Acute Gastritis Treatment & Management

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

Medical Care

Administer medical therapy as needed, depending on the cause and the pathological findings.

No specific therapy exists for acute gastritis, except for cases caused by H pylori.

Administer fluids and electrolytes as required, particularly if the patient is vomiting.

Discontinue the use of drugs known to cause gastritis (eg, NSAIDs, alcohol). A long-term prospective study found that patients with arthritis who were older than 65 years and regularly took low-dose aspirin were at an increased risk for dyspepsia severe enough to necessitate the discontinuation of NSAIDs.[2] This suggests that better management of NSAID use should be discussed with older patients in order to reduce NSAID-associated upper GI events.

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Surgical Care

Surgical intervention is not necessary, except in the case of phlegmonous gastritis. With this entity, surgical intervention with resection of the affected area may be the most effective form of treatment.

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Consultations

Consult a gastroenterologist in complicated cases.

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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

  1. Ford AC, Marwaha A, Lim A, Moayyedi P. What is the prevalence of clinically significant endoscopic findings in subjects with dyspepsia? Systematic review and meta-analysis. Clin Gastroenterol Hepatol. Oct 2010;8(10):830-7, 837.e1-2. [Medline].

  2. Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP. Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients. Aliment Pharmacol Ther. Nov 2010;32(10):1240-8. [Medline].

  3. Andersen LP. Colonization and infection by Helicobacter pylori in humans. Helicobacter. Nov 2007;12 Suppl 2:12-5. [Medline].

  4. Beers M, Berkow R, eds. Gastritis. In: The Merck Manual of Diagnosis and Therapy. 18th ed. 2006:Section 3, Chapter 23. [Full Text].

  5. Feldman. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 7th ed. 2002:810-823.

  6. Ford A, Delaney B, Forman D. Eradication therapy for peptic ulcer disease in Helicobacter pylori positive patients. Cochrane Database Syst Rev. 2004;CD003840.

  7. Gelfand DW, Ott DJ, Chen MY. Radiologic evaluation of gastritis and duodenitis. AJR Am J Roentgenol. Aug 1999;173(2):357-61. [Medline].

  8. Gisbert JP, Pajares JM. Diagnosis of Helicobacter pylori infection by stool antigen determination: a systematic review. Am J Gastroenterol. Oct 2001;96(10):2829-38. [Medline].

  9. Haruma K. Helicobacter heilmannii: a spiral shaped organism other than Helicobacter pylori. Intern Med. Mar 1999;38(3):217-8. [Medline].

  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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