Gastritis Flashcards
What does the term gastritis refer to?
Histologically documented inflammation of the gastric mucosa
Gastritis is not synonymous with mucosal erythema seen during endoscopy or with dyspepsia.
Is gastritis interchangeable with dyspepsia?
No
Gastritis specifically refers to inflammation of the gastric mucosa, while dyspepsia is a broader term for digestive discomfort.
Fill in the blank: Gastritis is classified based on _______ features.
[histologic]
What are the two main types of gastritis based on time course?
Acute and chronic
These classifications help in understanding the duration and potential treatment of gastritis.
What are the most common causes of acute gastritis?
Infectious causes, primarily H. pylori infection
Acute infection with H. pylori induces gastritis, though it has not been extensively studied.
What are the symptoms of acute H. pylori gastritis?
Sudden onset of epigastric pain, nausea, and vomiting
Limited mucosal histologic studies show marked infiltrate of neutrophils with edema and hyperemia.
What could happen if acute gastritis is not treated?
It may evolve into chronic gastritis
Hypochlorhydria lasting for up to 1 year may follow acute H. pylori infection.
What is phlegmonous gastritis?
A rare, potentially life-threatening disorder characterized by marked and diffuse acute inflammatory infiltrates of the entire gastric wall
It may be accompanied by necrosis.
Which individuals are at risk for phlegmonous gastritis?
Elderly individuals, alcoholics, and AIDS patients
Potential iatrogenic causes include polypectomy and mucosal injection with India ink.
What organisms are associated with phlegmonous gastritis?
- Streptococci
- Staphylococci
- Escherichia coli
- Proteus
- Haemophilus species
Failure of supportive measures and antibiotics may result in gastrectomy.
What types of gastritis may occur in immunocompromised individuals?
Herpetic (herpes simplex) or CMV gastritis
Histologic findings of intranuclear inclusions would be observed in CMV gastritis.
What is chronic gastritis primarily characterized by histologically?
An inflammatory cell infiltrate consisting primarily of lymphocytes and plasma cells
Very scant neutrophil involvement is also noted.
What are the initial areas affected by the inflammation in chronic gastritis?
Superficial and glandular portions of the gastric mucosa
The inflammation may be patchy in distribution.
What can chronic gastritis progress to in terms of glandular destruction?
Atrophy and metaplasia
What histologic characteristics classify chronic gastritis?
Superficial atrophic changes and gastric atrophy
What is the association of atrophic gastritis with gastric cancer?
It has led to the development of endoscopic and serologic markers of severity.
List some tools used for assessing chronic gastritis severity.
- Gross inspection during endoscopy
- Magnification endoscopy
- Endoscopy with narrow band imaging
- Autofluorescence imaging
- Measurement of serum biomarkers (pepsinogen I and II levels, gastrin-17, anti–H. pylori serologies)
What is the early phase of chronic gastritis called?
Superficial gastritis
What are the characteristics of superficial gastritis?
Inflammatory changes are limited to the lamina propria of the surface mucosa, with edema and cellular infiltrates separating intact gastric glands.
What follows superficial gastritis in the progression of chronic gastritis?
Atrophic gastritis
What occurs during the atrophic gastritis stage?
The inflammatory infiltrate extends deeper into the mucosa, leading to distortion and destruction of the glands.
What is the final stage of chronic gastritis?
Gastric atrophy
What happens to glandular structures during gastric atrophy?
Glandular structures are lost, and there is a paucity of inflammatory infiltrates.
What can be observed endoscopically in gastric atrophy?
The mucosa may be substantially thin, permitting clear visualization of the underlying blood vessels.
