Gastritis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Gastritis may be seen as a commonly occuring inflammatory disease in many individuals. Gastritis | Gastritis may be seen as a commonly occuring inflammatory disease in many individuals. Gastritis usually persists throughout life and the chance of spontaneous healing is rare. Gastritis is mostl associated with the presence of Helicobacter pylori infection. The gastric mucosa undergoes inflammation and may lead to atrophic gastirtis. Chronic gastirtis is a conditon which is commonly observed as a manifestation of pathogenesis of many gastric disease consitions. Gastric secretory functions are usualy impaired due to the gastric mucosa undergoing inflammation and atrophy. Increase in the prevalence of gastirtis is attributed to the increasing age and the onset varies among different ethnicities. The increased risk of developing duodenal and peptic ulcers have been observed in individuals with persistent gastirtis. Biopsies and routine evaluations may help redict the progression of gastirtis to further conditions such as the peptic ulcer disease. Complications of Gastritis may include, peptic ulcers, gastrointestinal perforation, gastrointestinal bleeding, gastric polyp, anemia due to erosive gastritis, vitamin B12 deficiency, pernicious anemia, gastric outlet obstruction, increased risk of developing benign or malignant growths in the lining of the stomach which may lead to stomach cancer. Prognosis for gastritis is majorly dependent upon the type of gastritis and etiological factors. In Acute gastirtis, the condition improves upon refraining from risk factors such as NSAIDs, alcohol, cigarette smoking, acidic food, and beverages. In Autoimmune gastirtis, pyrognosis is usually good for vitamin B12 deficiency when treated with cyanocobalamin therapy. Although in Autoimmune gastirtis, there is an increased risk for carcinoid tumors and gastric adenocarcinoma. In Chronic gastirtis associated with Helicobacter pylori infection, the prognosis is good. The triple therapy regimen may not be effective when compared to quadruple bismuth-based regimen is has proven to be very effective comparatively. In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop peptic ulcer disease, adenocarcinoma and MALT lymphoma. | ||
==Natural History== | ==Natural History== | ||
Gastritis | Gastritis is a common inflammatory disease. Gastritis usually persists throughout life and the chance of spontaneous healing is rare. Gastritis is most commonly associated with Helicobacter pylori infection. The gastric mucosa undergoes inflammatory changes which may finally lead to atrophic gastritis. Chronic gastritis is a conditon which is commonly observed as a manifestation of pathogenesis of many gastric disease consitions. Gastric secretory functions are usualy impaired due to the gastric mucosa undergoing inflammation and atrophy. Increase in the prevalence of gastritis is attributed to the increasing age and the onset varies among different ethnicities. The increased risk of developing duodenal and peptic ulcers have been observed in individuals with persistent gastritis. Biopsies and routine evaluations may help redict the progression of gastritis to further conditions such as the peptic ulcer disease. <ref name="pmid20180646">{{cite journal| author=Redéen S, Petersson F, Kechagias S, Mårdh E, Borch K| title=Natural history of chronic gastritis in a population-based cohort. | journal=Scand J Gastroenterol | year= 2010 | volume= 45 | issue= 5 | pages= 540-9 | pmid=20180646 | doi=10.3109/00365521003624151 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20180646 }} </ref> <ref name="pmid1912435">{{cite journal| author=Sipponen P, Kekki M, Siurala M| title=The Sydney System: epidemiology and natural history of chronic gastritis. | journal=J Gastroenterol Hepatol | year= 1991 | volume= 6 | issue= 3 | pages= 244-51 | pmid=1912435 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1912435 }} </ref> <ref name="pmid1397747">{{cite journal| author=Sipponen P| title=Natural history of gastritis and its relationship to peptic ulcer disease. | journal=Digestion | year= 1992 | volume= 51 Suppl 1 | issue= | pages= 70-5 | pmid=1397747 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1397747 }} </ref> | ||
==Complications== | ==Complications== | ||
*'''Acute | *'''Acute gastirtis Complications:''' | ||
**Ulcer bleed | **Ulcer bleed | ||
**Bleeding as a result of gastric erosion | **Bleeding as a result of gastric erosion | ||
| Line 17: | Line 17: | ||
**Gastric outlet obstruction | **Gastric outlet obstruction | ||
*'''Chronic | *'''Chronic gastirtis Complications:''' | ||
**Atrophic | **Atrophic gastirtis | ||
**Peptic ulcers | **Peptic ulcers | ||
**Gastrointestinal Perforation | **Gastrointestinal Perforation | ||
**Gastrointestinal Bleeding | **Gastrointestinal Bleeding | ||
**Anemia due to erosive | **Anemia due to erosive gastirtis | ||
**Stomach Cancer | **Stomach Cancer | ||
**Vitamin B12 deficiency | **Vitamin B12 deficiency | ||
| Line 28: | Line 28: | ||
**Increased risk of developing benign or malignant growths in the lining of the stomach. | **Increased risk of developing benign or malignant growths in the lining of the stomach. | ||
*'''Atrophic | *'''Atrophic gastirtis Complications:''' | ||
**Atrophic | **Atrophic gastirtis as a result of ''Helicobacter pylori infection'': | ||
***Gastric ulceration | ***Gastric ulceration | ||
***Gastric cancer (adenocarcinoma) | ***Gastric cancer (adenocarcinoma) | ||
**Atrophic | **Atrophic gastirtis as a result of atrophic gastirtis due to ''Autoimmune gastirtis'': | ||
***Gastric polyp | ***Gastric polyp | ||
***Gastric cancer (adenocarcinoma) | ***Gastric cancer (adenocarcinoma) | ||
***Pernicious anemia | ***Pernicious anemia | ||
*'''Stress Induced | *'''Stress Induced gastirtis Complications:''' | ||
**Rarely, Stress-Induced | **Rarely, Stress-Induced gastirtis may lead to severe bleeding that can prove fatal and leads to a life-threatening situation. | ||
*'''Helicobacter pylori-associated | *'''Helicobacter pylori-associated gastirtis Complications:''' | ||
**Chronic Helicobacter pylori-associated | **Chronic Helicobacter pylori-associated gastirtis increases the risk for mucosa-associated lymphoid tissue (MALT) lymphoma. | ||
**[[Gastric ulcer|Gastric]] and [[duodenal ulcer|duodenal ulcers]] | **[[Gastric ulcer|Gastric]] and [[duodenal ulcer|duodenal ulcers]] | ||
**[[Gastric adenocarcinoma]] | **[[Gastric adenocarcinoma]] | ||
| Line 49: | Line 49: | ||
==Prognosis== | ==Prognosis== | ||
*Prognosis for | *Prognosis for gastirtis is majorly dependent upon the type of gastirtis and etiological factors: | ||
**In Acute | **In Acute gastirtis, the condition improves upon refraining from risk factors such as NSAIDs, alcohol, cigarette smoking, acidic food, and beverages. <ref name="pmid20955443">{{cite journal| author=Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP| title=Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients. | journal=Aliment Pharmacol Ther | year= 2010 | volume= 32 | issue= 10 | pages= 1240-8 | pmid=20955443 | doi=10.1111/j.1365-2036.2010.04465.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20955443 }} </ref> | ||
**In Autoimmune | **In Autoimmune gastirtis, prognosis is usually good for vitamin B12 deficiency when treated with cyanocobalamin therapy. Although in autoimmune gastirtis, there is an increased risk for carcinoid tumors and gastric adenocarcinoma. <ref name="pmid17059512">{{cite journal| author=Burkitt MD, Pritchard DM| title=Review article: Pathogenesis and management of gastric carcinoid tumours. | journal=Aliment Pharmacol Ther | year= 2006 | volume= 24 | issue= 9 | pages= 1305-20 | pmid=17059512 | doi=10.1111/j.1365-2036.2006.03130.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17059512 }} </ref> <ref name="pmid8431855">{{cite journal| author=Hsing AW, Hansson LE, McLaughlin JK, Nyren O, Blot WJ, Ekbom A et al.| title=Pernicious anemia and subsequent cancer. A population-based cohort study. | journal=Cancer | year= 1993 | volume= 71 | issue= 3 | pages= 745-50 | pmid=8431855 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8431855 }} </ref> | ||
**In Chronic | **In Chronic gastirtis associated with Helicobacter pylori infection, the prognosis is good. | ||
***The triple therapy regimen may not be effective when compared to quadruple bismuth-based regimen is has proven to be very effective comparatively. <ref name="pmid17608775">{{cite journal| author=Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology| title=American College of Gastroenterology guideline on the management of Helicobacter pylori infection. | journal=Am J Gastroenterol | year= 2007 | volume= 102 | issue= 8 | pages= 1808-25 | pmid=17608775 | doi=10.1111/j.1572-0241.2007.01393.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17608775 }} </ref> | ***The triple therapy regimen may not be effective when compared to quadruple bismuth-based regimen is has proven to be very effective comparatively. <ref name="pmid17608775">{{cite journal| author=Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology| title=American College of Gastroenterology guideline on the management of Helicobacter pylori infection. | journal=Am J Gastroenterol | year= 2007 | volume= 102 | issue= 8 | pages= 1808-25 | pmid=17608775 | doi=10.1111/j.1572-0241.2007.01393.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17608775 }} </ref> | ||
***In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop [[Peptic ulcer disease|peptic ulcer disease]], [[Adenocarcinoma|adenocarcinoma]] and [[MALT lymphoma]]. | ***In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop [[Peptic ulcer disease|peptic ulcer disease]], [[Adenocarcinoma|adenocarcinoma]] and [[MALT lymphoma]]. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gastritis may be seen as a commonly occuring inflammatory disease in many individuals. Gastritis usually persists throughout life and the chance of spontaneous healing is rare. Gastritis is mostl associated with the presence of Helicobacter pylori infection. The gastric mucosa undergoes inflammation and may lead to atrophic gastirtis. Chronic gastirtis is a conditon which is commonly observed as a manifestation of pathogenesis of many gastric disease consitions. Gastric secretory functions are usualy impaired due to the gastric mucosa undergoing inflammation and atrophy. Increase in the prevalence of gastirtis is attributed to the increasing age and the onset varies among different ethnicities. The increased risk of developing duodenal and peptic ulcers have been observed in individuals with persistent gastirtis. Biopsies and routine evaluations may help redict the progression of gastirtis to further conditions such as the peptic ulcer disease. Complications of Gastritis may include, peptic ulcers, gastrointestinal perforation, gastrointestinal bleeding, gastric polyp, anemia due to erosive gastritis, vitamin B12 deficiency, pernicious anemia, gastric outlet obstruction, increased risk of developing benign or malignant growths in the lining of the stomach which may lead to stomach cancer. Prognosis for gastritis is majorly dependent upon the type of gastritis and etiological factors. In Acute gastirtis, the condition improves upon refraining from risk factors such as NSAIDs, alcohol, cigarette smoking, acidic food, and beverages. In Autoimmune gastirtis, pyrognosis is usually good for vitamin B12 deficiency when treated with cyanocobalamin therapy. Although in Autoimmune gastirtis, there is an increased risk for carcinoid tumors and gastric adenocarcinoma. In Chronic gastirtis associated with Helicobacter pylori infection, the prognosis is good. The triple therapy regimen may not be effective when compared to quadruple bismuth-based regimen is has proven to be very effective comparatively. In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop peptic ulcer disease, adenocarcinoma and MALT lymphoma.
Natural History
Gastritis is a common inflammatory disease. Gastritis usually persists throughout life and the chance of spontaneous healing is rare. Gastritis is most commonly associated with Helicobacter pylori infection. The gastric mucosa undergoes inflammatory changes which may finally lead to atrophic gastritis. Chronic gastritis is a conditon which is commonly observed as a manifestation of pathogenesis of many gastric disease consitions. Gastric secretory functions are usualy impaired due to the gastric mucosa undergoing inflammation and atrophy. Increase in the prevalence of gastritis is attributed to the increasing age and the onset varies among different ethnicities. The increased risk of developing duodenal and peptic ulcers have been observed in individuals with persistent gastritis. Biopsies and routine evaluations may help redict the progression of gastritis to further conditions such as the peptic ulcer disease. [1] [2] [3]
Complications
- Acute gastirtis Complications:
- Ulcer bleed
- Bleeding as a result of gastric erosion
- Anemia as a result of the bleeding from the ulcer or due to the gastric erosion
- Gastric outlet obstruction
- Chronic gastirtis Complications:
- Atrophic gastirtis
- Peptic ulcers
- Gastrointestinal Perforation
- Gastrointestinal Bleeding
- Anemia due to erosive gastirtis
- Stomach Cancer
- Vitamin B12 deficiency
- Pernicious anemia
- Increased risk of developing benign or malignant growths in the lining of the stomach.
- Atrophic gastirtis Complications:
- Atrophic gastirtis as a result of Helicobacter pylori infection:
- Gastric ulceration
- Gastric cancer (adenocarcinoma)
- Atrophic gastirtis as a result of atrophic gastirtis due to Autoimmune gastirtis:
- Gastric polyp
- Gastric cancer (adenocarcinoma)
- Pernicious anemia
- Atrophic gastirtis as a result of Helicobacter pylori infection:
- Stress Induced gastirtis Complications:
- Rarely, Stress-Induced gastirtis may lead to severe bleeding that can prove fatal and leads to a life-threatening situation.
- Helicobacter pylori-associated gastirtis Complications:
- Chronic Helicobacter pylori-associated gastirtis increases the risk for mucosa-associated lymphoid tissue (MALT) lymphoma.
- Gastric and duodenal ulcers
- Gastric adenocarcinoma
- Pseudomembranous colitis following H. pylori treatment
- B12 and iron deficiency anemia
- Post Treatment complication of of Helicobacter pylori infection is Clostridium difficile infection
Prognosis
- Prognosis for gastirtis is majorly dependent upon the type of gastirtis and etiological factors:
- In Acute gastirtis, the condition improves upon refraining from risk factors such as NSAIDs, alcohol, cigarette smoking, acidic food, and beverages. [4]
- In Autoimmune gastirtis, prognosis is usually good for vitamin B12 deficiency when treated with cyanocobalamin therapy. Although in autoimmune gastirtis, there is an increased risk for carcinoid tumors and gastric adenocarcinoma. [5] [6]
- In Chronic gastirtis associated with Helicobacter pylori infection, the prognosis is good.
- The triple therapy regimen may not be effective when compared to quadruple bismuth-based regimen is has proven to be very effective comparatively. [7]
- In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop peptic ulcer disease, adenocarcinoma and MALT lymphoma.
References
- ↑ Redéen S, Petersson F, Kechagias S, Mårdh E, Borch K (2010). "Natural history of chronic gastritis in a population-based cohort". Scand J Gastroenterol. 45 (5): 540–9. doi:10.3109/00365521003624151. PMID 20180646.
- ↑ Sipponen P, Kekki M, Siurala M (1991). "The Sydney System: epidemiology and natural history of chronic gastritis". J Gastroenterol Hepatol. 6 (3): 244–51. PMID 1912435.
- ↑ Sipponen P (1992). "Natural history of gastritis and its relationship to peptic ulcer disease". Digestion. 51 Suppl 1: 70–5. PMID 1397747.
- ↑ Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP (2010). "Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients". Aliment Pharmacol Ther. 32 (10): 1240–8. doi:10.1111/j.1365-2036.2010.04465.x. PMID 20955443.
- ↑ Burkitt MD, Pritchard DM (2006). "Review article: Pathogenesis and management of gastric carcinoid tumours". Aliment Pharmacol Ther. 24 (9): 1305–20. doi:10.1111/j.1365-2036.2006.03130.x. PMID 17059512.
- ↑ Hsing AW, Hansson LE, McLaughlin JK, Nyren O, Blot WJ, Ekbom A; et al. (1993). "Pernicious anemia and subsequent cancer. A population-based cohort study". Cancer. 71 (3): 745–50. PMID 8431855.
- ↑ Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology (2007). "American College of Gastroenterology guideline on the management of Helicobacter pylori infection". Am J Gastroenterol. 102 (8): 1808–25. doi:10.1111/j.1572-0241.2007.01393.x. PMID 17608775.