Erosive gastritis

by Jason Wasserman MD PhD FRCPC
December 12, 2024


This article is designed to help you understand your pathology report for erosive gastritis of the stomach. Each section explains an important aspect of the diagnosis and what it means for you.

What is erosive gastritis?

Erosive gastritis is a condition where the protective lining inside the stomach becomes damaged or worn away. This damage leads to the loss of specialized cells called epithelial cells, which normally form a barrier to protect the stomach from its own acid and digestive enzymes. When this barrier is compromised, the underlying tissue is exposed, leading to pain, inflammation, and sometimes bleeding.

What are the symptoms of erosive gastritis?

Erosive gastritis can cause a range of symptoms, including:

  • Abdominal pain or discomfort, especially after eating.
  • Bloating or a feeling of fullness.
  • Decreased appetite or nausea.
  • Black stools, a sign of bleeding in the stomach.

If the bleeding is significant or prolonged, it can lead to anemia, a condition where the body does not have enough healthy red blood cells to carry oxygen.

What causes erosive gastritis?

There are many potential causes of erosive gastritis. Common causes include:

  • Medications: Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen can damage the stomach lining.
  • Alcohol: Excessive alcohol use can irritate and erode the stomach lining.
  • Iron pills: Some people experience stomach irritation when taking iron supplements.
  • Stress: Physical stress, such as severe illness or injury, can contribute to gastritis.
  • Chemotherapy or radiation therapy: These treatments can harm the stomach lining.

Identifying the underlying cause is an important step in treating and managing the condition.

How is this diagnosis made?

The diagnosis of erosive gastritis is typically made after a biopsy, a procedure in which a small sample of tissue is removed from the stomach lining. A pathologist examines the tissue under a microscope. Additional tests, such as special stains or immunohistochemistry, may be performed to check for the presence of bacteria like Helicobacter pylori, which can also cause gastritis.

What are the microscopic features of erosive gastritis?

Under the microscope, erosive gastritis has several distinctive features, including:

  • Loss of epithelial cells: The protective barrier of cells on the stomach lining is missing in areas, exposing the underlying tissue.
  • Inflammation: Both acute (neutrophils) and chronic (lymphocytes and plasma cells) inflammatory cells are often seen.
  • Erosions: Small areas of tissue damage where the epithelium is completely gone.
  • Edema and congestion: Swelling and increased blood flow may be seen in the tissue beneath the erosion.
  • Fibrin deposition: A protein called fibrin may be present, indicating tissue injury.

These changes help the pathologist confirm the diagnosis and identify any underlying causes of the condition.

Treatment

Erosive gastritis is a serious condition that requires prompt treatment to prevent further damage to the stomach and alleviate symptoms. Treatment typically involves addressing the underlying cause. Steps may include:

  • Stopping or adjusting medications: If NSAIDs, alcohol, or other substances are contributing to the condition, your doctor may recommend stopping or replacing them.
  • Medications to protect the stomach lining: Drugs such as proton pump inhibitors (PPIs) or H2 blockers can reduce stomach acid and allow the lining to heal.
  • Identifying and treating infections: If bacteria like Helicobacter pylori are present, your doctor may prescribe antibiotics to eliminate the infection.
  • Dietary changes: Avoiding foods or beverages that irritate the stomach, such as spicy foods, alcohol, or caffeine, may help reduce symptoms.

Your doctor will develop a personalized treatment plan based on the findings in your pathology report and your overall health. If you have any questions about your diagnosis or treatment, be sure to ask your healthcare provider.

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