Wilfred M WeinsteinMD

This chapter deals mainly with those aspects of chronic gastritis that carry an increased risk of carcinoma at the population level (ie, intestinal metaplasia [IM]), or those that arise from the "soil" of chronic gastritis, such as hyperplastic polyps, adenomas, and nonadenomatous or endoscopically invisible dysplasia. These are virtually all triggered by Helicobacter pylori. Two other conditions associated with different types of mucosal injury will be discussed, including (1) Ménétrier's disease, a hypertrophic gastropathy and (2) the postoperative stomach, a reactive gastropathy. Both carry an increased risk of cancer. Gastropathy is a pattern of mucosal injury in which inflammatory infiltrates may be present but are not the signature feature. In the case of Ménétrier's type of hyper-trophic gastropathy the main change is a "growth disorder" with expansion of gastric pits to replace the oxyntic acid-secreting glands. Reactive gastropathy is a form of mucosal injury with highly reactive epithelial cells and some foveo-lar hyperplasia and minimal to no inflammation.

IM of the gastric cardia (gastroesophageal junction [GEJ]) is more related to the spectrum of gastroesophageal reflux disease (GERD). Its management will be discussed briefly at the end of this chapter.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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