the most reliable means of diagnosis. Biopsies should be obtained from reliable means of diagnosis. Biopsies should be obtained from several different areas, since chronic gastritis may be a localized disease.
Histologically, chronic gastritis is divided into superficial gastritis, atrophic gastritis, and gastric atrophy. When inflammatory cells (neutrophils, lymphocytes, plasma cells, and a few eosinophils) are limited to the gastric pits and upper lamina propria, gastritis is classified as superficial. In atrophic gastritis, inflammatory cells invade deeper into the lamina propria and glandular epithelim. Lymphoid follicles
may also be seen. As the disease progresses, thinning of the mucosa occurs with loss of glandular elements. In some patients intestinal metaplasia develops with loss of parietal and chief cells and development of goblet cells, absorptive cells, and intestinal villi. Finally, in patients with gastric atrophy, parietal and chief cells are absent, mucosal thickness is reduced markedly, and only a small number of inflammatory cells are present.
Chronic atrophy gastritis has been divided into Type A and Type B, based primarily on the anatomic portion of the stomach involved and the presence or absence of parietal cell antibodies. In Type A gastritis, the fundus and body of the stomach are involved, whereas the antrum is relatively normal. Parietal cell antibodies are tbund in a large percentage of patients, and pernicious anemia may develop. On the other hand, in Type B gastritis the antrum is involved primarily. Although inflammation is found frequently in the fundus and body, parietal cell antibodies do not occur.
In traditional Chinese medicine, there is no equivalent term for chronic gastritis and this condition is described as disharmony of the function and coordination,of the liver and the stomach, due to stagnation of dampness caused by deficiency of the slpeen.
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