幽门螺杆菌感染和使用非甾体抗炎药 (NSAID) 或酒精是最常见的原因。其他病因包括应激(继发于黏膜缺血)和自身免疫性胃炎。罕见的类型包括蜂窝织炎性胃炎(一种罕见的细菌感染)。
阅读更多诊断基于临床病史和特征性的组织学发现。一系列的方法可用于诊断幽门螺杆菌感染。
出现提示存在上消化道 (GI) 恶性肿瘤的可疑特征时,需要尽快在适当的临床情况下做内镜检查。这些特征包括消化道出血、贫血、早饱、原因不明的体重下降(>10% 的体重)、进行性吞咽困难、吞咽疼痛或持续性呕吐。
治疗取决于病因。可选择的方案包括幽门螺杆菌根除治疗,减少 NSAID 或酒精暴露,以及使用 H₂ 受体拮抗剂和/或质子泵抑制剂进行对症治疗。
如果不进行治疗,可能进展为消化性溃疡病。 某些胃炎形式的其他并发症包括胃癌和胃淋巴瘤。
胃炎的定义是胃黏膜炎症的组织学表现。 更广义的“胃病”包括以或者不以炎症为特点的损伤。[1]Varis K. Gastritis - a misused term in clinical gastroenterology. Scand J Gastroenterol Suppl. 1988;155:53-60.http://www.ncbi.nlm.nih.gov/pubmed/3245001?tool=bestpractice.com[2]Laine L, Weinstein WM. Subepithelial hemorrhages and erosions of human stomach. Dig Dis Sci. 1988;33:490-503.http://www.ncbi.nlm.nih.gov/pubmed/3280275?tool=bestpractice.com[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com
阅读更多幽门螺杆菌感染可能引起急性或者慢性胃炎。[4]Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG Clinical Guideline: Treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2017;112(2):212-239.https://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/28071659?tool=bestpractice.com 服用NSAID、饮酒或酗酒[1]Varis K. Gastritis - a misused term in clinical gastroenterology. Scand J Gastroenterol Suppl. 1988;155:53-60.http://www.ncbi.nlm.nih.gov/pubmed/3245001?tool=bestpractice.com[2]Laine L, Weinstein WM. Subepithelial hemorrhages and erosions of human stomach. Dig Dis Sci. 1988;33:490-503.http://www.ncbi.nlm.nih.gov/pubmed/3280275?tool=bestpractice.com[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com 以及既往胃部手术或胆囊切除术引起的胆汁反流性胃炎入胃均可以引起糜烂性胃炎。[5]Bondurant FJ, Maull KI, Nelson HS Jr, et al. Bile reflux gastritis. South Med J. 1987;80:161-165.http://www.ncbi.nlm.nih.gov/pubmed/3810208?tool=bestpractice.com[6]Niemala S. Duodenogastric reflux in patients with upper abdominal complaints or gastric ulcer with particular reference to reflux-associated gastritis. Scand J Gastroenterol Suppl. 1985;115:1-56.http://www.ncbi.nlm.nih.gov/pubmed/3863229?tool=bestpractice.com[7]Niemala S, Karttunen T, Heikkila J, et al. Characteristics of reflux gastritis. Scand J Gastroenterol. 1987;22:349-354.http://www.ncbi.nlm.nih.gov/pubmed/3589504?tool=bestpractice.com[8]McAlhany JC Jr, Hanover TM, Taylor SM, et al. Long-term follow-up of patients with Roux-en-Y gastrojejunostomy for gastric disease. Ann Surg. 1994;219:451-455.http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1243166&blobtype=pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8185395?tool=bestpractice.com 危重患者中可出现应激性胃炎,最常由黏膜缺血引起,表现为从表面(糜烂)到深层黏膜受损(称为应激性溃疡)的连续性病变。[9]Martindale RG. Contemporary strategies for the prevention of stress-related mucosal bleeding. Am J Health Syst Pharm. 2005;62(suppl 2):S11-S17.http://www.ncbi.nlm.nih.gov/pubmed/15905595?tool=bestpractice.com 自身免疫性胃炎是弥漫性黏膜萎缩,特征性表现为壁细胞和内因子的自身抗体导致炎性浸润和胃体黏膜层萎缩。[3]Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001;11:717-740.http://www.ncbi.nlm.nih.gov/pubmed/11689363?tool=bestpractice.com[10]Kekki M, Siurala M, Varis K, et al. Classification principles and genetics of chronic gastritis. Scand J Gastroenterol Suppl. 1987;141:1-28.http://www.ncbi.nlm.nih.gov/pubmed/3481655?tool=bestpractice.com 化脓性胃炎是一种罕见却威胁生命的胃黏膜下层和固有基层的感染,见于免疫抑制的患者。[11]Shipman PJ, Drury P. Emphysematous gastritis: case report and literature review. Australas Radiol. 2001;45:64-66.http://www.ncbi.nlm.nih.gov/pubmed/11259977?tool=bestpractice.com[12]Dharap SB, Ghag G, Biswas A. Acute necrotizing gastritis. Indian J Gastroenterol. 2003;22:150-151.http://www.ncbi.nlm.nih.gov/pubmed/12962444?tool=bestpractice.com[13]Carlson AP, Chan WH, Ketai LH, et al. Emphysematous gastritis in a severely burned patient: case report and literature review. J Trauma. 2007;62:765-767.http://www.ncbi.nlm.nih.gov/pubmed/17414363?tool=bestpractice.com[14]Loi T, See JY, Diddapur RK, et al. Emphysematous gastritis: a case report and a review of literature. Ann Acad Med Singapore. 2007;36:72-73.http://www.ncbi.nlm.nih.gov/pubmed/17285190?tool=bestpractice.com