What is the difference between gastritis and gastroenteritis?

Difference Between Gastritis and Gastroenteritis

Gastritis and gastroenteritis are distinct gastrointestinal conditions with different anatomical involvement, etiologies, and treatment approaches. While both can cause similar symptoms, understanding their differences is crucial for proper diagnosis and management.

Anatomical Differences

• Gastritis:

  • Inflammation limited to the stomach lining
  • Defined as the loss of gastric glands, with or without metaplasia, in the setting of chronic inflammation 1
  • Does not involve the intestines

• Gastroenteritis:

  • Inflammation affecting both the stomach and intestines 1
  • Can extend to include colitis (inflammation of the colon) 2
  • More extensive gastrointestinal tract involvement

Etiological Differences

Gastritis

• Primary causes:

  • Helicobacter pylori infection (most common cause)
  • Autoimmunity
  • Prolonged use of NSAIDs
  • Alcohol consumption
  • Stress

• Specific types:

  • Atrophic gastritis: characterized by loss of gastric glands 1, 3
  • Autoimmune gastritis: associated with pernicious anemia and vitamin B12 deficiency 1
  • Eosinophilic gastritis: rare condition with eosinophil infiltration 4

Gastroenteritis

• Primary causes:

  • Viruses (most common cause - particularly norovirus and rotavirus)
  • Bacteria (Salmonella, Campylobacter, Shigella, etc.)
  • Parasites
  • Food poisoning 1, 2

• Epidemiology:

  • Highest incidence in children under 5 years
  • Highest hospitalization and death rates in persons 65 years or older 1

Clinical Presentation Differences

Gastritis

• Symptoms:

  • Upper abdominal pain/discomfort
  • Nausea
  • Possible vomiting
  • Possible bleeding (in hemorrhagic gastritis)
  • Often more chronic in nature
  • Symptoms may persist for weeks to months

• Endoscopic features (in atrophic gastritis):

  • Pale appearance of gastric mucosa
  • Increased visibility of vasculature due to thinning
  • Loss of gastric folds 1

Gastroenteritis

• Symptoms:
  • Acute watery diarrhea (primary feature)
  • Nausea and vomiting
  • Abdominal cramping
  • Possible fever
  • Usually self-limiting (typically resolves within 7 days) 1
  • Can present as acute bloody diarrhea (dysentery) with frequent scant stools containing blood and mucus 1

Diagnostic Approach Differences

Gastritis

• Diagnosis:
  • Confirmed by histopathology from endoscopic biopsies
  • Testing for H. pylori infection
  • Checking antiparietal cell antibodies and anti-intrinsic factor antibodies in suspected autoimmune gastritis 1
  • Endoscopic visualization of the stomach mucosa

Gastroenteritis

• Diagnosis:
  • Primarily clinical for mild cases
  • Microbial studies for severe or prolonged symptoms
  • Stool testing for blood, pathogens
  • Multiplex antimicrobial testing preferred over traditional stool cultures 2
  • Testing for C. difficile in patients with recent antibiotic exposure 2

Treatment Approach Differences

Gastritis

• Treatment:
  • Proton pump inhibitors (PPIs) such as esomeprazole or rabeprazole (20-40 mg twice daily) 5
  • H. pylori eradication if infection is present
  • Treatment of underlying cause (stopping NSAIDs, alcohol)
  • Vitamin B12 supplementation in autoimmune gastritis
  • Reassessment after 2-4 weeks of therapy 5

Gastroenteritis

• Treatment:
  • Primarily supportive care with oral rehydration
  • Nasogastric or intravenous hydration for severe cases
  • Antimicrobial therapy only for specific bacterial infections with severe symptoms, C. difficile, travel-related diarrhea, and parasitic infections 2
  • Symptom control with antiemetics, antimotility, and/or antisecretory drugs 2
  • Usually self-resolving without specific treatment

Complications and Prognosis

Gastritis

• Complications:
  • Atrophic gastritis can progress to gastric cancer 1, 3
  • Bleeding from erosions or ulcers
  • Iron deficiency and vitamin B12 deficiency in autoimmune gastritis 1

Gastroenteritis

• Complications:
  • Dehydration (primary concern)
  • Post-infectious irritable bowel syndrome (occurs in approximately 9% of patients) 2
  • Post-infectious lactose intolerance 2
  • Usually resolves completely without long-term sequelae

Key Takeaways

• Gastritis is inflammation limited to the stomach, often chronic, and frequently associated with H. pylori or autoimmunity
• Gastroenteritis involves both stomach and intestines, is usually acute and self-limiting, and is predominantly caused by infectious agents
• Treatment approaches differ significantly, with gastritis requiring acid suppression and potential H. pylori eradication, while gastroenteritis primarily requires hydration and supportive care
• Gastritis has potential long-term complications including progression to gastric cancer, while gastroenteritis typically resolves completely but may lead to post-infectious IBS