This is usually a response to irritant drugs or alcohol. The drugs most commonly implicated are non-steroidal anti-inflammatory drugs including aspirin,even at low doses,although many others may also be involved. Other causes include the initial response to helicobactar pylori infection and severe physiological stress,eg. in extensive burns and multiple organ failure.
There are varying degrees of severity. Mild cases can be asymptomatic or may present with nausea and vomiting associated with inflammatory changes of the gastric mucosa. Erosions can also occur,which are characterised by tissue loss affecting the superficial layers of the gastric mucosa. In more serious cases,there are multiple erosions,which may result in life-threatening haemorrhage causing haematemesis(vomiting of frank blood or black’coffee grounds’ when there has been time for digestion of blood to occur) and malaena(passing black tarry feaces), especially in elderly people.
The outcome depends on the extent of the damage. In many cases recovery is uneventful after the cause is removed. Where there has been extensive tissue damage healing is by fibrosis causing reduced elasticity and peristalsis.
