Chronic gastritis is chronologically divided into a:
- superficial gastritis, non-atrophic (Sipponen 2015) at the beginning of the disease
- atrophic gastritis (in the further course [Kayacetin 2014]).
Classification of chronic gastritis according to histological features (Kasper 2015) is done by the so-called ABC classification (Braun 2022):
- Type A:
The inflammatory changes with atrophy of the mucosa (Kayacetin 2104) preferentially affect cardia and corpus (Herold 2022) with typical recess of the antrum (Kasper 2015).
Antibodies against vestibular cells are found (Krams 2010), hence the name "autoimmune gastritis" (AIG). Type A occurs less frequently than type B (Kasper 2015).
- Type B:
Here, bacterial inflammation is found, predominantly caused by Helicobacter pylori (Herold 2022).
The inflammatory changes are predominantly in the antrum (Kasper 2015) and show an ascending spread with atrophy of the glandular bodies and vestibular cells. This results in hypochlorhydria in type B (Herold 2022). Type B occurs more markedly than type A. At the onset of the disease, the number of H. pylori is highest and decreases with progression of gastric atrophy (Kasper 2015)
- Type AB:
These terms, used predominantly in Anglo-Saxon countries, denote a mixed form of inflammation with respect to its localization (Kasper 2015).
- Type C:
Type C is a chemically toxic gastritis (Frühmorgen 2013). It is caused by drugs, bile reflux, etc. (Krams 2010) and induces chronic gastritis of the antrum (Herold 2022).
- Rarely occurring special forms of chronic gastritis:
These include, for example:
Crohn's- gastritis, lymphocytic gastritis, eosinophilic gast ritis (Herold 2022).
Another classification, the so-called OLGA/OLGIM classification (Operative Link on Gastritis/IM Assessment or Operative Link for Gastric Intestinal Metaplasia Assessment) is used to categorize patients in low, intermediate or high risk for developing gastric cancer (Sipponen 2015).
Atrophy score
Antrum
|
Corpus |
No atrophy (score 0) |
Mild atrophy (score 1) |
Mod atrophy (score 2) |
Severe atrophy (score 3) |
No atrophy (score 0)
(incl incisura angularis)
|
STAGE 0 |
STAGE I |
STAGE II |
STAGE III |
Mild atrophy (score 1) (incl incisura angularis) |
STAGE I |
STAGE I |
STAGE II |
STAGE III |
Mod atrophy (score 2)
(incl incisura angularis)
|
STAGE II |
STAGE II |
STAGE III |
STAGE IV |
Severe atrophy (score 3)
(incl incisura angularis)
|
STAGE III |
STAGE III |
STAGE IV |
STAGE IV |
from: Sipponen P, Maaroos HI (2015)