Chronic Gastritis (6 of 8)

H pylori–associated chronic gastritis progresses with the following 2 main topographic patterns that have different clinical consequences: Antral predominant gastritis is characterized by inflammation and is mostly limited to the antrum. Individuals with peptic ulcers usually demonstrate this pattern of gastritis. Multifocal atrophic gastritis is characterized by involvement of the corpus and gastric antrum with progressive development of gastric atrophy (loss of the gastric glands) and partial replacement of gastric glands by an intestinal-type epithelium (intestinal metaplasia) Individuals who develop gastric carcinoma and gastric ulcers usually demonstrate this pattern of gastritis. Most of the people who are infected with H pylori do not develop significant clinical complications, and they remain carriers with asymptomatic chronic gastritis. Some individuals who carry additional risk factors may develop peptic ulcer, gastric mucosa–associated lymphoid tissue (MALT) lymphomas, or gastric adenocarcinomas.