Acute and Chronic gastritis

1. Prepared by: Anish Dhakal (Aryan)
MBBS Student
Patan Academy of Health Sciences

2. Objectives
To discuss about acute and chronic
gastritis
To discuss the role of Helicobacter pylori
in peptic ulcer
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3. ACUTE GASTRITIS
1. Excessive alcohol consumption
2. NSAIDs
3. Radiation therapy
4. Decreased oxygen delivery
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Risk factors

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Gastritis is a mucosal inflammatory process

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6. Stress related mucosal disease
• Stress ulcers- shock, sepsis, or severe trauma
• Curling ulcers- severe burns or trauma
• Cushing ulcers- intracranial disease
Pathogenesis
-Stress induced splanchnic vasoconstriction
-Upregulation of NO synthase
-Increased release of vasoconstrictor endothelin-1
Ischemia
Gastric mucosal injury

7. CHRONIC GASTRITIS
Causes:
-H.pylori
-autoantibodies against parietal cells and intrinsic factor
-radiation injury
-chronic bile reflux
-mechanical injury
-systemic disease(Crohn disease,amyloidosis, graft-verses host disease)

8. H. PYLORI GASTRITIS
Spiral shaped bacilli
Mainly affects antrum with normal or increased acid
production
H. pylori ureases and proteases along with inflammation
weaken mucosal defenses
• Virulence Factors include:
1. Motility via flagella
2. Urease production buffering gastric acid
3. Bacterial adhesins to bind surface epithelial cells
4. Toxins (e.g. cagA)

9. PATHOGENESIS

10. MICROSCOPIC FEATURES

11. AUTOIMMUNE GASTRITIS
• Typically spares the antrum and is associated with
hypergastrinemia
• Characterized by:
-antibodies to parietal cells and intrinsic factor
-reduced serum pepsinogen I concentration
-endocrine cell hyperplasia
-vit B12 deficiency
-achlorhydria

12. PATHOGENESIS
• CD4+ T cells directed against parietal cell
components
• Loss of parietal cell which secrete gastric acid
and intrinsic factor

14. ROLE OF H. PYLORI IN
PEPTIC ULCER
• Increased expression of proinflamatory
cytokines, TNF, IL-1β
• Decreased expression of anti-inflammatory
cytokines(IL-10)
• Produces Urease
• Secrete phospholipase
• Damage proteoglycan of mucus
• Decreases bicarbonate secretion and increase HCl
production

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