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Gastritis

Last reviewed: 31 Jul 2025
Last updated: 19 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • dyspepsia/epigastric discomfort
  • no suspicious features of malignancy
Full details

Other diagnostic factors

  • nausea, vomiting, and loss of appetite
  • severe emesis
  • acute abdominal pain
  • fever
  • altered reflexes or sensory deficits
  • cognitive impairment
  • glossitis
  • coexisting autoimmune disease
Full details

Risk factors

  • Helicobacter pylori infection
  • nonsteroidal anti-inflammatory drug (NSAID) use
  • alcohol use/toxic ingestions
  • previous gastric surgery
  • critically ill patients
  • autoimmune disease
  • immunocompromise
  • infected peritoneojugular venous shunt
  • North European or Scandinavian ancestry
Full details

Diagnostic tests

1st tests to order

  • Helicobacter pylori urea breath test
  • Helicobacter pylori fecal antigen test
  • CBC
Full details

Tests to avoid

  • serology
Full details

Tests to consider

  • endoscopy
  • Helicobacter pylori rapid urease test
  • gastric mucosal histology
  • serum vitamin B12
  • upper gastrointestinal (GI) contrast series
  • blood/fluid cultures
  • parietal cell antibodies
  • intrinsic factor antibodies
Full details

Treatment algorithm

INITIAL

at risk of stress gastritis

ACUTE

Helicobacter pylori associated

erosive

autoimmune

bile reflux

phlegmonous gastritis

Contributors

Authors

Eli D. Ehrenpreis, MD, FACG, AGAF

Associate Director for Research

Internal Medicine Residency

Advocate Lutheran General Hospital

Park Ridge

IL

Disclosures

EDE declares that he has no competing interests.

Nick Adimi, MD, MS

Internal Medicine Resident

Department of Medicine

Advocate Lutheran General Hospital

Park Ridge

IL

Disclosures

NA declares that he has no competing interests.

Acknowledgements

Dr Eli D. Ehrenpreis and Dr Nick Adimi would like to gratefully acknowledge Dr Nicole Marie Gentile, Dr Parakkal Deepak, and Dr Elad Eichenwald, previous contributors to this topic.

Disclosures

NMG, PD, and EE declare that they have no competing interests.

Peer reviewers

Shazia Siddique, MD, MSHP

Assistant Professor of Medicine

Division of Gastroenterology

University of Pennsylvania

Philadelphia

PA

Disclosures

SS declares that she has no competing interests.

Anthony Axon, MB, BS, MD, FRCP

Professor and Consultant Gastroenterologist

Department of Gastroenterology

Leeds General Infirmary

Leeds

UK

Disclosures

AA is the author of studies referenced in this topic.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001 Oct;11(4):717-40. Abstract

Chey WD, Howden CW, Moss SF, et al. ACG clinical guideline: treatment of Helicobacter pylori Infection. Am J Gastroenterol. 2024 Sep 1;119(9):1730-53.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Peptic ulcer disease (PUD)
    • Gastroesophageal reflux disease (GERD)
    • Nonulcer dyspepsia
    More Differentials
  • Guidelines

    • ACG clinical guideline: treatment of Helicobacter pylori infection
    • Management of Helicobacter pylori infection
    More Guidelines
  • Patient information

    Peptic ulcers

    More Patient information
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