GI: Gastritis and Gastropathy Flashcards
What is gastritis?
Gastritis is defined as the histological presence of gastric mucosal inflammation
What is gastropathy?
The broader term gastropathy encompasses lesions characterised by minimal or no inflammation
Aetiology of gastritis
A - Autoimmune (autoantibodies to parietal cells)
B - Bacterial (H. Pylori infection)
C - Chemicals (Drugs, alcohol, bile reflux)
What is autoimmune gastritis?
Autoimmune disease affecting body and fundus of the stomach, causing atrophic gastritis and loss of parietal cells with achlorhydria and intrinsic factor deficiency causing the clinical syndrome of ‘pernicious anaemia’.
What is the commonest cause of gastritis?
Helicobacter pylori
What are risk factors for gastritis?
- Alcohol
- NSAIDs
- H. Pylori
- Reflux/hiatus hernia
- Atrophic gastritis
- Granulomatous disease (Crohn’s, Sarcoidosis)
- CMV
- Zollinger-Ellison syndrome
What are the features of someone with gastritis?
- Dyspepsia
- Epigatric discomfort (blaoting/eindigestion)
- Nausea and Vomiting
- Loss of appetite
- Weight loss - must exclude gastric cancer
- Pernicious anaemia - lack if intrinsic factor due to parietal cell damage in the stomach
What investigations would you consider doing in someone with suspected gastritis?
- Bloods - FBC, Serum B12, parietal cell/intrinsic factor antibodies, Blood cultures
- H. pylori breath test/faecal antigen
- Upper GI endoscopy - only if alarm symptoms
What are alarm symptoms of someone with gastritis?
- Anaemia
- Loss of weight
- Anorexia
- Recent onset
- Malaena/haematemesis
- Swallowing difficulty
How would you manage someone with gastritis?
-
Treat the cause
- H. pylori eradication therapy
- Discontinue causative drugs
- Reduce alcohol and tobacco intake
- Cyanocobalamin - autoimmune
- PPI’s/H2 antagonists
What are complications of gastritis?
- Bleeding
- Perforation
- Malignancy
- Gastric outflow
