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Gastritis

Marie L Borum, MD, EdD, MPH and Nouf O Turki, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Inflammation of the gastric mucosa

  • Classified by duration:

    • Acute: neutrophilic infiltration on histology

    • Chronic: mixture of mononuclear cells, lymphocytes, macrophages on histology

  • Sub...

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...

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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