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Gastritis

Marie L Borum, MD, EdD, MPH and Valeria A Martinez-Lebron, MD Reviewed 06/2022
 


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

  • Epigastric discomfort, often aggravated by eating

  • Burning epigastric pain, anorexia

  • Nausea, with or without vomiting

  • Significant bleeding is unusual except in hemorrhagic gastritis.

  • Recta...

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 alcoho...

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 or...

REFERENCES

1
Shirin D, Matalon S, Avidan B, et al. Real-world Helicobacter pylori diagnosis in patients referred for esophagoduodenoscopy: The gap between guidelines and clinical practice. United Europ...

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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