Gastritis

The several forms of gastritis are extremely common gastric mucosal diseases that represent reactions to a variety of exogenous and endogenous noxious influences. The ingestion of alcohol and aspirin or the reflux of bile into the stomach are important etiologic factors in erosive gastritis, which currently is one of the most common causes of massive upper gastrointestinal hemorrhage. Alcohol, aspirin and bile salts damage the mucosa by disrupting the normal barrier to acid back-diffusion. Acute erosions and ulceration are common complications of the "stress" of serious trauma, major operations and shock; changes in mucosal permeability, blood flow and cell regeneration are factors that lead to these lesions. Atrophic gastritis that is confined to the fundic mucosa often is associated with immunologic phenomena; this lesion may be due to immunologic injury. Gastrointestinal bleeding and pernicious anemia or gastric carcinoma are the important complications of acute and chronic gastritis, respectively. Advances in the under-standing of gastritis coupled with the development of diagnostic tools (particularly the flexible fiberoptic gastroscopes) may permit earlier diagnosis and management of these conditions.