Abstract

Gastritis is an inflammation of the mucosa of the stomach, and has many etiologies. Gastritis can be classified as being acute or chronic. For the purpose of this chapter, we will focus only on chronic gastritis due to its relevance to gastric cancer. Among the causes of chronic gastritis are chronic bile reflux, stress, certain autoimmune disorders and bacterial infection, primarily Helicobacter pylori. Since 1870, both human and veterinary pathologists have described the presence of tiny curved bacteria within gastric mucosa, but the organisms were dismissed as irrelevant contaminants (1, 2). In 1947, when gastroscopy was first being used, Rudolf Schindler deemed gastritis as “one of the most debated diseases of the human body” and predicted that its significance would be discussed “for some time to come” (3). Schindler himself claimed that the “bacteriological etiology of chronic gastritis has not been convincingly proved in a single case” (3). In 1984, Warren and Marshall proposed that chronic “idiopathic” gastritis had a bacterial cause (i.e., H. pylori) (4). Their hypothesis was met with great skepticism. However, within a few years, the association between H. pylori gastritis, peptic ulcer, and gastric cancer came to be acknowledged and ultimately accepted (4). Subsequently, accurate morphological data were gathered by pathologic examination of autopsy material (5) and, later, of endoscopic biopsy specimens. As a result, distinct types and patterns of gastritis were recognized, which led to the conception, presentation, dismissal, and replacement of many different classification systems.