Gastritis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gastritis can be rapidly treated but may recur. Although majority of gastritis cases remain asymptomatic or without complications, the common complications, when it occurs, include peptic ulcers and gastric neoplasms (including malignant).
Natural History
Symptoms of gastritis improve with appropriate treatment.
Complications
- Acute Gastritis 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 Gastritis Complications:
- Atrophic gastritis
- Peptic ulcers
- Gastrointestinal Perforation
- Gastrointestinal Bleeding
- Anemia due to erosive gastritis
- Stomach Cancer
- Vitamin B12 deficiency
- Pernicious anemia
- Increased risk of developing benign or malignant growths in the lining of the stomach.
- Atrophic Gastritis Complications:
- Atrophic Gastritis as a result of Helicobacter pylori infection:
- Gastric ulceration
- Gastric cancer (adenocarcinoma)
- Atrophic Gastritis as a result of atrophic gastritis due to Autoimmune gastritis:
- Gastric polyp
- Gastric cancer (adenocarcinoma)
- Pernicious anemia
- Atrophic Gastritis as a result of Helicobacter pylori infection:
- Stress Induced Gastritis Complications:
- Rarely, Stress-Induced Gastritis may lead to severe bleeding that can prove fatal and leads to a life-threatening situation.
- Helicobacter pylori-associated Gastritis Complications:
- Chronic Helicobacter pylori-associated Gastritis 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 gastritis is majorly dependent upon the type of gastritis and etiological factors:
- In Acute Gastritis, the condition improves upon refraining from risk factors such as NSAIDs, alcohol, cigarette smoking, acidic food, and beverages. [1]
- In Autoimmune Gastritis, prognosis is usually good for vitamin B12 deficiency when treated with cyanocobalamin therapy. Although in Autoimmune Gastritis, there is an increased risk for carcinoid tumors and gastric adenocarcinoma. [2] [3]
- In Chronic Gastritis 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. [4]
- In individuals with Helicobacter pylori infection associated chronic gastritis, if left untreated may progress to develop peptic ulcer disease, adenocarcinoma and MALT lymphoma.
References
- ↑ 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.