Merck Manual

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Overview of Gastritis

By

Nimish Vakil

, MD, University of Wisconsin School of Medicine and Public Health

Last full review/revision Jan 2020| Content last modified Jan 2020
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Gastritis is inflammation of the gastric mucosa caused by any of several conditions, including infection (Helicobacter pylori), drugs (nonsteroidal anti-inflammatory drugs, alcohol), stress, and autoimmune phenomena (atrophic gastritis). Many cases are asymptomatic, but dyspepsia and gastrointestinal bleeding sometimes occur. Diagnosis is by endoscopy. Treatment is directed at the cause but often includes acid suppression and, for Helicobacter pylori infection, antibiotics.

Gastritis is classified as erosive gastritis or nonerosive gastritis based on the severity of mucosal injury. It is also classified according to the site of involvement (ie, cardia, body, antrum). Gastritis can be further classified histologically as acute or chronic based on the inflammatory cell type. No classification scheme matches perfectly with the pathophysiology; a large degree of overlap exists. Some forms of gastritis involve acid-peptic and H. pylori disease (see also Overview of Acid Secretion). Additionally, the term is often loosely applied to nonspecific (and often undiagnosed) abdominal discomfort and gastroenteritis.

Acute gastritis is characterized by polymorphonuclear leukocyte infiltration of the mucosa of the antrum and body.

Chronic gastritis implies some degree of atrophy (with loss of function of the mucosa) or metaplasia. It predominantly involves the antrum (with subsequent loss of G cells and decreased gastrin secretion) or the corpus (with loss of oxyntic glands, leading to reduced acid, pepsin, and intrinsic factor).

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