SECTION II Review of Literature

A. Definition
Gastritis is inflammation of the gastric mucosa which can be acute chronic, diffuse or localized. (Soepaman, 1998). Gastritis is inflammation of the gastric mucosa (MansjoerArif, 1999). Gastritis is inflammation of the gastric mucosa (Sjamsuhidajat, R, 1998). Based on the definition above authors concluded that Gastritis is an inflammation of gastric mucosa which can be acute, chronic, diffuse or localized.

B. Ethiology
The classification from gastritis symptom 1. Predispotition factors : that is analagesik, anti inflamation, aspirin. 2. Low Dosis Aspirin can make erotion gaster mucose. 3. Chemistry material factors: Lysol, Alcohol, Kafein, Steroid and digitalis to annoyance blood micro sirculation 4. Alcohol and cigarette 5. Heavy stess (secunder) cause on fire, disaster, and surgery 6. Infection bacterial gastritis of out body.

C. Patofisiologi
Erosive gastritis is a gastric mucosal erosion caused by damage to mucosal defenses. Alcohol consumption does not cause chronic gastritis. Chronic gastritis refers to a wide range of problems of the gastric tissues that are the result of H. pylori infection. The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining. In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis. Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn's disease, certain connective tissue disorders, and liver or kidney failure.

D. Clinical Manifestation
Clinical manifestations usually appear anorexia, nausea, vomiting, epigastric pain, gastrointestinal bleeding in Haematemesis melena, a further sign of anemia. a) Autoimmune gastritis: The clinical manifestations are primarily related to the deficiency in cobalamin, which is not adequately absorbed because of IF deficiency as a result of severe gastric parietal cell atrophy. The disease has an insidious onset and progresses slowly. Cobalamin deficiency affects the hematologic, gastrointestinal, and neurologic systems. b) Hematologic manifestations: The most significant manifestation is megaloblastic anemia, but, rarely, purpura due to thrombocytopenia may develop. Symptoms of anemia include weakness, light-headedness, vertigo and tinnitus, palpitations, angina, and symptoms of congestive failure. c) Gastrointestinal manifestations: The lack of cobalamin is associated with

megaloblastosis of the gastrointestinal tract epithelium. Patients sometimes report having a sore tongue. Anorexia with moderate weight loss that is occasionally

associated with diarrhea may result from malabsorption associated with megaloblastic changes of the small intestinal epithelial cells. d) Neurologic manifestations: These result from demyelination, followed by axonal degeneration and neuronal death. The affected sites include peripheral nerves, posterior and lateral columns of the spinal cord, and cerebrum. Signs and symptoms include numbness and paresthesias in the extremities, weakness, and ataxia. Sphincter disturbances may occur. Mental function disturbances vary from mild irritability to severe dementia or psychosis. The neurologic disease may occur in a patient with hematocrit and red cell parameters within the reference range.

E. Classification
Causes of Gastritis can be distinguished according to the classification as follows: a) Acute gastritis The reason is analgesic drugs, especially anti-inflammatory aspirin (low dose of aspirin can cause erosion had gastric mucosa). Chemicals eglisol, alcohol, smoking, caffeine pepper, steroids and digitalis. b) Chronic gastritis The cause and pathogenesis are generally unknown. Gastritis is a common occurrence in the elderly, but the suspect in drinkers of alcohol, and smoking.