Gastritis

Question 1

What are risk factors for gastritis?

Answer 1

• H. pylori infection
• NSAID use
• Alcohol/toxic insult
• Previous gastric surgery
• Critical illness
• Autoimmune disease (specifically thyroid, T1D, hypoparathyroidism)

Question 2

How might a patient with gastritis present?

Answer 2

• Gastritis risk factors
• Dyspepsia
• Nausea/vomiting
• Anorexia
• Epigastric pain

Question 3

What investigations should you think of in someone suspected to have gastritis?

Answer 3

• H. pylori breath/faecal test
• FBE (signs of autoimmune disease here - reduced MCH, haematocrit)
• Autoantibodies (B12, intrinsic factor)
• Endoscopy/biopsy

Question 4

What conditions can present similarly to gastritis and how are they distinguished?

Answer 4

• GI malignancy (malignant red flags present, though)
• PUD (endoscope differentiates)
• GORD (endoscope shows oesophageal involvement)

Question 5

What are the prinicples of management of gastritis?

Answer 5

• Reduce inflammation
• Reduce symptoms
• Treat underlying cause
  
  • H. pylori - triple therapy (PPI + amoxy, clarithromycin)
  • Erosive - cease NSAIDs
  • Autoimmune - monthly B12 injection