Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- dispepsia/desconforto epigástrico
- ausência de características suspeitas de neoplasia maligna
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
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
Diagnostic investigations
1st investigations to order
- teste respiratório da ureia para Helicobacter pylori
- teste do antígeno fecal de Helicobacter pylori
- Hemograma completo
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)
Emerging tests
- reação em cadeia da polimerase/cultura de Helicobacter pylori
Treatment algorithm
com risco de gastrite por estresse
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
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 DifferentialsGuidelines
- ACG clinical guideline: treatment of Helicobacter pylori infection
- Adverse events associated with EGD and EGD-related techniques
More GuidelinesPatient information
Úlceras pépticas
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