general, patient feels better. No fresh complaints. Adv- Discharge.

Comparative table of CBC is shown below.

( values of both the reports were rechecked in aabha pathology lab & elegance pathology lab, bopal)

	27/10/2020	28/10/2020
Hb	14.8	11.4
Total WBC count	20,000	5100
Differential WBC count	86/10/2/2/0	62/33/3/3/0
Platelate	2.37k	2.19k
ESR	20	–
SGPT	30.60	–
S. creatinine	1.16	–
Urine R & M	Nil	–

DISCUSSION:-
Acute gastritis is a term that encompasses a broad spectrum of entities that induce Inflammatory changes in gastric mucosa. The inflammation may involve the entire stomach (e.g. pangastritis) or a region of the stomach (eg- antral gastritis).

Acute gastritis may present with an array of symptoms. The most common being non descript epigastric discomfort. Other symptom may include-

• Fever with chills
• Nausea
• Vomiting
• Anoraxia
• Belching
• Bloating in abdomen

The diagnosis may be suspected from the history of the patient and can be confirmed histologically by biopsy taken from endoscopy.

Common causes of gastritis includes-

• Drugs
• Potent alcohol beverages
• Bacterial infections
• Viral infections
• Fungal infections
• Parasitic infections
• Acute stress
• Radiation
• Allergy
• Food poisoning
• Bile
• Ischaemia
• Direct trauma

Our patient was diagnosed as acute gastritis clinically & treated homoeopathically.

Here, a dose of psorainum 1M was given as anti- psoric medicine. (Aphorism 240)¹

CONCLUSION:-
Homoeopathic treatment played a major role to get rid of infection & cure in this case, instead of antibiotic regime. The result appeared to be well improved accordingly. In this case, 24 hour monitering played major role in order to observe improvement.

This shows that, as per aphorism 2,

With homoeopathic treatment, recovery ensues in most rapid, gentle way if selected  medicine is similimum & with proper posology. 

REFERENCE:-

1. Hahnemann S. Organon of medicine. B. Jain Publishers; 2002.