GASTRITIS Flashcards
Define gastritis.
Inflammatory condition of the stomach resulting from damage to gastric mucosa.
What type of glandular cells are found in the wall of the body of the stomach?
Parietal
Chief
What type of glandular cells are found in the wall of the antrum of the stomach?
Mucin producing cells
How might someone with suspected acute gastritis present?
Dyspepsia (indigestion) Heartburn Nausea Vomiting Epigastric pain
Severe:
Haematemesis
Melaena
What is the pathophysiology of gastritis?
Reduced protection of mucosa or direct epithelial damage
Acid diffusion
Infiltration of neutrophils
Oedema and congestion
What are some of the risk factors for gastritis?
Alcohol Smoking NSAIDs including aspirin Chemotherapy H. pylori HSV CMV (cytomegalovirus) Trauma, burns
What are the complications of gastritis?
Erosion and haemorrage Ischemia Necrosis Ulceration Perforation Shock Death
What is chronic gastritis?
Sustained inflammatory response to gastric mucosal damage.
What are the immediate complications of chronic gastritis?
Intestinal metaplasia
Glandular atrophy
What is the system most commonly used to classify gastritis?
Updated Sydney system
What are the three components of the Sydney System for classifying gastritis?
Aetiology
Topography
Morphology
What are the non-infectious aetiological causes of gastritis?
Autoimmune - (including pernicious anaemia) NSAIDs Alcohol Bile reflux Chemotherapy Radiation Allergy to gluten Foreign Bodies Crohn’s disease Systemic diseases
What are the infectious aetiological causes of gastritis?
Helicobacter pylori
Helicobacter heilmannii
Treponema pallidum
Micobacteria
CMV
Herpes virus
Candida Histoplasma capsulatum Giardia lamblia Cryptosporidium Strongyloides stercoralis Anisakidae
What are the three topographical locations for classifying gastritis?
Antral
Body
Pangastritis
What percentage of the population are colonised by H. pylori?
Up to 80%
What virulent proteins do some strains of H. pylori have, which makes them more likely to cause gastritis and gastric ulcers and also cancer?
CagA
VacA
What is autoimmune gastritis?
Chronic gastritis as a result of autoantibodies against the gastrin receptor, ATPase and intrinsic factor (pernicious anaemia), leading to atrophy of the stomach.
What are the complications of autoimmune gastritis?
Achlorhydria
Pernicious anaemia
Adenocarcinoma
Carcinoid
What other hereditary diseases is autoimmune gastritis associated with?
Hashimoto thyroiditis Type I diabetes mellitus Addison disease Primary hypoparathyroidism Graves disease Myasthenia gravis Lambert-Eaton syndrome
What are most of the signs and symptoms of autoimmune gastritis attributable to?
The vitamin B12 defiency
How does the body respond to the drop in acid production in autoimmune gastritis?
Increased production and secretion of gastrin leading to hypergastrinemia.
What cells continue to be stimulated by the excessive levels of gastrin in the blood in a patient with autoimmune gastritis? What happens as a result?
Enterochromaffin-like cells (ECL)
Hyperplasia of these cells
What type of gastric tumour is particularly associated with chronic gastritis involving H. pylori?
MALT lymphoma
