Metaplastic (chronic) atrophic gastritis

INTRODUCTION

Injury to the gastric mucosa is associated with epithelial cell damage and regeneration. The term gastritis is used to denote inflammation associated with mucosal injury. However, epithelial cell injury and regeneration are not always accompanied by mucosal inflammation. This distinction has caused considerable confusion since gastritis is often used to describe endoscopic or radiologic characteristics of the gastric mucosa rather than specific histologic findings. Epithelial cell damage and regeneration without associated inflammation is properly referred to as "gastropathy" [1,2]. (See "Classification and diagnosis of gastritis and gastropathy".)

The causes, natural history, and therapeutic implications of gastropathy differ from gastritis:

Gastropathy is usually caused by irritants such as drugs (eg, nonsteroidal antiinflammatory agents and alcohol), bile reflux, hypovolemia, and chronic congestion.

Gastritis is usually due to infectious agents (such as Helicobacter pylori) and autoimmune and hypersensitivity reactions.

Most classification systems distinguish acute, short-term from chronic, long-term disease. The terms acute and chronic are also used to describe the type of inflammatory cell infiltrate. Acute inflammation is usually associated with neutrophilic infiltration, while chronic inflammation is usually characterized by mononuclear cells, chiefly lymphocytes, plasma cells and macrophages. A practical clinicopathologic framework for the classification of gastritis and gastropathy based upon these factors can be proposed (table 1) [1].

                       

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Literature review current through: Nov 2014. | This topic last updated: Nov 25, 2013.
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