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Chronic Gastritis

Updated : July 1, 2024





Background

Chronic gastritis shows long-term inflammation of the stomach lining.

Chronic gastritis occurs due to various factors, including Helicobacter pylori bacterial infection and it is categorized based on their cause and histopathologic pattern.

H pylori bacterium is a major cause of chronic gastritis, and commonly observed symptoms are abdominal pain, bloating, loss of appetite and vomiting.

Epidemiology

Approximately 50% of the population is infected with this gastritis worldwide.

In autoimmune gastritis, the immune system attacks the stomach lining, is less common than H. pylori-associated gastritis.

Comparing North America and Western Europe to developing regions like sections of Africa, Asia, and America finds that these tend to have greater incidence rates.

Anatomy

Pathophysiology

Granulomatous gastritis is a rare condition where the stomach can be affected by tuberculosis lead to the development of caseating granulomas.

Autoimmune atrophic gastritis is linked to the presence of serum anti-parietal and anti-intrinsic factor antibodies.

Cytomegalovirus stomach infection is common in immunosuppressed patients, its potential link to gastric carcinoma development remains unclear.

Etiology

The adhesion of bacteria to gastric cells lead to cause tyrosine phosphorylation.

About 16% of celiac disease patients experience lymphocytic gastritis, which recovers after a gluten-free diet.

Intake of excessive amounts of alcohol can lead to stomach irritation and an increased chances of developing chronic gastritis.

Genetics

Prognostic Factors

The clinical course of H pylori infection worsens when patients develop complications like peptic ulcer.

H pylori strains has different virulence due to specific factors, which increase the risk of severe gastric diseases in those carrying factors

The lymphoid component of gastritis may take several months to disappear after treatment.

Clinical History

Chronic gastritis can occur at any age but seen more in older adults. In both male and female chronic gastritis develops.

Physical Examination

  • Signs of Systemic Illness
  • Abdominal Examination
  • Signs of Malnutrition

Age group

Associated comorbidity

Associated activity

Acuity of presentation

H pylori infection is a major risk factor for the development of peptic ulcers for gastric and duodenal ulcers.

Patients may not initially notice the sudden changes in their gastrointestinal symptoms.

Differential Diagnoses

  • Acute Gastritis
  • Gastroesophageal Reflux Disease
  • Peptic Ulcer Disease
  • Gastric Ulcers

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

Antibiotic treatments are effective in >90% of patients but in some critical cases it shows serious symptoms which are challenging to treat.

Physician should avoid smoking cigarettes and consumption of alcohol on daily basis.

In acid suppression therapy involves use of proton pump inhibitors is combined with antibiotics to enhance treatment efficacy.

Schedule follow-up visits to monitor the progress of patients, recovery, and ensure resolution of symptoms.

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Use of a non-pharmacological approach for treating Chronic Gastritis

Patient should start taking healthy diet including fruits and vegetables, grains.

Physician and consultants should encourage the patients about good hygiene practices and how to minimize exposure to infectious agents which reduces the risk of H pylori infection.

Enough water and fluids intake on regular basis must be followed by patient during period of recovery which reduces risk of any other complications.

Provide enough education about gastritis and its related causes, how it spreads, and how to stop with management strategies.

Use of Antibiotics in treatment of Chronic Gastritis

  • Amoxicillin: Amoxicillin a derivative of ampicillin which has a similar antibacterial spectrum to penicillin that targets on gram-positive and gram-negative organisms.
  • Clarithromycin: It is a semi-synthetic macrolide antibiotic binds to the P site of the 50S ribosomal subunit in susceptible organisms potentially inhibiting bacterial growth by dissociating peptidyl tRNA from ribosomes.
  • Metronidazole: It may cause DNA damage and disrupt nucleic acid synthesis in H. pylori by bacterial enzymes, that causes bacterial cell death.

Use of proton pump inhibitors in the treatment of Chronic Gastritis

  • Omeprazole: It is used in gastritis treatment inhibits the proton pump in gastric parietal cells and reduces gastric acid secretion when combined with antibiotics.
  • Lansoprazole: It inhibits the proton pump inhibitors in gastric parietal cells, thus reduces gastric acid secretion.
  • Pantoprazole: It reduces gastric acid secretion by inhibiting the H+/K+-ATP pump at the secretory surface of gastric parietal cells.

Use of Gastrointestinal Agents in the treatment of Chronic Gastritis

  • Bismuth subsalicylate: It has a cytoprotective effect on the gastrointestinal mucosa, enhances prostaglandin production and regulates the immune response.

Procedures for chronic gastritis depends on diagnosis, severity assessment, complications identification, and treatment decision-making by physician.

Upper gastrointestinal endoscopy is a diagnostic procedure used to visualize gastric mucosa and obtain biopsy samples for further analysis.

Use of phases in managing Chronic Gastritis

In the initial diagnosis phase, the physician assesses symptoms related to gastritis, then refers to diagnostic test to confirm the presence of chronic gastritis.

The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints along with treatment response.

Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.

Medication

 

teprenone 

The suggested dose is 50 mg orally thrice a day



 
 

Media Gallary

Chronic Gastritis

Updated : July 1, 2024




Chronic gastritis shows long-term inflammation of the stomach lining.

Chronic gastritis occurs due to various factors, including Helicobacter pylori bacterial infection and it is categorized based on their cause and histopathologic pattern.

H pylori bacterium is a major cause of chronic gastritis, and commonly observed symptoms are abdominal pain, bloating, loss of appetite and vomiting.

Approximately 50% of the population is infected with this gastritis worldwide.

In autoimmune gastritis, the immune system attacks the stomach lining, is less common than H. pylori-associated gastritis.

Comparing North America and Western Europe to developing regions like sections of Africa, Asia, and America finds that these tend to have greater incidence rates.

Granulomatous gastritis is a rare condition where the stomach can be affected by tuberculosis lead to the development of caseating granulomas.

Autoimmune atrophic gastritis is linked to the presence of serum anti-parietal and anti-intrinsic factor antibodies.

Cytomegalovirus stomach infection is common in immunosuppressed patients, its potential link to gastric carcinoma development remains unclear.

The adhesion of bacteria to gastric cells lead to cause tyrosine phosphorylation.

About 16% of celiac disease patients experience lymphocytic gastritis, which recovers after a gluten-free diet.

Intake of excessive amounts of alcohol can lead to stomach irritation and an increased chances of developing chronic gastritis.

The clinical course of H pylori infection worsens when patients develop complications like peptic ulcer.

H pylori strains has different virulence due to specific factors, which increase the risk of severe gastric diseases in those carrying factors

The lymphoid component of gastritis may take several months to disappear after treatment.

Chronic gastritis can occur at any age but seen more in older adults. In both male and female chronic gastritis develops.

  • Signs of Systemic Illness
  • Abdominal Examination
  • Signs of Malnutrition

H pylori infection is a major risk factor for the development of peptic ulcers for gastric and duodenal ulcers.

Patients may not initially notice the sudden changes in their gastrointestinal symptoms.

  • Acute Gastritis
  • Gastroesophageal Reflux Disease
  • Peptic Ulcer Disease
  • Gastric Ulcers

Antibiotic treatments are effective in >90% of patients but in some critical cases it shows serious symptoms which are challenging to treat.

Physician should avoid smoking cigarettes and consumption of alcohol on daily basis.

In acid suppression therapy involves use of proton pump inhibitors is combined with antibiotics to enhance treatment efficacy.

Schedule follow-up visits to monitor the progress of patients, recovery, and ensure resolution of symptoms.

Patient should start taking healthy diet including fruits and vegetables, grains.

Physician and consultants should encourage the patients about good hygiene practices and how to minimize exposure to infectious agents which reduces the risk of H pylori infection.

Enough water and fluids intake on regular basis must be followed by patient during period of recovery which reduces risk of any other complications.

Provide enough education about gastritis and its related causes, how it spreads, and how to stop with management strategies.

  • Amoxicillin: Amoxicillin a derivative of ampicillin which has a similar antibacterial spectrum to penicillin that targets on gram-positive and gram-negative organisms.
  • Clarithromycin: It is a semi-synthetic macrolide antibiotic binds to the P site of the 50S ribosomal subunit in susceptible organisms potentially inhibiting bacterial growth by dissociating peptidyl tRNA from ribosomes.
  • Metronidazole: It may cause DNA damage and disrupt nucleic acid synthesis in H. pylori by bacterial enzymes, that causes bacterial cell death.

  • Omeprazole: It is used in gastritis treatment inhibits the proton pump in gastric parietal cells and reduces gastric acid secretion when combined with antibiotics.
  • Lansoprazole: It inhibits the proton pump inhibitors in gastric parietal cells, thus reduces gastric acid secretion.
  • Pantoprazole: It reduces gastric acid secretion by inhibiting the H+/K+-ATP pump at the secretory surface of gastric parietal cells.

  • Bismuth subsalicylate: It has a cytoprotective effect on the gastrointestinal mucosa, enhances prostaglandin production and regulates the immune response.

Procedures for chronic gastritis depends on diagnosis, severity assessment, complications identification, and treatment decision-making by physician.

Upper gastrointestinal endoscopy is a diagnostic procedure used to visualize gastric mucosa and obtain biopsy samples for further analysis.

In the initial diagnosis phase, the physician assesses symptoms related to gastritis, then refers to diagnostic test to confirm the presence of chronic gastritis.

The regular follow-up visits with the physician are required to check the improvement of patients and newly observed complaints along with treatment response.

Long-term management phase is a very important phase which involves continuous monitoring, supportive care, and surveillance for late effects of treatment.

teprenone 

The suggested dose is 50 mg orally thrice a day