GI: Gastritis and Gastropathy Flashcards

1
Q

What is gastritis?

A

Gastritis is defined as the histological presence of gastric mucosal inflammation

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2
Q

What is gastropathy?

A

The broader term gastropathy encompasses lesions characterised by minimal or no inflammation

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3
Q

Aetiology of gastritis

A

A - Autoimmune (autoantibodies to parietal cells)

B - Bacterial (H. Pylori infection)

C - Chemicals (Drugs, alcohol, bile reflux)

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4
Q

What is autoimmune gastritis?

A

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’.

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5
Q

What is the commonest cause of gastritis?

A

Helicobacter pylori

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6
Q

What are risk factors for gastritis?

A
  • Alcohol
  • NSAIDs
  • H. Pylori
  • Reflux/hiatus hernia
  • Atrophic gastritis
  • Granulomatous disease (Crohn’s, Sarcoidosis)
  • CMV
  • Zollinger-Ellison syndrome
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7
Q

What are the features of someone with gastritis?

A
  • 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
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8
Q

What investigations would you consider doing in someone with suspected gastritis?

A
  • Bloods - FBC, Serum B12, parietal cell/intrinsic factor antibodies, Blood cultures
  • H. pylori breath test/faecal antigen
  • Upper GI endoscopy - only if alarm symptoms
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9
Q

What are alarm symptoms of someone with gastritis?

A
  • Anaemia
  • Loss of weight
  • Anorexia
  • Recent onset
  • Malaena/haematemesis
  • Swallowing difficulty
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10
Q

How would you manage someone with gastritis?

A
  • Treat the cause
    • H. pylori eradication therapy
    • Discontinue causative drugs
    • Reduce alcohol and tobacco intake
    • Cyanocobalamin - autoimmune
  • PPI’s/H2 antagonists
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11
Q

What are complications of gastritis?

A
  • Bleeding
  • Perforation
  • Malignancy
  • Gastric outflow
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