Gastritis

Abstract

Prior to the late 1950's gastritis was recognized as a pathologic entity of unclear etiology and uncertain clinical significance. As such the field held little interest to all but a few dedicated clinical investigators. Now, three decades later the situation is very different. Substantial advances have been realized in the areas of etiology and pathogenesis of gastritis (both endoscopic and histologic) along with an improved, though still far from complete understanding of the clinical significance of this group of disorders. Whilst the current review has focussed largely on the contributions of immunology to new knowledge in the area of histologic gastritis, equally important gains have come from the disciplines of clinical gastroenterology, pathology and more recently microbiology. Historically, the entry of these disciplines into the modern investigation of gastritis occurred at different times and each has been heralded by a significant advance - the discovery of gastric autoantibodies in the late 1950's, the endoscopy era and a better definition of pathologic diversity in gastritis beginning in the early 1970's, and the rediscovery of gastric spiral bacteria and their correlation with histologic gastritis in the early 1980's. Increasingly, as the current review attempts to show, there is a convergence of the observations from each of these investigative areas which is beginning to provide the basis for new approaches to the diagnosis and classification of gastritis and the expectation for an improved understaning of the clinical significance of this diverse group of disorders in the future. © 1990 Springer-Verlag.