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Gastritis and Other Gastropathies. In: Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 810-827.

Gastritis is defined as microscopic inflammation of the stomach, thus biopsy is required for definitive diagnosis. This chapter on gastritis and other gastropathies is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include classification; chronic, nonspecific gastritides, including diffuse antral-predominant gastritis, multifocal atrophic gastritis, and diffuse corporal atrophic gastritis; infectious gastritis, including that due to viruses, bacteria, fungi, or parasites; granulomatous gastritides, including sarcoidosis and xanthogranulomatous gastritis; distinctive forms of gastritis, including collagenous gastritis, lymphocytic gastritis, and eosinophilic gastritis; miscellaneous forms of gastritis, including gastritis cystica profound and gastric graft-versus-host disease (GVHD); reactive gastropathies (acute erosive gastritis), including medications, alcohol, cocaine, stress, radiation, bile reflux, ischemia, bezoar, prolapse gastropathy, linear gastric erosions in a hiatal hernia (Cameron's ulcer), and congestive gastropathy (portal hypertensive gastropathy); and hyperplastic gastropathies, notably Menetrier's disease and hyperplastic, hypersecretory gastropathy. The chapter includes a mini-outline with page citations, full-color illustrations, and extensive references. 11 figures. 1 table. 217 references.

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Digestive Diseases and Disorders Sourcebook. Detroit, MI: Omnigraphics. 2000. 300 p.

This sourcebook provides basic information for the layperson about common disorders of the upper and lower digestive tract. The sourcebook also includes information about medications and recommendations for maintaining a healthy digestive tract. The book's 40 chapters are arranged in three major parts. The first section, Maintaining a Healthy Digestive Tract, offers basic information about the digestive system and digestive diseases, information about tests and treatments, and recommendations for maintaining a healthy digestive system. The second section, Digestive Diseases and Functional Disorders, describes nearly 40 different diseases and disorders affecting the digestive system. These include appendicitis, bleeding in the digestive tract, celiac disease, colostomy, constipation, constipation in children, Crohn's disease, cyclic vomiting syndrome, diarrhea, diverticulosis and diverticulitis, gallstones, gas in the digestive tract, heartburn (gastroesophageal reflux disease), hemorrhoids, hernias, Hirschsprung's disease, ileostomy, indigestion (dyspepsia), intestinal pseudo-obstruction, irritable bowel syndrome (IBS), IBS in children, lactose intolerance, Menetrier's disease, rapid gastric emptying, short bowel syndrome, ulcerative colitis, ulcers, Whipple's disease, and Zollinger Ellison syndrome. The final section offers a glossary of terms, a subject index and a directory of digestive diseases organizations (which includes website and email addresses as available). Material in the book was collected from a wide range of government agencies, nonprofit organizations, and periodicals.

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Pediatric Gastrointestinal Mucosal Biopsy: Special Considerations in Children. Gastrointestinal Endoscopy Clinics of North America. 10(4): 669-712. October 2000.

In most disorders of the gastrointestinal (GI) mucosa that occur in both children and adults, the mucosal manifestations are the same. This article focuses on those disorders and the approaches to GI procedures and mucosal biopsy that are of a particularly or peculiarly pediatric nature (i.e., are different from those in adults). The authors discuss issues pertaining to endoscopy and other techniques of mucosal biopsy in children, because some approaches and techniques are considerably different from those in adults. In children as in adults, most mucosal biopsies are taken at upper GI endoscopy or colonoscopy, with rectal suction biopsy (RSB) being performed occasionally and blind esophageal suction biopsy very rarely. The authors caution that major problems can arise in pediatric endoscopy when children are approached and instrumented like adults. The authors describe the preparation of the child and family, sedation, bowel preparation, and fasting. The authors include a section discussing disorders in which there are special features in children that may be significantly different from adults, including gastroesophageal reflux disease (GERD), idiopathic eosinophilic esophagitis, Barrett's esophagus, Helicobacter pylori infections, Crohn's disease, allergic gastritis, celiac gastritis, chronic granulomatous disease, Menetrier's disease, neonatal gastropathies, Henoch Schonlein gastritis, cow's milk protein enteritis, microvillous inclusion disease, tufting enteropathy, autoimmune enteropathy, inflammatory bowel disease, pseudomembranous colitis, necrotizing enterocolitis, glycogen storage disease, Hirschsprung's disease, intestinal neuronal dysplasia, and colorectal cancer. 217 references.

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Treatment of Helicobacter Pylori: An Overview. Alimentary Pharmacology and Therapeutics. 14(Supplement 3): 1-6. October 2000.

Helicobacter pylori is recognized to be a serious pathogen, but there is still controversy as to who should be treated. This article reviews the arguments and some of the data advanced to support the differing views; the author briefly considers the currently used therapies and how they may best be employed. There is consensus for treatment of patients with H. pylori positive peptic ulcer and B cell lymphoma. Patients with lymphcytic gastritis and giant fold gastritis (Menetrier's disease) may also respond to treatment. Patients with functional dyspepsia have a 20 percent placebo response with a 5 to 10 percent 'eradication' response, results not dissimilar from empirical treatment with a proton pump inhibitor (PPI). A 'test and treat' policy for patients with uninvestigated dyspepsia remains controversial. Some clinicians have suggested that eradication of the H. pylori may increase the patient's risk of gastroesophageal reflux disease (GERD) or predispose patients to adenocarcinoma at the gastroesophageal junction (stomach cancer). However, PPI treatment without H. pylori eradication induces greater inflammation in the gastric corpus; this is the phenotype associated with non-cardia gastric cancer. A minority of clinicians believe the H. pylori should be eradicated in all individuals. The author concludes that, when choosing treatment, it is logical to start with a combination of antibiotics that, in the event of failure, will allow a second combination to be used without overlap. The author recommends the use of amoxycillin, clarithromycin, and a PPI for the first treatment, which then leaves the option of ranitidine bismuth citrate, tetracycline, and metronidazole, in the event of first line failure. 37 references.

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