Gastritis Pain Characteristics
None of the listed options (A-D) are typical of gastritis. Gastritis typically presents with epigastric pain or discomfort that worsens after eating, not with the specific patterns described in these answer choices 1, 2.
Why Each Option is Incorrect
Option A: Pain worse on drinking warm milk
- This is atypical for gastritis. Gastritis pain characteristically worsens after eating, but warm milk specifically is not a recognized aggravating factor 1.
- In fact, gastritis often presents with nonspecific dyspeptic symptoms rather than food-specific triggers 2, 3.
Option B: Pain which wakes the child from sleep
- This pattern is more suggestive of peptic ulcer disease, not gastritis. Nocturnal pain awakening patients from sleep is a classic feature of duodenal ulcers 1.
- Gastritis is typically asymptomatic or presents with daytime postprandial discomfort 4, 2.
Option C: Pain worse first thing in the morning and relieved by eating
- This is characteristic of duodenal ulcer, not gastritis. The pattern of fasting pain relieved by food intake suggests acid-related ulcer disease 1.
- Gastritis pain typically worsens after eating, not improves with eating 1, 2.
Option D: Pain going through to the back
- This is characteristic of pancreatic disease or posterior penetrating peptic ulcers, not gastritis. Radiation of pain to the back suggests deeper pathology beyond the gastric mucosa 1.
- Gastritis pain remains localized to the epigastrium without radiation 1, 2.
Actual Typical Features of Gastritis
The characteristic presentation of gastritis includes:
- Epigastric pain or discomfort that worsens after eating 1, 2
- Early satiety and postprandial fullness 1, 2
- Nausea and vomiting 1
- Bloating and abdominal distension 1
- Heartburn or acid reflux symptoms 1
- Often asymptomatic, especially in early stages 4, 2, 3
Critical Clinical Pitfall
The most important pitfall is that gastritis is frequently asymptomatic and does not constitute a distinct clinical syndrome based on symptoms alone 4, 3. Studies demonstrate no correlation between upper abdominal dyspepsia symptoms and histological gastritis 3. When symptoms do occur, they are nonspecific and overlap significantly with functional dyspepsia 2, 3.