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Gastritis

Marie L Borum, MD, EdD, MPH and Ivan Berezowski, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • Inflammation of the gastric mucosa

  • Can be classified by time course

    • Acute: neutrophilic infiltration on histology

    • Chronic: mixture of mononuclear cells, lymphocytes, macrophages on his...

DIAGNOSIS

HISTORY

  • Burning epigastric pain or discomfort, often aggravated by eating

  • Unintentional weight loss, anorexia

  • Nausea, with or without vomiting

  • Significant bleeding is unusual except in hemorrhag...

TREATMENT

GENERAL MEASURES

  • H. pylori treatment is required to relieve symptoms.

  • Parenteral fluid and electrolyte supplements if unable to tolerate oral intake

  • Discontinue NSAID use. Abstinence from alcoh...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Confirm H. pylori eradication 4+ weeks after treatment. 

Patient Monitoring

  • Consider repeat endoscopy after 6 weeks if gastritis was severe or if poor treatment res...

REFERENCES

1
Yang H, Guan L, Hu B. Detection and treatment of Helicobacter pylori: problems and advances. Gastroenterol Res Pract. 2022;2022:4710964. doi: 10.1155/2022/4710964.
2
Malfertheiner P, Megraud...

ADDITIONAL READING

SEE ALSO

Retnakumar RJ, Nath AN, Nair GB, et al. Gastrointestinal microbiome in the context of Helicobacter pylori infection in stomach and gastroduodenal diseases. Pro...

CODES

ICD10

  • K29.5 Unspecified chronic gastritis

  • K29.40 Chronic atrophic gastritis without bleeding

  • K29.50 Unspecified chronic gastritis without bleeding

  • K29.2 Alcoholic gastritis

  • K29.41 Chronic atrophic ga...

CLINICAL PEARLS

  • H. pylori is the most common cause of gastritis; >50% of adult patients are colonized with H. pylori by age 60 years.

  • H. pylori antibodies decline in the year after treatment and sho...

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