Wednesday, January 19, 2011

Atrophic gastritis

Atrophic gastritis

    
* Introduction
    
* Signs and symptoms
    
* Diagnosis
    
* Treatment
Atrophic gastritis is a histological entity characterized by chronic inflammation of the gastric mucosa with loss of gastric glandular cells and their reinlocuirea intestinal type epithelium, pyloric-type glands and fibrous tissue. Gastric mucosal atrophy processes ste endpoint of chronic gastritis is associated with Helicobacter pylori infection, other unidentified environmental factors and autoimmunity against gastric glands.
The two main causes of gastritis atrophic gastritis result from distinct topography which can be distinguished histologically. Gastritis associated with Helicobacter pylori infection is usually a multifocal process involving entrepre oxintica lining the gastric body and bottom, while autoimmune gastritis is restricted by the extensive loss of parietal cell mass. Gastritis associated with bacterial infection is asymptomatic but individuals with the disease are at increased risk of developing gastric carcinoma.
The frequency of atrophic gastritis is not known because it is asymptomatic chronic gastritis, however, the prevalence of the two main causes of atrophic gastritis, chronic infection with Helicobacter pylori and autoimmunity is similar. 50% of the world population is infected with Helicobacter pylori atrophic gastritis is why foarete encountered. Infection is common in Asia and developing countries.
Mortaliatea and morbidity associated with atrophic gastritis is related to specific complications that develop during the disease. Similar to other patients infected with Helicobacter pylori, atrophic gastritis patients develop dyspeptic symptoms complain. Patients with bacterial infection or autoimmune gastritis are at risk of developing gastric carcinoma and carcinoid tumors. Major effects of autoimmune gastritis are loss of parietal cells which include aclorhidria, hipergastrinemia, pepsin and pepsinogenului loss, anemia and increased risk of neoplasms. Autoimmune atrophic gastritis is the most common cause of pernicious anemia in temperate climetele. The risk of gastric carcinoma is three times higher in these patients ecit general population. Autominua gastritis and Helicobacter pylori that have a significant role in the development of refractory iron deficiency anemia.
Pathogenesis
Atrophic gastritis associated with Helicobacter pylori. Helicobacter pylori is a gram-negative bacterium that infects and colonizes the stomach. The bacterium survives in the gastric mucosa to gastric surface epithelium and upper portions of gastric foveolelor, rare being found in deep glands. Infection is usually acquired during childhood and progresses in a lifetime if untreated. Host response to this H. pylori is composed of B and T lymphocyte infiltration in the lamina propria and gastric epithelium, followed by infiltration with macrophages, polymorphonuclear phagocytes, which will possibly bacteria.
Lesions associated with the release of toxic byproducts of bacteria and inflammatory cells cause the loss of gastric and gastric atrophy in time. During gastric mucosal atrophy glands develop some type intestinal epithelium. Other glands are replaced by fibrous tissue only. Loss of gastric glands of the body to reduce the number of parietal cells with significant functional changes that reduce secretion and increase gastric pH.
The pathogenic mechanisms of Helicobacter pylori infection include: -Antral gastritis, inflammation is mostly limited to the antrum, individuals with peptic ulcer develop this type of gastritis Multifocal atrophic gastritis, which involves the body, bed and entrepre progressive development of gastric atrophy and gastric intestinal metaplasia, those who develop an ulcer and gastric carcinoma have this type of gastritis.
Autoimmune atrophic gastritis. Development of chronic atrophic gastritis limited to the mucosal lining of the body background and marked atrophy of the parietal cells characterizes autoimmune gastritis. It is associated with serum antibodies and anti-intrinsic factor antiparietali that cause deficiency of intrinsic factor is pernicious anemia cobalamin availability decreases.
Causes and risk factors. Atrophic gastritis is usually associated with Helicobacter pylori infection or autoimmune gastritis.

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