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Stress-Induced Gastritis Clinical Presentation

  • Author: Rohan C Clarke, MD; Chief Editor: BS Anand, MD  more...
Updated: Jun 25, 2015


Patients who may have an increased risk of stress gastritis are those with massive burn injury, head injury associated with raised intracranial pressure, sepsis and positive blood culture results, severe trauma, and multiple system organ failure. The clinician should have a high incidence of suspicion in patients in these settings who are noted to have decreased hematocrit values and who are not receiving prophylaxis for stress gastritis.



Clinical presentation is varied, but the following clues should raise the level of clinical suspicion for this entity:

  • Coffee ground vomitus
  • Melena
  • Hematemesis (in extreme cases)
  • Orthostasis (unusual)


Prolonged mechanical ventilation and coagulopathy increase predisposition to stress gastritis. Causative factors include the following conditions:

  • Severe trauma
  • Massive burns
  • Hypotension
  • Sepsis with positive blood culture results
  • CNS injury with raised intracranial pressure
  • Mechanical ventilation
  • Multiorgan failure
Contributor Information and Disclosures

Rohan C Clarke, MD Director, Department of Gastroenterology, JPS Health Systems Hospital

Rohan C Clarke, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Cubist; <br/>Received reimbursement from Boston Scientific for learning observership for eus; Received honoraria from Optimer pharmaceutical for speaking and teaching.


Emmanuel Gbadehan, MD Instructor in Clinical Medicine, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Gastroenterology, Harlem Hospital Center, North General Hospital

Emmanuel Gbadehan, MD is a member of the following medical societies: American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Uzodinma R Dim, MD Clinical Cardiac Electrophysiology Fellow, Division of Cardiovascular Medicine, University of Iowa Hospital and Clinics

Uzodinma R Dim, MD is a member of the following medical societies: American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, Association of Black Cardiologists

Disclosure: Nothing to disclose.

Rachael M Ferraro, DO Internal Medicine Hospitalist, Torrance Memorial Medical Center, Little Company of Mary Hospital

Rachael M Ferraro, DO is a member of the following medical societies: American College of Osteopathic Internists, American College of Physicians, American Osteopathic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

BS Anand, MD Professor, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

BS Anand, MD is a member of the following medical societies: American Association for the Study of Liver Diseases, American College of Gastroenterology, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Additional Contributors

Ann Ouyang, MBBS Professor, Department of Internal Medicine, Pennsylvania State University College of Medicine; Attending Physician, Division of Gastroenterology and Hepatology, Milton S Hershey Medical Center

Disclosure: Nothing to disclose.


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.

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