Chapter 409. Inflammatory Disorders of the Stomach

Ranjan Dohil and Eric Hassall

Topics Discussed: gastric ulcer; gastritis; gastritis nsaid; gastroenterology and hepatology; helicobacter pylori; helicobacter pylori gastritis; nsaid-associated gastropathy; peptic ulcer; stomach diseases.

Sections: Historical Perspective, References.

Excerpt:"The terms acid peptic diseases, peptic diseases, or acid-related disorders are used synonymously to describe conditions that involve gastric acid and pepsin in their pathogenesis; they refer to a number of disorders including esophagitis, gastritis, peptic ulcer disease, and duodenitis. Gastritis is a condition diagnosed histologically, not clinically or radiologically.^1-5 It is characterized by the presence of inflammatory cells and is often found to be present in biopsies taken from gastric mucosa that appears normal at endoscopy. Some forms of chronic, severe gastritis may destroy mucosal elements, resulting in atrophic gastritis and intestinal metaplasia, which in some forms may be preneoplastic. Although gastritis and ulcer disease may occur as stand-alone entities, they are often part of a continuum of disease.^2,3,6 A special case is that of Helicobacter pylori, an important cause of gastritis and peptic ulcer disease discussed separately.Peptic ulcer and gastritis are uncommon in infants and young children. Peptic disorders are far less prevalent in the pediatric age group overall than in adults, accounting for probably no more than 10% to 20% of children seeking medical attention for abdominal pain even in a subspecialty gastrointestinal (GI) outpatient clinic setting.⁷ In adults, there has been a profound decline in the frequency of uncomplicated peptic ulcer disease. In contrast, there has been a relative increase in..."

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