A histologic term for inflammation of the gastric mucosa.
Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs) or alcohol are the most common causes. Other causes include stress (secondary to mucosal ischemia) and autoimmune gastritis. Rare forms include phlegmonous gastritis (a rare bacterial infection).
Diagnosis is based on clinical history; BUN breath testing for H pylori should be performed in all patients.
Presence of suspicious features suggestive of upper GI malignancy requires urgent endoscopy. These include GI bleeding, anemia, early satiety, unexplained weight loss (>10% body weight), progressive dysphagia, odynophagia, or persistent vomiting.
Treatment depends on the etiology. Options include H pylori-eradication therapy, reduction of NSAIDs or alcohol exposure, and symptomatic therapy with histamine-2 antagonists and/or proton-pump inhibitors.
If untreated, progression to peptic ulcer disease may occur. Other complications include gastric carcinoma and gastric lymphoma.
- dyspepsia/epigastric discomfort
- no suspicious features of malignancy
- nausea, vomiting, and loss of appetite
- severe emesis
- acute abdominal pain
- altered reflexes or sensory deficits
- cognitive impairment
- angular cheilitis or atrophic glossitis
- coexisting autoimmune disease
1st Tests To Order
- Helicobacter pylori urea breath test
- H pylori fecal antigen test
Other Tests to Consider
- H pylori rapid urease test
- gastric mucosa histology
- serum vitamin B12
- upper GI contrast series
- blood/fluid cultures
- parietal cell antibodies
- intrinsic factor antibodies
- H pylori culture/PCR
at risk of stress gastritis
- antisecretory agents: preventive therapy
Helicobacter pylori associated
- H pylori eradication therapy
- agent exposure discontinuation/reduction
- histamine-2 antagonist or proton-pump inhibitor
- rabeprazole or sucralfate
- ICU admission and supportive care
- empiric broad-spectrum antibiotics