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4 - Gastritis

Published online by Cambridge University Press:  03 February 2010

Richard V. Heatley
Affiliation:
St James's University Hospital, Leeds
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Summary

Introduction

Normal gastric mucosa contains few, if any, inflammatory cells. Gastritis represents the inflammatory response within the gastric mucosa resulting from injury, whatsoever the nature. The diagnosis is essentially histological since naked eye appearances are known to be unreliable. The advent of fibre-optic endoscopy and biopsy has considerably increased our knowledge about this condition and its natural history (Heatley & Wyatt, 1994). On a worldwide basis, gastritis is extremely common. Various classifications of gastric inflammation have developed based upon current knowledge at the time but, more recently, existing systems have been swept aside by the current terminology based upon known pathogenic mechanisms (Misiewicz, 1991). Most cases of gastritis are now known to be caused by infection with Helicobacter pylori. Other causes, including auto-immune gastritis, probably represent less than 10% of all cases of gastritis in most populations (Heatley & Wyatt, 1994).

Acute gastritis

The histological changes observed are usually simply those associated with acute inflammation, namely hyperaemia, infiltration with polymorphonuclear cells and oedema, together with a variable loss of surface epithelium. Macroscopically, oedema, small superficial haemorrhages and erosions or small ulcers may be visible (Heatley & Wyatt, 1994). A range of external influences have been shown to produce these changes but amongst the most important are alcohol excess, some spices, non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin and metabolic disturbances associated with acute illnesses, in particular uraemia. Salicylate ingestion is one of the most studied models of acute injury.

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Publisher: Cambridge University Press
Print publication year: 1994

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  • Gastritis
  • Edited by Richard V. Heatley, St James's University Hospital, Leeds
  • Book: Gastrointestinal and Hepatic Immunology
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511570261.005
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  • Gastritis
  • Edited by Richard V. Heatley, St James's University Hospital, Leeds
  • Book: Gastrointestinal and Hepatic Immunology
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511570261.005
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Gastritis
  • Edited by Richard V. Heatley, St James's University Hospital, Leeds
  • Book: Gastrointestinal and Hepatic Immunology
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511570261.005
Available formats
×