Acute & Chronic Gastritis

Gastritis is histologically defined inflammation, irritation, or erosion of the gastric mucosal lining. It can manifest acutely with neutrophilic infiltration, or chronically with mucosal atrophy, intestinal metaplasia, and glandular loss.

• Gnawing, burning, or aching upper abdominal (epigastric) discomfort
• Postprandial fullness and early satiety after eating only small amounts of food
• Nausea and episodic vomiting
• Bloating, frequent belching, and loss of appetite
• Hemorrhagic gastritis: Hematemesis (coffee-ground vomitus) or melena

Etiologies include Helicobacter pylori infection, regular NSAID or aspirin use, heavy alcohol consumption, severe systemic physiological stress (burns, sepsis, mechanical ventilation), bile reflux, and autoimmune destruction of parietal cells (Autoimmune Atrophic Gastritis).

Upper Endoscopy with gastric mucosal biopsy is the definitive diagnostic procedure. Non-invasive testing for H. pylori via stool antigen or urea breath test; CBC to screen for iron-deficiency or megaloblastic anemia.

Acid suppression and elimination of mucosal irritants: Proton Pump Inhibitors (Pantoprazole, Omeprazole) or H2-Blockers (Famotidine) for 4 to 8 weeks; eradication of H. pylori with antibiotics; complete cessation of alcohol and NSAIDs; Vitamin B12 replacement for autoimmune gastritis.