Gastritis

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Introduction

• Inflammation of the gastric mucosa which may be acute or chronic
• The most important risk factors for acute gastritis include drugs (NSAIDs) and alcohol
• H. pylori infection is the most important risk factor for chronic gastritis.

Clinical features

• Upper abdominal burning pain or discomfort that mimics peptic ulcer disease (PUD)

Complications

• Acute gastritis: Upper gastrointestinal (GI) haemorrhage
• Chronic gastritis: peptic ulcer disease; gastric cancer

Investigations

• Upper GI Endoscopy (macroscopic diagnosis)
• Histology of gastric biopsy for definitive diagnosis

Treatment goals

• Eliminate pain
• Address offending agent
• Prevent progression to PUD or gastric cancer

Drug treatment

Acute Gastritis
• Antacids
- Magnesium trisilicate 1 - 2 tablets or suspension 10 mL orally three times daily or as required
Or:
• H receptor antagonist:
- Ranitidine 150 mg orally once daily as required
Or:
• Proton pump inhibitors
- Omeprazole 20 mg orally once daily as required
Type A gastritis
• Endoscopic surveillance every 2 - 3 years for early detection of cancer
Type B gastritis
• Eradication of H.pylori using triple therapy with
- Clarithromycin 500 mg orally twice daily
- Amoxicillin 1g orally every twice daily
- Omeprazole 20 mg orally twice daily
- All for 10 – 14 days

Prevention

• Avoid risk factors (NSAIDs, alcohol, etc)