Beyond Helicobacter: dealing with other variants of gastritis—an algorithmic approach

Abstract

In daily practice, the presence of inflammation in gastric biopsies prompts a mental algorithm, an early question being whether the lesion present is Helicobacter‐associated. If Helicobacter organisms are not found, then there is a further algorithm, governed by the predominant type of inflammatory cells present, and the presence of other features such as intraepithelial lymphocytosis, a subepithelial collagen band, granulomas, coexisting chronic inflammation, focality, and superimposed reactive changes including erosions and ulcers. Each of these generates its own differential diagnosis. If no inflammation is present, then the two major changes specifically looked for are the changes associated with hypergastrinaemia, by far the most common cause of which is treatment with proton pump inhibitors, and reactive changes. These may be present with and without accompanying inflammation, and, when the epithelial changes dominate, the term gastropathy is preferred. In this article, we present an approach to non‐Helicobacter inflammation and gastropathies.

Helicobacter pylori‐negative Chronic Gastritis in Children

“…The incidence of chronic gastritis in children is not well described but limited evidence implies that the incidence ranges from 2% to 8% (2,3) with incidence increasing after the age of 10 years (4). H pylori ‐negative gastritis is considered when, in the presence of histological inflammation, staining of gastric mucosal biopsies for H pylori is negative (5). In the absence of medications, which may be the cause of acute gastritis (such as nonsteroidal anti‐inflammatory drugs, NSAIDs), other potential causes of gastritis should be considered (Table 1), such as autoimmune or atrophic gastritis, eosinophilic gastritis, collagenous gastritis, and upper gastrointestinal involvement of inflammatory bowel diseases (IBD).…”

Estudio Fitoquímico Y Evaluación Preliminar Del Efecto Gastroprotector Del Extracto Etanólico De Anacyclus Radiatus

“…La gastritis aguda causada por los medicamentos antiinflamatorios no esteroides o por el alcohol puede aliviarse dejar de consumirlos. Algunos tratamientos comunes incluyen antibióticos para eliminar H. pylori, inhibidores de la bomba de protones (H+/K+/ATPasa), bloqueadores H2 y antiácidos locales(El-Zimaity & Riddell, 2021).…”