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
- Pathological findings not always correlate with symptoms
- Hyperemic mucosa
- Neutrophilic infiltration
Treatment
- Proton pump inhibitors
- Treat bleeding if presents
- Surgery if phlegmonous or necrotizing gastritis
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