Features and management

Clinical features:

• epigastric discomfort and nausea

Endoscopic features:

• may be no abnormality visible at gastroscopy; in general, erythema and erosions in the antral mucosa. If there is associated duodenitis then this increases the likelihood of H. pylori.

Diagnosis:

• listed separately

Management:

• NICE guidance states that H. pylori-positive peptic ulcer disease or non-ulcer dyspepsia requires treatment with H. pylori eradication therapy. For more detailed regarding the NICE guideline see linked item

Prognosis:

• natural history is uncertain. Often progresses to patchy atrophy (does not usually lead to complete achlorhydria). There is thought to be a 3-4 fold increased risk of gastric carcinoma. There is evidence linking this form of gastritis with the development of lymphoma of mucosa-associated lymphoid tissue type

Reference:

1. NICE. Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management. Clinical guideline CG184. Published September 2014, last updated October 2019
2. Moayyedi PM, Lacy BE, Andrews CN, et al. ACG and CAG clinical guideline: management of dyspepsia. Am J Gastroenterol. 2017;112(7):988-1013.
3. 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.