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Acute and chronic gastritis due to Helicobacter pylori

Pamela J Jensen, MD
Mark Feldman, MD, MACP, AGAF, FACG
Section Editor
J Thomas Lamont, MD
Deputy Editor
Shilpa Grover, MD, MPH, AGAF


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 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 drugs (eg, nonsteroidal antiinflammatory agents), alcohol, bile, circulatory failure, or chronic congestion.

Gastritis is usually caused by infectious agents (such as Helicobacter pylori) or autoimmune and hypersensitivity reactions, although in many cases the cause of the gastritis is unknown.

Most gastritis 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 ("active") 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 2017. | This topic last updated: Jul 14, 2016.
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