Gastritis

Basics

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

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