Gastritis

Description

Macro or microscopic inflammation of mucosa of stomach

Epidemiology

• 8 out of every 1,000 people are estimated to have gastritis.
• >2% of ICU patients have heavy bleeding secondary to gastritis.

Etiology

• Common causes
  • Physiologic stress (e.g., chronic disease, CNS disease, overwhelming sepsis, ICU patients)
  • Peptic disease
  • Drug-induced (e.g., NSAIDs, steroids, valproate; more rarely, iron, calcium salts, potassium chloride, antibiotics)
  • Infection
    • Helicobacter pylori (children more likely to have more severe gastritis, specifically located in antrum of stomach)
    • Tuberculosis
    • Cytomegalovirus
    • Parasites
  • Celiac disease: lymphocytic gastritis
  • Major surgery; severe burns; renal, liver, respiratory failure; severe trauma
  • Caustic ingestions (e.g., lye, strong acids, pine oil)
  • Protein sensitivity (e.g., cow’s milk-protein allergy), allergic enteropathy
  • Eosinophilic gastroenteritis
  • Crohn disease:
    • Up to 40% of Crohn patients have gastroduodenal involvement.
    • Gastric Crohn disease may manifest itself as highly focal, non-H. pylori, nongranulomatous gastritis.
  • Direct trauma (nasogastric tubes)
  • Ethanol
  • Idiopathic
• Less common causes:
  • Radiation induced
  • Hypertrophic gastritis (Ménétrier disease)
  • Autoimmune gastritis
  • Collagenous gastritis
  • Zollinger-Ellison syndrome
  • Vascular injury