ABSTRACT
Se hace una revisión de los diferentes tipos de gastritis, incluyendo cuadros en los que el edema y eritema puede semejar el cuadro, pero sin la típica reacción inflamatoria que denominamos gastropatías. Se hace una descripción de diversos aspectos epidemiológicos, etiológicos, etiopatogénicos; se desarrolla diversas clasificaciones propuestas y se describe los métodos diagnósticos, tratamientos recomendados y el pronóstico de esta molestia tan común.
A review of the different types of gastritis, including features in which the edema and erythema can resemble the picture, but without the typical inflammatory reaction that is called gastropathy. A description of various epidemiological, aetiological, pathogenetic, are proposed. The review describes the diagnoses and treatment recommendations and prognosis of this common disorder.
Subject(s)
Gastritis/classification , Gastritis/diagnosis , Gastritis/epidemiology , Gastritis/etiology , Gastritis/therapy , Stomach DiseasesABSTRACT
Background: Varioliform gastritis (VG) is found in approximately 0.3 to 2.8 percent of upper gastrointestinal endoscopies. Its etiology is not known. We have observed a higher frequency of VG in patients with liver cirrhosis. Aim: To confirm if there is an association between VG and liver cirrhosis. Patients and Methods: Two case-control studies were done. A retrospective study, reviewing the endoscopy database of a gastroenterological unit. A prospective study, identifying cases with the endoscopic diagnosis of VG among all patients referred for upper gastrointestinal endoscopies. The presence of liver cirrhosis, based on clinical, laboratory, ultrasonographic and endoscopic features was registered among patients with VG. Results: VG was found in 549 of 11.659 upper gastrointestinal endoscopies. Fourteen percent of patients with VG had cirrhosis compared to 5.6 percent in control patients (c² 29,8; p < 0.01). The odds ratio (OR) for having cirrhosis of patients with VG was 9.3 (95 percent confidence intervals 3.4-25.5, p < 0,01), according to a logistic regression analysis. In the prospective study, that included 1.498 upper gastrointestinal endoscopies, VG was also significantly more common among patients with liver cirrhosis. Conclusions: A higher frequency of VG was found among patients with liver cirrhosis. Therefore, the endoscopic finding of VG should alert physicians to look for the presence of a coexistent liver cirrhosis.
Subject(s)
Female , Humans , Male , Middle Aged , Gastritis/epidemiology , Liver Cirrhosis/epidemiology , Endoscopy, Digestive System , Epidemiologic Methods , Gastritis/classificationABSTRACT
Patients of chronic gastritis should be investigated with gastric mucosal biopsy, parietal cell antibody, intrinsic factor antibody, Helicobacter pylori antibody, urea breath test or faecal antigen test for Helicobacter pylori, to accurately classify them. The results of these tests will indicate Helicobacter pylori infection (present or past), the role of hereditary factor (intrinsic factor antibody present or absent) and the success or failure of Helicobacter pylori eradication treatment.
Subject(s)
Biopsy , Chronic Disease , Gastric Mucosa/pathology , Gastritis/classification , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Humans , Intrinsic Factor/analysis , Parietal Cells, Gastric/pathologySubject(s)
Humans , Gastritis, Atrophic , Gastritis, Hypertrophic , Gastritis/classification , Stomach Neoplasms , Stomach UlcerABSTRACT
Few terms in gastroenterology are more ambiguous thangastritis. Is has different meanings for the lay people, the clinician, the endoscopist. In this revision the authours analysed the classification, the different types of gastritis, the etiology and the tratment.In a comprehensive text it is also described the roleof helicobacter pulory and its treatment
Subject(s)
Humans , Gastritis/microbiology , Gastritis/pathology , Helicobacter Infections , Helicobacter pylori , Chronic Disease , Gastritis/classificationABSTRACT
Objetivo: Establecer la utilidad de la escaa visual del "Sistema Sydney"actualizado (Ssa) para calificar las biopsias con gastritis crónica en la edad pediátrica. Material y métodos: Se analizaron 79 biopsias gástricas de 15 pacientes con gastritis crónica asociada con H. Pylori. Se obtuvieron biopsias de antro y cuerpo de todos los pacientes, y en 13 series de biopsias de 11 pacientes (dos con dos series), se realizaron cinco biopsias siguiendo la propuesta del Ssa: dos del antro a 2-3 cm proximales al piloro (una de la curvatura menor y otro de la curvatura mayor), dos del cuerpo a 8 cm del cardias (una de la curvatura menor y otro de la curvatura mayor), y una de la incisura angularis. La presencia de sulfomucinas se detectó mediante la coloración de azul Alcian-PAS a pH 1,0, preferentemente en las muestras de la incisura angularis. En cada muestra se calificó la densidad de H. pylori, infiltrados de neutrófilos y células mononucleadas, atrofia y metaplasia intestinal como: normal (ausencia), leve moderada o marcada, y se determinó la presencia o no de folículos linfóides. Resultados: Diez pacientes fueron mujeres y cinco, varones; la edad osciló entre 2 y 16 años (promedio: 10.8 años). Los principales síntomas de presentación fueron dolor abdominal recurrente (10 casos), hemorragia gastrointestinal (4 casos), pirosis (2 casos), vómitos y anemia (uno cada uno). Un paciente tenía hipertensión portal. En los 15 pacientes, se efectuaron en total 79 biopsias. La evaluación de esas muestras siguiendo la escala de analogía visual del Ssa mostró las siguientes calificaciones morfológicas: no hubo infiltrados de neutrófilos en 27 biopsias; fueron leves en 35 y moderados en 17. No se halló ninguna biopsia con marcada cantidad de neutrófilos. Los infiltrados mononucleares fueron leves en 38 biopsias, moderados en 36, y abundantes en 5. La densidad de H. pylori fue considerada leve en 39 biopsias, moderada en 27 y marcada en dos. En tres biopsias postratamiento del mismo paciente (caso 8) no se encontró H. pylori. Otras ocho biopsias (7 del cuerpo y una del antro) revelaron ausencia de H. pylori, aunque los gérmenes estuvieron presentes simultáneamente en otros sitios del estómago...
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Gastritis/microbiology , Helicobacter Infections/complications , Helicobacter pylori/isolation & purification , Biopsy/standards , Chronic Disease , Evaluation Study , Gastritis/classification , Gastritis/pathology , Severity of Illness IndexSubject(s)
Duodenal Ulcer/physiopathology , Anastomosis, Roux-en-Y/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Diabetes Mellitus/complications , Gastric Dilatation/etiology , Gastric Dilatation/drug therapy , Stomach/anatomy & histology , Stomach/physiology , Gastrinoma/diagnosis , Gastrinoma/epidemiology , Gastritis/classification , Gastritis/physiopathology , Helicobacter Infections/complications , Stomach Neoplasms/physiopathology , Gastric Juice/physiology , Gastric Juice/metabolism , Dumping Syndrome/etiology , Dumping Syndrome/physiopathology , Vagotomy, Truncal/adverse effects , Duodenal Ulcer/etiology , Duodenal Ulcer/microbiology , Peptic Ulcer/etiology , Peptic Ulcer/physiopathologyABSTRACT
Three endoscopic systematic biopsies were obtained from 261 patients showing chronic gastritis. Histopathologic features of chronic gastritis were graded from 0 to 3 points according to the Sydney System. In addition, an extension and grading histopathologic score was applied. This score was obtained from the sum of qualified grades for each feature in all three samples. Inflammation, activity, atrophy and intestinal metaplasia were predominantly grade 1 and H pylori density was predominantly grade 2. Only 2,6 percent of the sections whith out atrophy showed intestinal metaplasia, while 79,3 percent of the sections depicting grade 2-3 intestinal metaplasia showed moderate to severe atrophy. Inflammation was more severe in antral lesser curvature and the more severe atrophy was present in the antrum than in the corpus mucosa. Sydney System and extension and grading histopathologic score showed more extensive activity in patients older than 45 years. A lower histopathologic score of H pylori was seen in these patients. The presence of H pylori was directly correlated with inflammation severity and inversely with atrophy. These results, in accordance with data shown in the literature, suggest that the Sydney System and extension and grading histopathologic score can be applied to compare chronic gastritis features in different groups of patients
Subject(s)
Humans , Male , Female , Gastritis/pathology , Severity of Illness Index , Biopsy , Helicobacter pylori/isolation & purification , Gastritis/classification , Endoscopy, Digestive System/methodsABSTRACT
Helicobacter pylori es un bacilo Gram-negativo espiralado que produce grandes cantidades de ureasa que le confiere un medio óptimo para la colonización de mucosa gástrica. En la actualidad se le considera como el mecanismo principal del daño de la mucosa gástrica y se ha identificado en 80 por ciento de los pacientes con gastritis y en 95 por ciento de aquéllos con úlcera duodenal. Muchos niños infectados son asintomáticos, sin embargo, síntomas como dolor abdominal recurrente, vómito, hematemesis se asocian frecuentemente a esta infección. La infección crónica por esta bacteria está relacionada con el desarrollo de cáncer gástrico principalmente con linfoma tipo MALT; por estas implicaciones se consideró importante hacer un diagnóstico precoz y un tratamiento oportuno como a continuación se describe.
Subject(s)
Humans , Child , Helicobacter pylori/chemistry , Helicobacter pylori/classification , Helicobacter pylori/growth & development , Helicobacter pylori/isolation & purification , Helicobacter pylori/pathogenicity , Gastritis/classification , Gastritis/etiology , Gastritis/microbiology , Gastritis/nursing , Duodenal Ulcer/diagnosis , Duodenal Ulcer/epidemiology , Duodenal Ulcer/etiology , Duodenal Ulcer/microbiologySubject(s)
Humans , Gastric Acid , Stomach/physiology , Gastric Mucosa/blood supply , Stomach Diseases/classification , Pyloric Stenosis/etiology , Gastritis/classification , Gastrointestinal Motility/physiology , Helicobacter Infections/diagnosis , Esophageal Perforation/etiology , Digestive System Surgical Procedures/adverse effects , Prostaglandins/pharmacology , Stomach Neoplasms/diagnosis , Stress, Physiological/complications , Peptic Ulcer/diagnosis , Gastric Emptying/physiologyABSTRACT
La gastritis crónica, enfermedad multifactorial, es muy frecuente en el mundo. La gastritis atrófica multifocal es la de mayor incidencia en poblaciones con alto riesgo de cáncer y úlceras gástricos: ésta no suele ser reversible, como si lo son la de reflujo o la antral difusa. Se insiste en una unificación, por parte de patólogos y otros especialistas, de la terminología, nomenclatura y clasificación empleadas para evitar confusiones. Implícitas incluso en el nuevo sistema de Sidney.