GASTRITIS

• Gastritis is inflammation of the gastric mucosa.
• Gastritis may be of 2 types-

1. Acute
2. Chronic

 1. Acute gastritis-

• It is a transient acute inflammatory involvement of the stomach, mainly mucosa.

Etiology-

• Diet & personal habits- alcohol, smoking, malnutrition.
• Infections- bacterial (H. Pylori), viral infections
• Drugs- NSAIDs, aspirin, cortisone
• Severe stress, trauma, surgery

Classification-

1. Acute H. Pylori gastritis
2. Acute infective gastritis
3. Acute non- infective gastritis

Clinical features-

• Epigastric pain
• Nausea
• Vomiting
• Hypochlorhydria
• Haematemesis or melaena
• Anorexia

  

2. Chronic gastritis–

• Chronic gastritis has lymphocytes and plasma cells.
• Erosive gastritis involves body and fundus both.

 Etiology–

• Reflux of duodenal contents into stomach.
• Infection with H. Pylori
• Disease of stomach & duodenum
• Chronic hypochromic anaemia

Classification-

• According to the predominant site of involvement-

1. Type A- autoimmune gastritis (body predominant form)
2. Type B- H.pylori related (antral predominant form)
3. Type AB (environmental gastritis)

 

     1. Type A- autoimmune gastritis

• It mainly involves fundus & body.
• Associated with pernicious anaemia.
• Destruction of parietal cells.
• Presence of circulating antibodies (anti IF antibodies)

Clinical features-

• Intestinal metaplasia
• Hypoachlorhydria- depletion of gastric acid producing mucosal area.
• Hypergastrinaemia- hyperplasia of G cells.
• Vitamin B12 deficiency

     2. Type B (H. Pylori related)

• More common
• H. Pylori is the cause of infection.
• It involves the region of antral mucosa.
• Also called as hypersecretory gastritis
• Associated with peptic ulcer, cell lymphoma, gastric MALT lymphoma.

 Treatment–

1. Acute gastritis-

• Avoiding the cause
• Antacids
• Acid suppression (PPI or antiemetics)

     2. Chronic gastritis

• Patient with pernicious anaemia- parentral Vitamin B12 supplement
• H. Pylori related gastritis- eradication of H. pylori

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