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Gastritis (PATHOPHYSIOLOGY (Infectious granulomatous gastritis:…

- - - - Triple therapies ADULT
        Twice-daily PPI or ranitidine bismuth citrate triple therapies include the following:
        Lansoprazole 30 mg, omeprazole 20 mg, or ranitidine bismuth citrate 400 mg orally twice daily
        Clarithromycin 500 mg orally twice daily
        Amoxicillin 1000 mg or metronidazole 500 mg orally twice daily
      - Quadruple therapies ADULT
        PPI (lansoprazole 30 mg or omeprazole 20 mg) orally twice daily
        Tetracycline HCl 500 mg orally 4 times daily
        Bismuth subsalicylate 120 mg orally 4 times daily
        Metronidazole 500 mg orally 3 times daily
    - - Optimal therapy for H pylori infection in childhood is not well established.Isolated studies have shown eradication efficiencies with triple therapies, ranging from 56-87% of the cases. In children, clarithromycin and metronidazole H pylori resistance is a problem in several countries, resulting in less efficient eradication regimens.
      - Eradication rates in children have been reported to be as high as 96% with alternative eradication regimens that include amoxicillin, bismuth, and metronidazole
      - Bismuth toxicity is not a concern in children receiving H pylori therapy, but salicylate ingestion from the use of bismuth subsalicylate is. Inform parents of the presence of subsalicylate. Ideally, children younger than 16 years should not receive salicylate-containing compounds, because of the risk of Reye syndrome
- - - - Lymphocytic gastritis has an incidence of between 0.83% and 2.5% in patients undergoing endoscopy and of 4-5% in those with chronic gastritis. The disease has been reported in various parts of the world but more commonly in Europe, and it appears to be less common in the United States. [59, 60]
        Chronic reactive chemical gastropathy is one of the most common and poorly recognized lesions of the stomach
      - An estimated 50% of the world population is infected with H pylori; consequently, chronic gastritis is extremely frequent. H pylori infection is highly prevalent in Asia and in developing countries, and multifocal atrophic gastritis and gastric adenocarcinomas are more prevalent in these areas.
        Autoimmune gastritis is a relatively rare disease, most frequently observed in individuals of northern European descent and black people. The prevalence of pernicious anemia, resulting from autoimmune gastritis, has been estimated at 127 cases per 100,000 population in the United Kingdom, Denmark, and Sweden. The frequency of pernicious anemia is increased in patients with other immunologic diseases, including Graves disease, myxedema, thyroiditis, vitiligo and hypoparathyroidism
- - - - Lymphocytic gastritis mostly affects middle-aged or elderly patients. It may be associated with chronic H pylori infection, gluten-sensitive enteropathy, and Menetrier disease. It may represent a hypersensitivity reaction involving the gastric body. Lymphocytic gastritis has been described as complicating MALT lymphoma and gastric carcinoma.
        
        Some patients with eosinophilic gastroenteritis have underlying connective tissue disorders. Those with predominant mucosal involvement may report nausea, vomiting, and abdominal pain related to the ingestion of specific foods. Those with involvement of the muscularis propria and resulting thickening and rigidity may present with outlet obstruction symptoms.
        
        Graft versus host disease (GVHD) follows allogeneic bone marrow transplantation or transfusions, especially in patients who are immunocompromised. Patients with isolated gastric GVHD have symptoms of nausea, vomiting, and upper abdominal pain without diarrhea.