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04-21-2008, 03:52 PM
ŒType A gastritis:
· Aetiology: Autoimmune condition in which there is circulating antibodies to the parietal cells.
·Pathology:
· This results in atrophy of the parietal cells and hypochlorohydria and ultimately achlorohydria.
· As intrinsic factor is produced by the parietal cells, there is malabsorption of the vitamin B12 which, if untreated, leads to pernicious anaemia.
· The G cells is not affected, so, hypochlorohydria leads to chronic hypergastrinemia.
· The ECL cells also is not affected and hypertrophy of these cells may predispose to adenomas which may turn malignant.
Type B gastritis:
· Aetiology: Mostly it is associated with Helicobacter pylori and affects mainly pyloric antrum.
· Pathology:
It usually results in peptic ulcer disease. Helicopacter pangastritis is common manifestation of infection and patients with pangastritis are more prone to the development of cancer.
Chronic pangastritis with atrophy is associated with intestinal metaplasia and sometimes dysplasia with significant malignant potential and if this condition is identified, the patient should be regularly screaned endoscopically.
ŽReflux Gastritis:
· Aetiology:It is caused by entero gastric reflux. It is particularly common after gastric surgery and occationally occurs in patients who have had cholecystectomy.
· Pathology:Its histological features is distinct from other types of gastritis. It is treated conservatively by bile chelating agents. Operations for the condition should reserved for the most severe cases.
Erosive gastritis:
· Aetiology: This is caused by agents which disturb the gastric mucosal barrier; NSAIDs and alcohol are common causes.
· Pathology: Superficial ulcers limited to mucosa and sumucosa which may bleed and may lead to severe hematemesis.
Stress gastritis:
· Aetiology:This is a common sequel of serious illness or injury and is characterized by the reduction of blood supply to superficial mucosa of the stomach.
· Diagnosis:It is usually diagnosed after bleeding supervene in which case treatment can be extremely difficult.
·Treatment: Prevention of the condition is much easier than treating it. The routine use of H2 antagonists with or without mucous protecting agents such as sucralfate in intensive care patients reduces the incidence of bleeding from stress ulceration.


‘Menetrier’s disease:
· Aetiology: It is mostly due to overexpression of a peptide called transforming growth factor alpha (TGF-µ).
· Pathology: It is unusual condition characterized by gross hypertrophy of the gastric mucosal folds, mucous production and hypochlorohydria. This condition is premalignant and may present with hypoproteinemia and anaemia.
’Lymphocytic gastritis:
It is rare type of gastritis in which there is ifiltration of the gastric mucosa by T cells. It is probably associated with H.pylori.
“Other forms: Eosinophilic gastritisconsidered as allergic condition, Granulomatous gastritis in cases with Crohn’s disease.
SOURCE: DR. AYMAN SALEM'S BOOK
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