Introduction

• Superficial erosions - more common than deep ulceration.
• Cause: drugs (especially corticosteroids, non-steroidal anti-inflammatory drugs), mast cell neoplasia, hepatic disease, renal disease, gastric neoplasia, chronic gastritis, gastroma,Helicobacter.
• Signs: vomiting, hematemesis, melena and weight loss.
• Diagnosis: gastroscopy.
• Treatment: eliminate underlying cause, H2 antagonists, sucralfate.
• Prognosis: may perforate → septic peritonitis and death.

Pathogenesis

Pathophysiology

• Compromised blood supply → death of superficial gastric cells.
• Excessive gastric acid production due to gastrinoma, high parasympathetic drive → mucosal damage and erosions.
• Toxins directly damaging gastric mucosa and interfering with epithelial renewal, eg uremia → erosions in superficial cellular layer.
• Toxins, drugs and spiral organisms directly damaging gastric mucosal barrier stimulating histamine release → gastric and production → more damage → vicious cycle established.

Timecourse

• Variable depending on etiology.

Diagnosis

Treatment

Outcomes