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[gastro- + -itis]
Acute or chronic inflammation of the lining of the stomach.
SYN: SEE: endogastritis
SEE: Helicobacter pylori

Gastritis is estimated to be present in one third of the world's adult population. Its prevalence increases with age. The annual incidence of new diagnoses has been decreasing over the last several decades.

Worldwide, the most common cause is infection with Helicobacter pylori. Other relatively common causes of gastric inflammation include use of alcohol and tobacco products and injury to the lining of the stomach by nonsteroidal anti-inflammatory drugs (NSAIDs). Autoimmune diseases, e.g., pernicious anemia, duodenal reflux, and gastric ischemia are sometimes responsible. Acute gastritis may develop in hospitalized patients, e.g., those with major traumatic injuries, burns, severe infections, organ failure, or major surgery.

The inflammation may be asymptomatic or evidenced only by mild upper abdominal discomfort (typically a “burning sensation”), or it may present with epigastric pain, nausea, vomiting, and hematemesis.

Gastritis may be suspected based on the patient's presenting symptoms and signs. It can be confirmed with barium swallow testing or upper gastrointestinal (GI) endoscopy.

When H. pylori is responsible, antibiotics and a potent acid-suppressing agent cure most patients. Abstaining from alcohol, tobacco, and NSAIDs improves gastritis caused by these agents. Antacids, an H2 blocking agent, e.g., famotidine, or proton pump inhibitors, e.g., esomeprazole, are also given to promote healing.

Restoration of a normal healthy stomach usually occurs with treatment and avoidance of precipitating factors.

If the patient requires hospitalization, general patient care concerns apply. If bleeding occurs, the patient is monitored for anemia, and appropriate treatment is instituted. If there is severe hemorrhage, blood transfusion, vasopressin infusion, and (less frequently) surgery may be required. The patient is educated about the disorder. Compliance with multidrug antibiotic regimens is encouraged when the patient is found to have gastritis caused by H. pylori. If gastritis is caused by smoking, alcohol, or NSAIDs, abstinence from these substances is encouraged. Patients are advised that, if they are unable to take foods or liquids by mouth or begin to vomit blood, they should seek medical attention promptly.

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