Primary prevention

Reduction of non-steroidal anti-inflammatory drug (NSAID) and alcohol use can reduce the incidence and severity of erosive gastritis.[31] Patients at increased risk for NSAID-related gastrointestinal (GI) complications include those with a prior history of a GI event (ulcer, haemorrhage), age over 60 years, high dosage of NSAIDs, and concurrent use of corticosteroids or anticoagulants.[22][23] Caution in the use of NSAIDs and careful monitoring of these patients is advised.[32] Critically ill patients are at risk of developing stress-induced GI bleeding.[9] The main risk factors for stress-induced GI bleeding are mechanical ventilation for >48 hours and the presence of a coagulopathy.[9] For patients at risk, prophylactic therapy with H₂ antagonists or a proton-pump inhibitor has demonstrated efficacy.[33] Sucralfate or misoprostol are alternative treatments to prevent stress ulcerations of the gastric mucosa in patients at risk.[9]

For patients undergoing gastric surgery for malignancy or peptic ulcer disease, use of a Roux-en-Y limb or isoperistaltic jejunal interposition procedure reduces the risk of iatrogenic bile-reflux gastritis and oesophagogastric injury.[5][8]

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