Acute gastritis

Topic Completed: 1 August 2012

Minor changes: 31 August 2020

Copyright: 2003-2021,, Inc.

PubMed Search: acute gastritis[title]

Elliot Weisenberg, M.D.
Page views in 2020: 6,629
Page views in 2021 to date: 6,821
Cite this page: Weisenberg E. Acute gastritis. website. Accessed December 6th, 2021.
Definition / general
  • Includes acute hemorrhage and acute erosive gastritis
  • Acute mucosal inflammatory process, usually transient (normal stomach has only rare inflammatory cells)
  • Associated with heavy use of NSAIDs (non-steroidal anti-inflammatory drugs, including aspirin), excessive alcohol use, heavy smoking, cancer chemotherapy, bile reflux, uremia, systemic infections (Salmonella), severe stress (trauma, burns, surgery), ischemia and shock, acid / alkali ingestion as part of suicide attempts, gastric irradiation or freezing, mechanical trauma (nasogastric tube), distal gastrectomy
  • Symptoms: none; or pain, nausea and vomiting
  • May be accompanied by local hemorrhage or mucosal sloughing
  • Severe erosive disease may cause acute GI bleed, acute gastric ulcer
  • Major cause of massive hematemesis in alcoholics
  • Occurs in 25% of those who take daily aspirin for rheumatoid arthritis
  • 20% develop overt bleeding; fatal in up to 5%
  • Treatment: proton pump inhibitors reduce severity of mucosal damage and facilitate healing
  • Mucosal damage due to increased acid secretion with back diffusion into mucosa, decreased bicarbonate buffer, reduced blood flow, disruption of mucous layer
Gross images

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Various images

Microscopic (histologic) description
  • Mild: modest edema of lamina propria, vascular congestion, intact epithelium, scattered neutrophils, and hemorrhage in mucosa, erosions with more severe disease
  • Moderate / severe: loss of superficial epithelium above muscularis mucosa, accompanied by hemorrhage and variable acute inflammatory infiltrate and extrusion of a fibrinopurulent exudate into the lumen, nearby epithelium may show regenerative changes
Microscopic (histologic) images

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Acute gastritis

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