Gastritis

Question 1

Give the definition of gastritis:

Answer 1

the histological presence of gastric mucosal inflammation

Question 2

Give 8 causes of gastritis:

Answer 2

1. H.pylori infection
2. NSAID use
3. Alcohol
4. Stress (secondary to mucosal oshaemia)
5. Autoimmune gastritis
6. Crohn’s disease
7. Viruses (eg CMV and HSV)
8. Duodenogastric reflux

Question 3

What two categories can gastritis be divided into?

Answer 3

1. Erosive
2. Non-erosive

Question 4

What is erosive gastritis?

Answer 4

This form involves both inflammation and wearing away (erosion) of the stomach lining. Erosive gastritis typically develops suddenly (called acute erosive gastritis) but may develop slowly (called chronic erosive gastritis), usually in people who are otherwise healthy.

Question 5

What is non-erosive gastritis?

Answer 5

Nonerosive gastritis is characterized by changes in the stomach lining that range from wasting away (atrophy) of the stomach lining to transformation of stomach tissue into another type of intestinal tissue (metaplasia). Often, several types of white blood cells accumulate in the stomach and cause varying degrees of inflammation. Inflammation can occur in the entire stomach or only in certain parts.

Question 6

Is H. pylori gram positive or negative?

Answer 6

Gram negative

Question 7

What shape is H. pylori?

Answer 7

spiral

Question 8

In which region of the stomach do H. pylori most abundantly colonise?

Answer 8

antrum

Question 9

Give three ways in which H. pylori can cause gastritis:

Answer 9

1) urease enzymes produce ammonium and chloride which are directly cytotoxic
2) the bacteria binds to MHC II molecules on gastric epithelial cells, triggering apoptosis
3) some infective strains produce CagA (cytotoxic-associated protein) and VacA (vaculating toxin) genes that produce a more intense inflammatory response

Question 10

Which two regions of the stomach are affected more severely by autoimmune gastritis?

Answer 10

1. Fundus
2. Body

Question 11

Describe how autoimmune gastritis can cause pernicious anaemia: (3)

Answer 11

1) antibodies against parietal cells cause atrophic gastritis (loss of glandular tissue)
2) this results in low production of gastric acid and intrinsic factor
3) this leads to vitamin B12 deficiency, anaemia and iron deficiency

Question 12

What is atrophic gastritis?

Answer 12

loss of glandular cells in the mucosa and replacement with fibrous tissue

Question 13

What are 3 complications of gastritis?

Answer 13

1. Bleeding
2. Ulcers
3. Narrowing of the passage out of the stomach

Question 14

How do we diagnose gastritis?

Answer 14

Upper endoscopy

A doctor suspects gastritis when a person has upper abdominal discomfort, pain, or nausea. Tests usually are not needed. However, if the doctor is uncertain of the diagnosis, or if symptoms do not resolve with treatment, the doctor may do upper endoscopy.

Question 15

What is the treatment of gastritis?

Answer 15

Medications that reduce acid production and antacids

Sometimes antibiotics that treat H. pylori infection

Treatments to stop bleeding

Regardless of the cause of gastritis, symptoms of gastritis can be relieved by taking medications that neutralize or reduce the production of stomach acid and by discontinuing medications that cause symptoms.