Acute gastritis

Aetiology:

Gastritis can commonly be caused by:

Drugs such as Aspirin and other NSAIDs

Infections (e.g. CMV and HSV), particularly in the immunocompromised

Alcohol in high concentrations damages the gastric mucosal barrier

Severe stress

Secondary to:

Burns (Curling ulcers)

Trauma

Shock

Renal disease

Liver disease

Pathology:

There is an acute inflammatory infiltrate in the superficial gastric mucosa predominantly with neutrophils

This is sometimes accompanied by mucosal erosions

Multiple small erosions (often with an oedematous mucosa) are described as acute erosive gastritis

Acute gastric ulceration occurs in the same setting as erosions but ulcers are larger and less superficial

Clinical features:

The correlation between the pathological changes and symptoms is poor.

The commonest symptoms are:

Indigestion

Vomiting

GI haemorrhage can occur (usually from NSAIDs)

Dx and rx:

In many pts, symptoms settle without dx but endoscopy is necessary in pts with a GI haemorrhage to confirm the presence of acute ulcers or erosions

No specific therapy is required apart from removal of the offending cause (if possible)