Chronic Gastritis

1.

Internal medicine · Case presentation
Chronic Gastritis
Definition
A long-lasting inflammation of the stomach lining, with gradual loss of gastric glands (atrophy)
and, in some patients, intestinal metaplasia.
Main forms: non-atrophic (H. pylori) · atrophic (autoimmune or H. pylori) · special forms

2.

Causes
Infection
Autoimmune
Chemical
Helicobacter pylori: the most
common cause worldwide
Antibodies against parietal cells
and intrinsic factor
NSAIDs, aspirin, alcohol, bile
reflux
Risk factors: smoking, irregular and spicy diet, chronic stress, older age.

3.

Symptoms
Common
Atrophic form
• Burning or dull pain in the upper abdomen
• Weakness, pale skin (B12 deficiency anemia)
• Early satiety and fullness after meals
• Weight loss
• Nausea, bloating, belching
• Numbness in the hands and feet
• Poor appetite
Alarm signs: vomiting blood, black stools, weight loss, trouble swallowing. These need urgent evaluation.

4.

Diagnostic methods
Gold standard
H. pylori tests
Laboratory
Upper endoscopy (EGD) with
biopsies from the antrum and
the body of the stomach, then
histology
Urea breath test, stool antigen
test, rapid urease test on biopsy
Complete blood count, vitamin
B12, anti-parietal cell antibodies,
pepsinogens

5.

Treatment
1. Eradicate H. pylori
2. Relieve symptoms
3. Remove the cause
PPI plus two antibiotics, or
bismuth-based quadruple
therapy, for 14 days
PPIs or antacids; prokinetics for
nausea and fullness
Stop NSAIDs, alcohol and
smoking; vitamin B12 injections
in atrophic gastritis
Diet therapy supports every step. Antibiotic choice follows local guidelines and resistance.

6.

After discharge: what NOT to do
• Do not stop the medicines early, even if you feel well • Do not eat spicy, fried or very hot food, or large late
• Do not take NSAIDs or aspirin without a doctor
• Do not drink alcohol or smoke
meals
• Do not skip follow-up visits and control tests
• Do not ignore black stools or vomiting blood: call an
ambulance

7.

Sample one-day menu
Breakfast
Snack
Lunch
Oatmeal in water or milk, soft-boiled egg, weak
tea
Baked apples
Vegetable puree soup, steamed chicken cutlet,
buckwheat
Afternoon snack
Dinner
Before bed
Cottage cheese, crackers, rosehip tea
Baked white fish, mashed potatoes, steamed
carrots
Warm milk or kefir, if tolerated