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Gastritis

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 17 Aug 2025
Última actualización: 21 Feb 2025

Resumen

Definición

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • dispepsia/malestar epigástrico
  • sin características sospechosas de neoplasia maligna
Full details

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
Full details

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
Full details

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)
Full details

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
Full details

Emerging tests

  • Cultivo de H pylori/reacción en cadena de la polimerasa (PCR)

Treatment algorithm

INITIAL

en riesgo de gastritis por estrés

ACUTE

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

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

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.

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