13.10 Pathology: Gastritis and peptic ulceration Flashcards
What can prostaglandins do in relation to mucosal injury (2) and how (3)?
- Prevent and reverse mucosal injury
- Inhibit acid secretion, stimulate HCO3 and mucus secretions
How long does acute gastritis take to heal? Why?
A few days (24-48hr regeneration)
How long does it take for acute gastritis to progress to chronic gastritis (with H. Pylori)?
3-4 weeks
How can you distinguish:
Gastric erosion
Acute ulcer
Chronic ulcer
Erosion-Through mucosa
Acute -Through muscularis mucosae
Chronic -All the way to the muscularis propria
How do NSAID induced ulcers occur?
Inhibition of COX and PG synthesis
What are the 3 main types of chronic gastritis?
- Autoimmune
- Helicobacter-associated
- Chemical
How does autoimmune gastritis occur?
Immune mediated destruction of acid secreting tubules, then atrophy
What is Pernicious anaemia due to?
B12 deficiency
How does chemical gastritis occur?
Bile reflux
What are 3 bacterial factors that enable H. pylori to colonise the gastric mucosa?
Adhesions, urease and motility microaerophilism
What is a long term danger of chronic gastritis (e.g. as a result of H. Pylori)?
Adenocarcinoma (due to metaplasia–>dysplasia)
What are the two major patterns of H. Pylori gastritis?
- Antrum dominant (duodenal ulcer)
- Pan-gastritis (gastric ulcer)
Which pattern of gastritis (due to H. Pylori) causes increased and which causes reduced acid output?
Antrum predominant: increased acid output
Pan-gastritis: reduced acid output
What are the differences and similarities in pathology between the two patterns of H. pylori gastritis?
Both: chronic inflammation, polymorphs
Pan-gastitis: atrophy, intestinal metaplasia
What is peptic ulcer disease?
A breach in the mucosa extending beyond the muscularis mucosae
