Gastritis: Difference between revisions
(Created page with "Gastritis is the inflammation of the stomach. There are many causes of gastritis, and some are very common. Atrophic gastritis is a common type, in which atrophy and later intestinal metaplasia of the gastric mucosa occurs. Gastritis may predispose to peptic ulcer disease and gastric cancer. In some conditions commonly referred to as gastritis there is no inflammation, and so the term ''gastropathy'' is more appropriate. H. pylori is the most common cause of gastritis,...") |
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Gastritis is the inflammation of the stomach. There are many causes of gastritis, and some are very common. Atrophic gastritis is a common type, in which atrophy and later intestinal metaplasia of the gastric mucosa occurs. Gastritis may predispose to peptic ulcer disease and gastric cancer. | '''Gastritis''' is the inflammation of the stomach. There are many causes of gastritis, and some are very common. '''Atrophic gastritis''' is a common type, in which atrophy and later intestinal metaplasia of the gastric mucosa occurs. Gastritis may predispose to peptic ulcer disease and gastric cancer. | ||
In some conditions commonly referred to as gastritis there is no inflammation, and so the term ''gastropathy'' is more appropriate. | In some conditions commonly referred to as gastritis there is no inflammation, and so the term ''gastropathy'' is more appropriate. | ||
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* Atrophic gastritis | * Atrophic gastritis | ||
** Autoimmune metaplastic atrophic gastritis (AMAG) | ** Autoimmune metaplastic atrophic gastritis (AMAG) | ||
** Environmental metaplastic atrophic gastritis (EMAG) = helicobacter pylori gastritis | ** [[Helicobacter pylori gastritis|Environmental metaplastic atrophic gastritis]] (EMAG) = helicobacter pylori gastritis | ||
* Reactive/regenerative gastropathy/gastritis = chemical gastritis | * Reactive/regenerative gastropathy/gastritis = chemical gastritis | ||
** Chronic NSAID use | ** Chronic NSAID use | ||
| Line 44: | Line 44: | ||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
Gastritis is a histological diagnosis and therefore requires endoscopy with biopsy for proper diagnosis. However, H. pylori is the most common cause of gastritis and can be diagnosed without biopsy. If H. pylori has been ruled out, biopsy might be required. | Gastritis is a histological diagnosis and therefore requires [[Upper endoscopy|endoscopy]] with biopsy for proper diagnosis. However, H. pylori is the most common cause of gastritis and can be diagnosed without biopsy. If H. pylori has been ruled out, biopsy might be required. | ||
The mucosa often looks normal macroscopically. The histological findings depend on the cause: | The mucosa often looks normal macroscopically. The histological findings depend on the cause: | ||
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== Treatment == | == Treatment == | ||
PPIs and other anti-acid drugs may be used for symptomatic relief. Specific treatment is aimed at avoiding risk factors and treating the underlying cause if present. AMAG requires regular parenteral vitamin B12 supplements to prevent deficiency. | [[PPI|PPIs]] and other anti-acid drugs may be used for symptomatic relief. Specific treatment is aimed at avoiding risk factors and treating the underlying cause if present. AMAG requires regular parenteral [[Vitamin B12 supplement|vitamin B12 supplements]] to prevent deficiency. | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Revision as of 12:24, 27 October 2023
Gastritis is the inflammation of the stomach. There are many causes of gastritis, and some are very common. Atrophic gastritis is a common type, in which atrophy and later intestinal metaplasia of the gastric mucosa occurs. Gastritis may predispose to peptic ulcer disease and gastric cancer.
In some conditions commonly referred to as gastritis there is no inflammation, and so the term gastropathy is more appropriate.
H. pylori is the most common cause of gastritis, so-called helicobacter pylori gastritis.
Etiology and types
- Acute haemorrhagic erosive gastropathy = erosive gastritis
- NSAIDs
- Alcohol
- Smoking
- Critical illness (sepsis, ICU, trauma)
- Hypovolaemia
- Atrophic gastritis
- Autoimmune metaplastic atrophic gastritis (AMAG)
- Environmental metaplastic atrophic gastritis (EMAG) = helicobacter pylori gastritis
- Reactive/regenerative gastropathy/gastritis = chemical gastritis
- Chronic NSAID use
- Alcoholism
- Bile acid or pancreatic juice reflux
- “D” gastritis
- Viral, bacterial, yeast infection
- Allergy
- Granulomatous disease
- +++
Acute haemorrhagic erosive gastropathy refers to the acute development of multiple haemorrhagic erosive lesions in the stomach. It occurs when the balance of aggressive and protective factors tips in favour of aggressive factors.
Autoimmune metaplastic atrophic gastritis is an autoimmune disorder caused by idiopathic autoantibodies against parietal cells or intrinsic factor leading to atrophic gastritis. It may lead to B12 deficiency, in which case it’s known as pernicious anaemia.
Reactive gastropathy is a chronic gastropathy caused by long-term exposure to chemicals which injure the mucosa.
Clinical features
Many cases of gastritis are asymptomatic. Typical symptoms include:
- Dyspepsia (epigastric pain and discomfort in relation to food intake)
- Early satiety
- Bloating
- Epigastric tenderness
- Weight loss
Acute haemorrhagic erosive gastropathy can cause additional symptoms, like occult blood loss, heartburn, and haematemesis.
Diagnosis and evaluation
Gastritis is a histological diagnosis and therefore requires endoscopy with biopsy for proper diagnosis. However, H. pylori is the most common cause of gastritis and can be diagnosed without biopsy. If H. pylori has been ruled out, biopsy might be required.
The mucosa often looks normal macroscopically. The histological findings depend on the cause:
- Atrophic gastritis – chronic inflammation, atrophy, and metaplasia
- Acute haemorrhagic erosive gastropathy – erosions are present
- Reactive gastropathy – foveolar and smooth muscle hypoplasia, congestion, oedema,
Treatment
PPIs and other anti-acid drugs may be used for symptomatic relief. Specific treatment is aimed at avoiding risk factors and treating the underlying cause if present. AMAG requires regular parenteral vitamin B12 supplements to prevent deficiency.