Gastritis

Gastritis is acute or chronic inflammation of the stomach and is most often diffuse. It is usually diagnosed on upper gastrointestinal (UGI) endoscopy and can be confirmed and classified histologically by performing a gastric biopsy.

Acute gastritis:

This is also called or haemorrhagic gastritis. The common causes of acute gastritis are Aspirin and other NSAIDs, Alcohol, Other drugs – iron, potassium chloride, Severe trauma, Significant underlying diseases (sepsis, pulmonary or renal insufficiency), Burns (“Cushing’s ulcer”), CNS trauma (“Curling ulcer”), Bile reflux, Acute H. pylori infection

Of these, the most common cause is use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs).- Commonly called pain killers, usually abused by taking them casually without doctors’ prescription.

The mucosal damage can result in either slow Upper Gastro Intestinal bleeding which can be detected as positive faecal occult blood test or can manifest as massive Upper Gastro Intestinal bleeding. In some patients, epigastric discomfort, loss of appetite and nausea may be present.

Chronic gastritis:

Chronic gastritis progresses over years in three stages. In chronic superficial gastritis, there is infiltration of lymphocytes and plasma cells in the lamina propria. In atrophic gastritis, there is reduction in the gastric glands (parietal and chief cells) along with infiltration of plasma cells and lymphocytes. When there is associated polymorph infiltration, gastritis is termed active. In gastric atrophy, glands are lost, mucosal thickness is reduced, infiltration of lymphocytes and plasma cells is slight and there may be foci of intestinal metaplasia.

The two main types of chronic gastritis are autoimmune (formerly type A) and H. pylori-associated (formerly type B). Autoimmune gastritis involves the gastric body and spares the antrum. Parietal cell and intrinsic factor antibodies are serum markers of autoimmune chronic gastritis. Patients present with pernicious anaemia (megaloblastic anaemia with absolute achlorhydria) and features of vitamin B12 deficiency. Also, autoimmune chronic gastritis is a pre-malignant condition and can progress to gastric cancer. H. pylori-associated chronic gastritis usually involves the antrum but over a period of time may involve the body as well.