Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- dispepsia/malestar epigástrico
- sin características sospechosas de neoplasia maligna
Other diagnostic factors
- náuseas, vómitos y pérdida del apetito
- emesis grave
- dolor abdominal agudo
- fiebre
- reflejos alterados o déficits sensoriales
- trastorno cognitivo
- glositis
- enfermedad autoinmune coexistente
Risk factors
- Infección por Helicobacter pylori
- consumo de antiinflamatorios no esteroideos (AINE)
- consumo de alcohol/ingesta de sustancias tóxicas
- cirugía gástrica previa
- pacientes en estado crítico
- enfermedad autoinmune
- compromiso inmunológico
- ascendencia nórdica o escandinava
Diagnostic investigations
1st investigations to order
- prueba del aliento con urea para Helicobacter pylori
- prueba de antígenos para H pylori en materia fecal
- hemograma completo (HC)
Investigations to consider
- endoscopia
- prueba rápida de ureasa para H pylori
- histología de la mucosa gástrica
- vitamina B12 sérica
- radiografías seriadas del tracto gastrointestinal (GI) superior con contraste
- hemocultivos/cultivos de líquidos
- anticuerpos contra las células parietales
- anticuerpos contra factor intrínseco
Emerging tests
- Cultivo de H pylori/reacción en cadena de la polimerasa (PCR)
Treatment algorithm
en riesgo de gastritis por estrés
asociado con Helicobacter pylori
erosiva
autoinmune
reflujo biliar
gastritis flemonosa
Contributors
Authors
Eli D. Ehrenpreis, MD, FACG, AGAF
Professor of Medicine
Rosalind Franklin University Medical School
North Chicago, Illinois
Adjunct Professor of Pediatric Gastroenterology
University of Miami Miller Medical School
Miami, Florida
Associate Director for Research
Internal Medicine Residency
Advocate Lutheran General Hospital
Park Ridge, Illinois
Disclosures
EDE declares that he has no competing interests.
Acknowledgements
Dr Eli D. Ehrenpreis 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
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.
Garth Swanson, MD
Assistant Professor of Medicine
Section of Gastroenterology and Nutrition
Rush University Medical Center
Chicago
IL
Disclosures
GS declares that he has no competing interests.
References
Key articles
Varis K. Gastritis - a misused term in clinical gastroenterology. Scand J Gastroenterol Suppl. 1988 Jul 8;155:53-60. Abstract
Glickman JN, Antonioli DA. Gastritis. Gastrointest Endosc Clin N Am. 2001 Oct;11(4):717-40. Abstract
Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of helicobacter pylori Infection. Am J Gastroenterol. 2017 Feb;112(2):212-39.Full text Abstract
Lanza FL. A guideline for the treatment and prevention of NSAID-induced ulcers. Members of the Ad Hoc Committee on Practice Parameters of the American College of Gastroenterology. Am J Gastroenterol. 1998 Nov;93(11):2037-46.Full text Abstract
Kavitt RT, Cifu AS. Management of Helicobacter pylori infection. JAMA. 2017 Apr 18;317(15):1572-73. Abstract
Nyssen OP, McNicholl AG, Megraud F, et al. Sequential versus standard triple first-line therapy for Helicobacter pylori eradication. Cochrane Database Syst Rev. 2016 Jun 28;(6):CD009034.Full text Abstract
Ren Q, Yan X, Zhou Y, et al. Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection. Cochrane Database Syst Rev. 2016 Feb 7;2:CD009477.Full text Abstract
Lee YC, Chiang TH, Chou CK, et al. Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology. 2016 May;150(5):1113-1124.e5.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
- Enfermedad ulcerosa péptica (EUP)
- Enfermedad por reflujo gastroesofágico (ERGE)
- Dispepsia no ulcerosa
More DifferentialsDiretrizes
- Informed consent for GI endoscopic procedures
- Adverse events associated with EGD and EGD-related techniques
More GuidelinesFolhetos informativos para os pacientes
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