Risk of gastroduodenal ulcer in gastritis

The present evidence suggests that chronic gastritis is strongly associated with peptic ulcer disease. Gastritis, particularly in antrum, is nearly invariably present in patients with peptic ulcer. Gastritis is a progressive disease which begins as a superficial inflammation and progresses to atrophic gastritis. Gastritis can be considered to lower resistance of the gastric mucous membrane but it may also affect secretion of acid and pepsins from oxyntic mucosa. The presence or absence of gastritis, and its involvement in antral and/or body mucosa, can be considered to reflect the risk and probability of a person to contract peptic ulcer. Estimations of the risks of coexistent peptic ulcer in different types and grades of gastritis suggest that the relative risk (RR) of coexistent peptic ulcer disease is markedly increased in the presence of gastritis in general (RR = 7-10), as compared to patients who have a normal, non-gastritic stomach (RR = 1). This risk is particularly high in patients with gastritis of B type (atrophic gastritis is in antrum but body mucosa is non-atrophic) in whom the coexistent peptic ulcer is 20-30 times more common (RR = 20-30) than in patients who have normal stomach. On the other hand, the risk of peptic ulcer disease is low in patients who show marked atrophic alterations in the gastric body mucosa (A or AB types of gastritis), the risk being in these patients even lower (RR below 1) than that in patients with normal, non-gastritic stomach.