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home - Stomach - Gastritis and Gastropathy - Large Gastric Folds Gastropathy Written by Dr Sebastian Zeki

Large Gastric Folds Gastropathy

Enlarged gastric folds. Hyperplastic gastropathy — Hyperplastic gastropathy refers to conditions confined to the rugae in the gastric body and fundus, which are associated with an excessive number of mucosal epithelial cells. Treatment of Menetrier’s Disease:H. pylori eradication (clinical improvement in a few days).Octreotide for protein loss.Cases report of Erbitux (EGFr monoclonal antibody).Gastric resection occasionally (total as subtotal can result in anastomotic leaks). Large gastric folds associations:Helicobacter pylori —Both acute and chronic H. pylori gastritis.Neoplasia — Neoplasms, particularly lymphoma, adenocarcinoma, and carcinoid tumors, should be excluded in patients with enlarged gastric folds .Miscellaneous causes.Lymphocytic gastritis-may be related in some cases to H. pylori.Sarcoidosis.Eosinophilic gastroenteritis.Cronkhite-Canada syndrome. Causes of enlarged gastric folds:Chronic gastritis/lymphoid hyperplasia — 40%.Benign tumors — 16%.Gastric malignancy — 12%.Zollinger-Ellison syndrome — 10%.Menetrier's disease — 8%. Hyperplastic Gastropathy Types:Epithelial hyperplasia involving the surface and foveolar mucous cells. Increased numbers of parietal cells with no change in surface and foveolar mucous cells. A mixed-type hyperplastic gastropa-thy. Pathogenesis:TGF-Beta (increases gastric mucous production and inhibits acid secretion Menetrier's Disease - Polypoid abnormalities in the stomach 1 Polyadenomes polypeux consisted of multiple discrete gastric polyps, which are today classified as hyperplastic polyps 2. Ménétrier polyadenomes en nappe, or multiple sheet-like adenomas) is a novel entity associated with foveolar hyperplasia. Types Epigastric pain — 65 % Asthenia — 60 % Anorexia — 45 % Weight loss — 45 % Edema — 38 % Vomiting — 38 % Hypoalbuminaemia- 80%Mildly dec acid and inc gastrin Prognosis of Menetrier’s DiseaseIt develops into gastric atrophy over 4-8 years, with return of the serum albumin concentration to normal.Menetrier’s disease may have increased risk of gastric cancer but unclear. Gastropathy is commonly secondary to endogenous or exogenous irritants, such as bile reflux, alcohol, or aspirin and nonsteroidal antiinflammatory drugs. However, gastropathy can also be secondary to ischemia, stress, or chronic congestion. Gastropathy (ie, foveolar hyperplasia); the oxyntic glands can be normal or atrophic. These are the characteristic changes found in Ménétrier's disease. These changes are observed in the Zollinger-Ellison syndrome Both mucous and oxyntic glandular cells show hyperplasia, may also be seen in conditions such as lymphocytic and H. pylori gastritis. Written by Dr Sebastian Zeki

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