Gastritis

Gastritis and ulceration

This is inflammation of the lining of the stomach which can include the creation of ulcers.

Symptoms include:

• Abdominal pain

• Nausea

• Bloating

• Loss of appetite

• Bleeding seen in vomit or stools

Causes:

• Helicobacter Pylori: the bug tunnels into the stomach lining and can cause the stomach to create more acid to combat it.

• NSAIDs: Non Steroidal Anti-Inflammatory Drugs like ibuprofen, aspirin etc cause irritation to the stomach lining.

• Autoimmune Disorders: Some can attack or rritate the stomach lining.

• Bile reflux.

• Other possible suggested causes include stress and alcoholism.

Treatment:

• PPI medication or PCAB to reduce the amount of acid

• Eradication of H-Pylori if found.

• Avoid any trigger foods you identify.

• Avoid NSAIDs.

Foveolar Hyperplasia is one of many terms that may be encountered that can cause concern for those not generally accustomed to medical terms but is really just a descriptor of a type of gastric inflammation.

Hyperplasia just means the area is enlarged by extra cells, usually as a result of inflammation. The foveolae are the indentations of the stomach surface. 

Gastric Intestinal Metaplasia (GIM)

A possible progression suggested by Correa:

Gastritis + placement of goblet cells = Gastric Intestinal Metaplasia with possibility of mutation (dysplasia) to Gastric Cancer.

This is directly comparable to Barrett's Oesophagus and its possible mutation:

1. Columnar cells + goblet cells = Intestinal Metaplasia (i.e. Barrett's)
2. Possible dysplasia.
3. Possible cancer.

Untreated, risk is about 0.25% for both GIM and Barrett's.

The gastric precancerous cascade by Pelayo Correa (2011)

Overview of Current Concepts in Gastric Intestinal Metaplasia and Gastric Cancer (2018)

Overall, GIM carries a significant potential risk of malignancy and is becoming increasingly recognized, as well as the epidemiologic, genetic, and environmental risk factors associated with its development.
The availability and advancement of means of screening and detection for gastric adenocarcinoma need to be broadened to allow more gastroenterologists to develop both the ability and knowledge of how to endoscopically locate and manage precursor lesions. Further investigation is needed on methods for prevention and treatment of a disease that continues to carry a high burden of morbidity and mortality. 

Page last updated 24 September 2024