Gastrointestinal System Disorders Q 297

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Which of the following substances is most likely to cause gastritis?

  

    A. Milk

    B. Bicarbonate of soda, or baking soda

    C. Enteric-coated aspirin

    D. Nonsteroidal anti-inflammatory drugs

    

    

Correct Answer: D. Nonsteroidal anti-inflammatory drugs

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NSAIDs are a common cause of gastritis because they inhibit prostaglandin synthesis. When NSAIDs irritate the gastric mucosa, they weaken the resistance to acid, causing gastritis, ulcers, bleeding, or perforation. The damage ranges from superficial injury to single or multiple ulcers, some of which may bleed. Suppression of prostaglandin synthesis can occur systemically with both oral and parenteral NSAID therapy. The antiplatelet activity of some NSAIDs in low doses may cause bleeding from preexisting ulcers

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Option A: Milk, once thought to help gastritis, has little effect on the stomach mucosa. Studies on certain ingredients found in high concentrations in milk, such as calcium and amino acids, have suggested that milk may be harmful to ulcer patients because of its potential to directly stimulate acid secretion. Therapeutic endeavors have therefore aimed at reducing gastric acid secretion or neutralizing its effect.

Option B: Bicarbonate of soda, or baking soda, may be used to neutralize stomach acid, but it should be used cautiously because it may lead to metabolic acidosis. The Canadian Society of Intestinal Research reminds people that baking soda is a temporary solution to acid reflux. They advise people that sodium bicarbonate is available from a pharmacy in the form of tablets and effervescent powder.

Option C: ASA with enteric coating shouldn’t contribute significantly to gastritis because the coating limits the aspirin’s effect on the gastric mucosa. Enteric-coated aspirin is designed to resist dissolving and being absorbed in the stomach. As such, enteric-coated aspirin passes into the small intestine, where it’s absorbed into the bloodstream. The purported goal is to prevent stomach ulcers and bleeding that can sometimes occur with aspirin use.

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