Description

Microscopic inflammation of mucosa of stomach

Epidemiology

• Most common cause of upper GI tract hemorrhage in older children
• 8 out of every 1,000 people are estimated to have gastritis.
• >2% of ICU patients have heavy bleeding secondary to gastritis.

Etiology

• Physiologic stress (e.g., chronic disease, CNS disease, overwhelming sepsis, ICU patients)
• Peptic disease
• Drug-induced (e.g., NSAIDs, steroids, valproate; more rarely, iron, calcium salts, potassium chloride, antibiotics)
• Infection (e.g., tuberculosis, Helicobacter pylori, cytomegalovirus, parasites)
• H. pylori (children more likely to have more severe gastritis, specifically located in antrum of stomach)
• Celiac disease: lymphocytic gastritis
• Major surgery; severe burns; renal, liver, respiratory failure; severe trauma
• Caustic ingestions (e.g., lye, strong acids, pine oil)
• Protein sensitivity (e.g., cow’s milk-protein allergy), allergic enteropathy
• Eosinophilic gastroenteritis
• Crohn disease: Up to 40% of Crohn patients have gastroduodenal involvement.
• Gastric Crohn disease may manifest itself as highly focal, non–H. pylori, nongranulomatous gastritis.
• Direct trauma (nasogastric tubes)
• Ethanol
• Idiopathic
• Less common causes:
  • Radiation
  • Hypertrophic gastritis (Ménétrier disease)
  • Autoimmune gastritis
  • Collagenous gastritis
  • Zollinger-Ellison syndrome
  • Vascular injury