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Gastrite

  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisión: 17 Aug 2025
Última actualización: 21 Feb 2025

Resumen

Definición

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
  • ancestralidade norte-europeia e escandinava
Full details

Diagnostic tests

1st tests to order

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

Tests to consider

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

Emerging tests

  • reação em cadeia da polimerase/cultura de H 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

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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