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Gastrite

Last reviewed: 11 Sep 2025
Last updated: 19 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • dispepsia/desconforto epigástrico
  • ausência de características suspeitas de neoplasia maligna
Full details

Other diagnostic factors

  • náusea, vômitos e perda de apetite
  • êmese intensa
  • dor abdominal aguda
  • febre
  • reflexos alterados ou déficits sensoriais
  • comprometimento cognitivo
  • glossite
  • doença autoimune coexistente
Full details

Risk factors

  • infecção por Helicobacter pylori
  • uso de anti-inflamatórios não esteroidais (AINEs)
  • uso de álcool/ingestão de produtos tóxicos
  • cirurgia gástrica prévia
  • pacientes em estado crítico
  • doença autoimune
  • imunocomprometimento
  • anastomose venosa peritoneo-jugular infectada
  • ancestralidade norte-europeia e escandinava
Full details

Diagnostic investigations

1st investigations to order

  • teste respiratório da ureia para Helicobacter pylori
  • teste do antígeno fecal de Helicobacter pylori
  • Hemograma completo
Full details

Investigations to consider

  • endoscopia
  • teste de urease rápida de Helicobacter pylori
  • histologia da mucosa gástrica
  • vitamina B12 sérica
  • radiografias de contraste do trato gastrointestinal (GI) superior
  • hemoculturas/culturas de fluidos
  • anticorpos anticélulas parietais
  • anticorpos antifator intrínseco (FI)
Full details

Emerging tests

  • reação em cadeia da polimerase/cultura de Helicobacter pylori

Treatment algorithm

INITIAL

com risco de gastrite por estresse

ACUTE

associado a Helicobacter pylori

erosiva

autoimune

refluxo biliar

gastrite supurativa

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.

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

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

    • Úlcera péptica (UP)
    • Doença do refluxo gastroesofágico (DRGE)
    • Dispepsia não ulcerosa
    More Differentials
  • Guidelines

    • ACG clinical guideline: treatment of Helicobacter pylori infection
    • Adverse events associated with EGD and EGD-related techniques
    More Guidelines
  • Patient information

    Úlceras pépticas

    More Patient information
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