Acute gastritis

Acute gastritis 

Updated: 02/17/2021

© Jun Wang, MD, PhD

General features
  • Acute inflammation of gastric mucosa,
  • Erosive or non-erosive 
  • Usually clears spontaneous, except phlegmonous gastritis
Etiology
  • NSAIDs, alcohol, smoking, etc
  • Chemotherapy
  • Bacterial infections: Helicobacter pylori, etc 
  • Other micro-organisms, virus, fungus, parasite, etc
  • Other disorders: bile reflux, uremia, systemic infections (Salmonella), acute stress, ischemia and shock, gastric irradiation or freezing, etc
Pathogenesis NSAID associated gastritis
  • Direct epithelial damage due to increased acid production
  • COX-1 and COX-2 inhibition due to NSAID
Reduce mucosal blood flow, platelet function
Reduce mucus and bicarbonate production
Reduce angiogenesis
Increase leukocyte activation
Clinical presentations
  • May be asymptomatic
  • Pain, nausea and vomiting
  • May be accompanied by local hemorrhage or mucosal sloughing
  • Severe erosive disease may cause acute GI bleed, acute gastric ulcer
Key pathological features
Treatment
  • Proton pump inhibitors 
  • Treat bleeding if presents
  • Surgery if phlegmonous or necrotizing gastritis



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