Gastritis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Gastritis is inflammation of the gastric mucosa. The word comes from the Greek gastro- meaning of the stomach and -itis meaning inflammation. Depending on the cause, it may persist acutely or chronically and may coincide with more serious conditions such as atrophy of the stomach.

Common Causes of Gastritis

The following are known causes and factors related to gastritis:

Digestive System

• Bacterial infection (most often by Helicobacter pylori and other Helicobacter spp.)
• Fungal infection (most often in people with immunodeficiency)
• Parasitic infection (most often by Anisakis spp. from poorly cooked seafood)
• Viral infection
• Bile reflux
• NSAIDs
• Cigarette smoke
• Autoimmune disorders
• Excessive alcohol consumption
• Excessive caffeine consumption
• Certain allergens
• Certain types of radiation
• Stomach injury
• Stress

Differential Diagnosis

• Alcoholic gastropathy
• Aortic aneurysm (ruptured)
• Bacterial infections
• Burns
• Candida
• Corrosive gastritis
• Crohn's Disease
• Cytomegalovirus (CMV) in HIV
• Diseases of the biliary system
• Drugs
• Eosinophilic Gastritis
• Esophageal varices
• Functional dyspepsia
• Gastric carcinoma
• Gastritis in pernicious anemia
• Gastroduodenal ulcer
• Helicobacter pylori associated
• Intoxication
• Liver failure
• Lymphocytic gastritis
• Mallory-Weiss Tear
• Menetrier's Disease
• Pancreas carcinoma
• Pancreatitis
• Peptic ulcer
• Perforated ulcer
• Radiation
• Reflux esophagitis
• Renal Failure
• Respiratory failure
• Sarcoidosis
• Sepsis
• Shock
• Surgery
• Syphilis
• Trauma
• Tuberculosis
• Volvulus
• Zollinger-Ellison Syndrome

Symptoms

The following symptoms can be a result of gastritis or can be related to the underlying cause:

• Upper abdominal pain or discomfort
• Gastric hemorrhage
• Hypochlorhydria
• Appetite loss
• Belching
• Nausea
• Vomiting
• Fever
• Lethargy

Diagnosis

In suspected cases, a doctor usually orders a barium meal test and gastroscopy to determine gastritis and related conditions such as peptic ulcers and gastric cancer. It is always important that the doctor reviews a patient's history regarding medications, alcohol intake, smoking, and other factors that can be associated with gastritis. In some cases, the appearance of the stomach lining seen during gastroscopy and the results of the barium meal test are reliable in determining gastritis and the cause. However, the most reliable method for determining gastritis is doing a biopsy during gastroscopy and checking for histological characteristics of gastritis and infection. For Helicobacter infection (the most common cause), one can test non-invasively with a urea breath test, stool antigen test, or blood antibody test.

Treatment

Treatment usually consists of removing the irritant or the infection. In cases of infection, a doctor will most often prescribe antimicrobial drugs. Helicobacter infection typically responds well to the triple therapy protocol (consisting of two antibiotics, and a proton pump inhibitor). Regimens that work well include PCA or PCM triple therapy (PPI, Clarithromycin, Amoxicillin) or (PPI, Clarithromycin, Metronidazole). Quadruple therapy hasa >90% success rate and includes PPIs, Bismuth subsalicylates, Metronidazole, and Tetracycline.

See also

• Stomach
• Gastroenteritis
• Infection

External links

• http://www.merck.com/mmhe/sec09/ch121/ch121b.html
• http://www.emedicine.com/emerg/topic820.htm
• http://www.emedicine.com/med/topic852.htm
• http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10796.html
• ABC Salutaris: Gastritis

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