Gastritis (synonyms: Acute gastritis; acute gastroduodenitis; acute erosive gastritis; acute hemorrhagic gastritis; alcohol gastritis; alcohol toxic gastritis; allergic gastritis; atrophic gastritis; atrophic gastroduodenitis; bacterial gastritis; chronic antral gastritis; chronic fundic gastritis; chronic gastritis; chronic erosive gastritis; simple gastritis; erosive gastritis; gastritis erosiva; gastritis phlegmonosa; gastroduodenitis; gastroesophagitis; granulomatous gastritis; hypersecretory gastritis; hypertrophic gastritis; hemorrhagic gastritis; corpus gastritis; gastric mucosal hypertrophy; surface gastritis; reflux gastritis; irritable gastritis; recurrent gastritis; spastic gastritis; stump gastritis; plural: Gastritis; Greek. γαστήρ (gaster) stomach, with the suffix -itis expressing inflammation; ICD-10-GM K29.-: Gastritis and Duodenitis) refers to inflammation of the gastric mucosa. Gastritis can occur both acutely and chronically. The following forms of chronic gastritis are distinguished according to the ABC scheme:
| Type A (autoimmune gastritis) | Type B (bacterial gastritis) | Type C (chemical gastritis) | |
| Cause | Autoimmune disease or autoimmune gastritis with antibodies to parietal cells (APCA or anti-parietal cell autoantibodies; 90% of cases) and intrinsic factor (AIF; 70% of cases) | Infection by Helicobacter pylori (promotes acid secretion; releases mucosal toxic proteases and toxins);very rarely cytomegalovirus or enteroinvasive bacteria | Medications – nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (ASA), diclofenac; glucocorticoids, cytostatic drugsGall reflux after subtotal gastrectomy (about 4/5 of the stomach is removed) |
| Localization | Corpus gastritis, descending (voucher cells mainly in fundus and corpus). | Antrum gastritis (40% of cases), spreading toward corpus as it progresses (antrum + corpus: 50%; corpus only: 10%) | Antrum gastritis (but also in fundus and corpus). |
| Frequency | 5 % | 80 % | 15 % |
| Course/ Complications | Complete mucosal atrophy of the stomach (= atrophic gastritis) is found. Because intrinsic factor is essential for vitamin B12 absorption, pernicious anemia (anemia (anemia) caused by a deficiency of vitamin B12 (cobalamin)) may develop.Long-term complication: gastric carcinomaFor more information, see “Consequential diseases.” | Gastroduodenal ulcers (ventriculi ulcer /gastric ulcer or duodenal ulcer /duodenal ulcer) may develop. The risk of developing MALT lymphoma is increased.For more information, see “Consequential diseases.” | Gastroduodenal ulcers develop with a high risk of bleeding. These ulcers are acute in onset and heal after elimination of the precipitating cause.For further details, see “Consequential diseases”. |
In addition to these three main forms, there are several special forms of gastritis:
- Phlegmonous or abscessing gastritis – e.g. after streptococcal infection.
- Hemorrhagic-erosive gastritis
- Giant fold gastritis
- Viral gastritis – e.g. due to cytomegalovirus, varicella.
- Allergic gastritis – contains eosinophilic granulocyte infiltrates, e.g., due to food allergy.
- Specific gastritis – in the setting of tuberculosis, syphilis, Crohn’s disease, sarcoidosis, granulomatosis with polyangiitis (GPA; formerly Wegener’s granulomatosis), gluten-sensitive enteropathy, chemical irritation, radiation injury.
Frequency peak: chronic gastritis occurs increasingly in older age. The prevalence (disease frequency) for chronic gastritis is about 50% in the group over 50 years (in Western countries). For information on the prevalence of the respective forms of chronic gastritis, see the table. Course and prognosis: Acute gastritis occurs suddenly and may be accompanied by bleeding of the mucosa. While acute gastritis is often accompanied by an increase in gastric juice secretion, this is reduced in chronic gastritis.Acute gastritis usually heals spontaneously, but in chronic gastritis there may be so-called mucosal atrophy (decrease in gastric mucosa) with reduced acid production by the stomach.In the long-term course, it can even lead to the development of gastric carcinoma (stomach cancer). For more information on the course of chronic gastritis, see the table.
