* Gastritis
Prof. Khalid A. Jasim Al-Khazraji MBCHB , M.D , CABM , FRCP , FACP* The term gastritis should be reserved for histologically documented inflammation of the gastric mucosa,
There is no typical clinical manifestation of gastritis.
* Classification of GastritisI. Acute gastritisA. Acute H. pylori infection. B. Other acute infectious gastritides. II- Chronic atrophic gastritis: Type A: Autoimmune, body-predominant Type B: H. pylori–related, antral-predominant Indeterminant. III- Uncommon forms of gastritis: Lymphocytic Eosinophilic Crohn's disease Sarcoidosis Isolated granulomatous gastritis* ◑ Acute Gastritis - The most common causes of acute gastritis are infectious with H. pylori. Presenting with epigastric pain, nausea, and vomiting.
* Chronic gastritis has been classified according to histologic characteristics. These include superficial atrophic changes, and gastric atrophy.The early phase of chronic gastritis is superficial gastritis. The next stage is atrophic gastritis. Chronic gastritis is also classified according to the predominant site of involvement. Type A refers to the body-predominant form (autoimmune) and type B is the antral-predominant form (H. pylori–related). This classification is artificial in view of the difficulty in distinguishing between these two entities. The term AB gastritis has been used to refer to a mixed antral/body picture. ◑ Chronic Gastritis
* Type B, or antral-predominant, gastritis is the more common form of chronic gastritis. H. pylori infection is the cause of this entity. The conversion to a pangastritis is time-dependent–estimated to require 15–20 years. Early on, with antral-predominant findings.Multifocal atrophic gastritis, gastric atrophy with subsequent metaplasia, has been observed in chronic H. pylori–induced gastritis. This may ultimately lead to development of gastric adenocarcinoma.Infection with H. pylori is also associated with development of a low-grade B cell lymphoma, gastric MALT lymphoma. Type B Gastritis
* Treatment: Chronic Gastritis
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- Patients with pernicious anemia will require parenteral vitamin B12 supplementation on a long-term basis. - Eradication of H. pylori is not routinely recommended unless PUD or a low-grade MALT lymphoma is present.
* Erosive gastropathyLymphocytic gastritis : is characterrized by intense infiltration of the surface epithelium –celiac sprue thickened folds nodules like. Esinophilic gastiritis-antral predomenantMay cause obstruction treatment by steriodGranulomatous gastritis crohns-candidiasisT.B-SarcoidosisMenetriers disease-large,tortuous mucosalfold mostly body and fundus hyperplasiaof gastric pits,glandatrophy