Features and management

Clinical features:

• epigastric discomfort and nausea

Endoscopic features:

• may be no abnormality visible at gastroscopy; in general, erythema and erosions in the antral mucosa. If there is associated duodenitis then this increases the likelihood of H. pylori.

Diagnosis:

• listed separately

Management:

• NICE guidance states that H. pylori-positive peptic ulcer disease or non-ulcer dyspepsia requires treatment with H. pylori eradication therapy. For more detailed regarding the NICE guideline see linked item

Prognosis:

• natural history is uncertain. Often progresses to patchy atrophy (does not usually lead to complete achlorhydria). There is thought to be a 3-4 fold increased risk of gastric carcinoma. There is evidence linking this form of gastritis with the development of lymphoma of mucosa-associated lymphoid tissue type

Reference:

1. NICE (September 2014).Dyspepsia and gastro-oesophageal reflux disease - Investigation and management of dyspepsia, symptoms suggestive of gastro-oesophageal reflux disease, or both
2. Yeomans ND.Gastritis. Medicine International 1994; 22(6):221-4.
3. Bayerdorffer E et al. Lancet 1995;345: 1591-3.