Acute Gastritis Clinical Presentation

  • Author: Mohammad Wehbi, MD; Chief Editor: Julian Katz, MD   more...
 
Updated: Jan 12, 2011
 

History

  • Gnawing or burning epigastric distress, occasionally accompanied by nausea and/or vomiting. The pain may improve or worsen with eating.
  • Previous mucosal injury (eg, gastritis, peptic ulcer disease, endoscopic injury caused by polypectomy, injury caused by any surgery)
  • History of eating raw fish
  • Exposure to potentially noxious drugs or chemical agents. This includes corticosteroids or other prescription medications that can cause gastritis.
  • Routine use of aspirin or NSAIDs, especially at high doses
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Physical

The physical examination findings are often normal with occasional mild epigastric tenderness. The examination tends to exhibit more abnormalities as the patient develops complications in relation to gastritis.

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Causes

Acute gastritis has a number of causes, including certain drugs; alcohol; bacterial, viral, and fungal infections; acute stress (shock); radiation; allergy and food poisoning; bile; ischemia; and direct trauma.

  • Drugs - NSAIDs, such as aspirin, ibuprofen, and naproxen; cocaine; iron; colchicine, when at toxic levels, as in patients with failing renal or hepatic function; kayexalate; chemotherapeutic agents, such as mitomycin C, 5-fluoro-2-deoxyuridine, and floxuridine
  • Potent alcoholic beverages, such as whisky, vodka, and gin
  • Bacterial infections -H pylori (most frequent), H heilmanii (rare), streptococci (rare), staphylococci (rare), Proteus species (rare), Clostridium species (rare), E coli (rare), tuberculosis (rare), secondary syphilis (rare)
  • Viral infections (eg, CMV)
  • Fungal infections - Candidiasis, histoplasmosis, phycomycosis
  • Parasitic infection (eg, anisakidosis)
  • Acute stress (shock)
  • Radiation
  • Allergy and food poisoning
  • Bile: The reflux of bile (an alkaline medium important for the activation of digestive enzymes in the small intestine) from the small intestine to the stomach can induce gastritis.
  • Ischemia: This term is used to refer to damage induced by decreased blood supply to the stomach. This rare etiology is due to the rich blood supply to the stomach.
  • Direct trauma
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Contributor Information and Disclosures
Author

Mohammad Wehbi, MD  Assistant Professor of Medicine, Associate Program Director, Department of Gastroenterology, Atlanta Veterans Affairs Medical Center, Emory University School of Medicine

Mohammad Wehbi, MD is a member of the following medical societies: American College of Physicians, American Gastroenterological Association, and American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Nicole M Griglione, MD  Staff Physician, Department of Medicine, Emory University School of Medicine

Nicole M Griglione, MD is a member of the following medical societies: American Medical Association and Illinois State Medical Society

Disclosure: Nothing to disclose.

Richard H Snyder, MD  Vice-Chair, Program Director, Department of Medicine, Norfolk General Hospital; Clinical Associate Professor, Department of Internal Medicine, East Virginia Medical School

Richard H Snyder, MD is a member of the following medical societies: American College of Physicians

Disclosure: Nothing to disclose.

Gwendolyn Sarver  Pennsylvania State University College of Medicine

Disclosure: Nothing to disclose.

Kamil Obideen, MD  Assistant Professor of Medicine, Division of Digestive Diseases, Emory University School of Medicine; Consulting Staff, Division of Gastrointestinal Endoscopy, Atlanta Veterans Affairs Medical Center

Kamil Obideen, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Vincent W Yang, MD, PhD  R Bruce Logue Professor, Director, Division of Digestive Diseases, Department of Medicine, Professor of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine

Vincent W Yang, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American Gastroenterological Association, American Society for Clinical Investigation, and Association of American Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Waqar A Qureshi, MD  Associate Professor of Medicine, Chief of Endoscopy, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine and Veterans Affairs Medical Center

Waqar A Qureshi, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Simmy Bank, MD  Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine

Disclosure: Nothing to disclose.

Alex J Mechaber, MD, FACP  Senior Associate Dean for Undergraduate Medical Education, Associate Professor of Medicine, University of Miami Miller School of Medicine

Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine

Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD  Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility

Disclosure: Nothing to disclose.

References

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  10. Iwakiri Y, Kabemura T, Yasuda D, et al. A case of acute phlegmonous gastritis successfully treated with antibiotics. J Clin Gastroenterol. Mar 1999;28(2):175-7. [Medline].

  11. Kasper DL, Braunwald E, Fauci A, et al. Gastritis. In: Harrison's Principles of Internal Medicine: Companion Handbook. 16th ed. McGraw-Hill: 2006:Part 12, Chapter 274.

  12. Richieri JP, Pol B, Payan MJ. Acute necrotizing ischemic gastritis: clinical, endoscopic and histopathologic aspects. Gastrointest Endosc. Aug 1998;48(2):210-2. [Medline].

  13. Soltermann A, Koetzer S, Eigenmann F, et al. Correlation of Helicobacter pylori virulence genotypes vacA and cagA with histological parameters of gastritis and patient's age. Mod Pathol. Aug 2007;20(8):878-83. [Medline]. [Full Text].

  14. Srivastava A, Lauwers GY. Pathology of non-infective gastritis. Histopathology. Jan 2007;50(1):15-29. [Medline].

  15. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. Oct 10 2002;347(15):1175-86. [Medline].

  16. Yamamoto T, Matsumoto J, Shiota K, et al. Helicobacter heilmannii associated erosive gastritis. Intern Med. Mar 1999;38(3):240-3. [Medline].

 
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Acute gastritis with superficial erosions.
Mucosal erythema and edema consistent with acute gastritis.
 
 
 
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