Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (123 page)

   
Helicobacter pylori
infection is detectable in approximately 80% of patients with peptic ulcer and chronic gastritis. Diagnosis is by biopsy, culture, direct Gram staining, urease breath test, and serologic tests.

   Hypogastrinemia is caused by destruction of gastrin-producing cells in the antrum.

   Chronic antral gastritis is consistently present in patients with benign gastric ulcer.

   Gastric acid studies are of limited value. Severe hypochlorhydria or achlorhydria after maximal stimulation usually denotes mucosal atrophy.

   Other Causes

   Infections (other bacteria [syphilis], viral [e.g., CMV], parasitic [e.g., anisakiasis], fungal)

   Chemical (e.g., NSAIDs, bile reflux, other drugs)

   Lymphocytic gastritis

   Eosinophilic gastroenteritis

   Noninfectious granulomatous (e.g., sarcoidosis, Crohn disease)

   Ménétrier disease

   Radiation

CARCINOMA OF THE STOMACH

   Laboratory Findings