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Gastritis

Marie L. Borum, MD, EdD, MPH, MACP, FACG, AGAF and Jenny Davé, MD, MS Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Inflammation of the gastric mucosa

  • Can be classified by time course (acute vs. chronic)

    • Acute: Neutrophilic infiltration on histology

    • Chronic: Mixture of mononuclear cells, lymphocytes,...

DIAGNOSIS

HISTORY

  • Epigastric discomfort, often aggravated by eating

  • Burning epigastric pain

  • Anorexia

  • Nausea, with or without vomiting

  • Significant bleeding is unusual except in hemorrhagic gastritis.

  • Rectal ...

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 if possible.

  • Abstinence...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Usually no restrictions 
  • Confirm H. pylori eradication 4+ weeks after treatment.

Patient Monitoring

  • Consider repeat endoscopy after 6 weeks if gastritis was severe o...

REFERENCES

1
McColl KE. Clinical practice. Helicobacter pylori infection. N Engl J Med.  2010;362(17):1597–1604.
2
Shaukat A, Wang A, Acosta RD. The role of endoscopy in dyspepsia. Gastrointest Endo...

ADDITIONAL READING

  • Eslami L, Nasseri-Moghaddam S. Meta-analyses: does long-term PPI use increase the risk of gastric premalignant lesions? Arch Iran Med.  2013;16(8):449–458.

  • Lopetuso LR, Napoli M...

CODES

ICD10

  • K29.70 Gastritis, unspecified, without bleeding

  • K29.71 Gastritis, unspecified, with bleeding

  • K29.00 Acute gastritis without bleeding

  • K29.01 Acute gastritis with bleeding

  • K29.31 Chronic superfic...

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 shou...

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