Gastritis
Basics
Description
Description
- Inflammatory response of gastric mucosa to injury – “gastritis”
- 3 lines of defense of gastric mucosa:
- Mucous layer that forms protective pH gradient
- Surface epithelial cells that can repair small defects
- Postepithelial barrier that neutralizes any acid that has traversed first 2 layers
- No definite link between histologic gastritis and dyspeptic symptoms
- Epithelial cell damage with no associated inflammation – “gastropathy”
Etiology
Etiology
- Common causes of gastritis: Infections, autoimmune, drugs (i.e., cocaine), hypersensitivity, stress
- Common causes of gastropathy: Endogenous or exogenous irritants, such as bile reflux, alcohol, or aspirin and NSAIDs, ischemia, stress, chronic congestion
- Acute gastritis:
- Stress (sepsis, burns, trauma):
- Decrease in splanchnic blood flow leading to decreased mucus production, bicarbonate secretion, and prostaglandin synthesis
- Results in mucosal erosions and hemorrhage
- Alcohol:
- Induces production of leukotrienes that cause microvascular stasis, engorgement, and increased vascular permeability
- Leads to hemorrhage
- NSAIDs, including aspirin:
- Interfere with prostaglandin synthesis, leading to similar cascade as induced by alcohol
- Results in mucosal erosions
- Steroids
- Stress (sepsis, burns, trauma):
- Chronic gastritis:
- Produced by Helicobacter pylori
- Mechanism of H. pylori unclear:
- Gram-negative spiral bacteria found in gastric mucous layer
- Contains enzyme urease that allows it to change pH level (alkaline) of its microenvironment
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Citation
Schaider, Jeffrey J., et al., editors. "Gastritis." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307043/all/Gastritis.
Gastritis. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307043/all/Gastritis. Accessed December 9, 2024.
Gastritis. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307043/all/Gastritis
Gastritis [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 09]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307043/all/Gastritis.
* Article titles in AMA citation format should be in sentence-case
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T1 - Gastritis
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ED - Schaider,Jeffrey J,
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ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307043/all/Gastritis
PB - Lippincott Williams & Wilkins
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DB - Emergency Central
DP - Unbound Medicine
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