Clinical Gastroenterology Vol.19 No.6(10)

Theme Reconstruction of "Chronic Gastritis" in the Future
Title Problem Regarding "Chronic Gastritis" in ICD-10
Publish Date 2004/06
Author Junichi Akiyama Health Administration Center, Wakayama University
Author Naomi Uemura Department of Gastroenterology, International Medical Center of Japan
[ Summary ] "Chronic gastritis" is one of the most frequently used terms for medical diagnosis in Japan. However, it represents several conditions such as, dyspeptic symptoms and endoscopic chronic gastritis, as well as histological chronic gastritis. In the current, tenth revision of the International Statistical Classification of Disease and Related Health Problems (ICD-10), the classification of gastritis is also confusing, mainly due to a lack of recognition of Helicobacter pylori (H.pylori) infection and non-steroidal anti-inflammatory drugs (NSAIDs) as pathogenetic factors. H.pylori infection is known to be associated not only with histological gastritis and peptic ulcer disease, but also with gastric hyperplastic polyps, gastric MALT lymphoma, and gastric adenocarcinoma. NSAIDs are also regarded as one of the important risk factors for gastric mucosal injury. Therefore, H.pylori infection and NSAIDs should be taken into account in the classification of gastritis. A new subclassification termed "chronic gastiritis" should be based on the pathogenesis and should include chronic gastritis associated with H.pylori infection, and chronic gastritis other than H.pylori infection (chemical gastritis and special forms), as well as functional dyspepsia.
back