Gastritis. Bringing this enigma into sharper focus

Type A and type B (probably Campylobacter pylori) gastritis are distinct clinical (but largely asymptomatic) and histologic entities that can be separated from other disease processes. While the association of C pylori gastritis with peptic ulcer disease is well documented, no causal relationship has been established. Acute inflammatory conditions of the stomach secondary to other disease processes, macroscopic abnormalities of the gastric mucosa, and sometimes poorly characterized epigastric pain all carry the name "gastritis." The fact that, as a disease, gastritis remains an enigma largely stems from the multiple implications of the term. An accurate classification system of the gastritides would be helpful but is not yet available. Until it is, the term "gastritis" will have more meaning if accompanied by a description of the type of gastritis or of the responsible etiologic factor, secondary disease, or toxic insult (eg, gastric mucosal injury associated with use of nonsteroidal antiinflammatory drugs). Deletion of the term "gastritis" from the clinical vocabulary and substitution of better terms (eg, "nonulcer dyspepsia," "irritable bowel syndrome") will also serve to clarify the issue.