Chronic Gastritis: Causes, Types, and Treatment Overview

Chronic Gastritis: Causes, Types, and Treatment Overview

Question. Write Short notes on Chronic Gastritis.

Answer. When the acute gastritis remains longer and is not treated, it becomes chronic and is known as chronic gastritis.

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Etiology of Chronic Gastritis

• Repeated injury to the gastric mucosa by tea, coffee, alcohol, and spices
• Infection from the throat, teeth, gums, and sinuses
• NSAIDs
• Autoimmune pathology
• Very hot beverage
• Gastrectomy.

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Types of Gastritis

• Superficial
• Atrophic
• Hypertrophic
• Infectious
• Eosinophilic.

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There are mainly two types of chronic gastritis:

1. Type A gastritis
2. Type B gastritis.

Type A Gastritis (less common)

• It involves the body of the stomach and spars antrum.
• It is caused by autoimmune disorders like type I diabetes mellitus, Sjögren’s syndrome, Graves disease, Hashimoto disease, myasthenia gravis, etc.
• It is caused due to autoimmune activity against parietal cells.
• Parietal cell antibodies can be detected in serum.
• In severe cases, parietal cell atrophy leads to a deficiency of intrinsic factors which leads to pernicious anemia.
• The disease is asymptomatic and the long-term complication is gastric carcinoma.

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Treatment of Type A Gastritis

• In severe cases, corticosteroids are administered.
• In mild cases, parenteral iron should be administered.

Type B Gastritis

• This is a more common form of gastritis and involves the antrum of the stomach.
• The usual cause is gram­negative bacteria H. pylori.
• The condition is the precursor of peptic ulcer.
• There is the possibility of gastric carcinoma.

Diagnosis of Type B Gastritis

1. Gastric acid study, i.e. achlorhydria
2. Hemoglobin decreases
3. Serum gastrin increases.

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Management of Type B Gastritis

• Anti­ H. pylori treatment
  • Triple drug therapy: Proton pump inhibitor or ranitidine 400 mg BD + Bismuth subcitrate + Amoxicillin 1 gm or clarithromycin 500 mg or metronidazole 500 mg BD
  • Quadruple therapy: Omeprazole 10 mg BD + Tetracycline 500 mg QID + Bismuth subcitrate QID + Metronidazole 500 mg TDS.
    In both cases, 14 days course is preferred.
• Parenteral vitamin B12 is administered.