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K29.5 Chronic Gastritis – Causes and Treatment
K29.5 is the ICD-10 code for chronic gastritis – a long-lasting inflammation of the stomach lining. It can cause symptoms such as stomach pain, nausea, and bloating.
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K29.5 is the ICD-10 code for chronic gastritis – a long-lasting inflammation of the stomach lining. It can cause symptoms such as stomach pain, nausea, and bloating.
What is K29.5 – Chronic Gastritis?
K29.5 is the ICD-10 diagnosis code for chronic gastritis – a persistent, often slowly progressing inflammation of the gastric mucosa (stomach lining). Unlike acute gastritis, the chronic form develops over months or years and often goes unnoticed in its early stages. Depending on the underlying cause and course, it can lead to structural changes in the stomach lining and increase the risk of gastric ulcers or, in rare cases, stomach cancer.
Causes
Chronic gastritis can have several different causes. The most common include:
- Helicobacter pylori infection (Type B): The bacterium Helicobacter pylori is the most common cause of chronic gastritis worldwide. It colonizes the stomach lining and triggers a persistent inflammatory response.
- Autoimmune disease (Type A): The immune system mistakenly attacks the body's own gastric mucosal cells. This form is less common and can lead to vitamin B12 deficiency (pernicious anaemia).
- Chemical or toxic influences (Type C): Regular use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac, excessive alcohol consumption, or bile acid reflux can chronically irritate the stomach lining.
- Other factors: Stress, an unhealthy diet, smoking, and rare conditions such as Crohn's disease or coeliac disease may also play a role.
Symptoms
Many people with chronic gastritis initially experience no or only non-specific symptoms. Possible symptoms include:
- Dull or burning sensation in the upper abdomen
- Nausea, occasional vomiting
- Early feeling of fullness
- Belching, bloating
- Loss of appetite
- In severe cases: blood in the stool (tarry stools) as a sign of gastric bleeding
Diagnosis
The diagnosis of chronic gastritis is usually established through several examinations:
- Gastroscopy (upper endoscopy): Visual assessment of the stomach lining with tissue sampling (biopsies) for histological examination.
- Histological analysis: Microscopic examination of biopsy samples to determine the pattern of inflammation and rule out malignant changes.
- Helicobacter pylori testing: Via breath test (13C-urea breath test), stool antigen test, blood test, or biopsy.
- Blood tests: To check for autoantibodies (in Type A gastritis), vitamin B12 levels, and complete blood count.
Treatment
Treatment is guided by the underlying cause:
Helicobacter pylori Eradication
If a Helicobacter pylori infection is confirmed, eradication therapy is carried out using a combination of antibiotics (e.g., amoxicillin, clarithromycin) and a proton pump inhibitor (PPI) over 7–14 days.
Proton Pump Inhibitors (PPIs)
Medications such as omeprazole or pantoprazole reduce acid production in the stomach and support healing of the mucosal lining.
General Measures
- Avoiding substances that irritate the stomach lining (NSAIDs, alcohol, nicotine)
- Dietary adjustments: small, regular meals and avoidance of very fatty or spicy foods
- Stress reduction
Autoimmune Gastritis
In Type A gastritis, the primary focus is on treating a vitamin B12 deficiency, often through regular vitamin B12 injections.
Prognosis
With consistent treatment of the underlying cause – especially after successful eradication of Helicobacter pylori – the stomach lining can recover and inflammation can resolve. If left untreated, chronic gastritis may lead to gastric ulcers, atrophic changes, or rarely stomach cancer. Regular medical check-ups are therefore important.
References
- World Health Organization (WHO): ICD-10 Classification of Diseases – K29.5 Chronic Gastritis. Geneva, 2019.
- Malfertheiner P. et al.: Management of Helicobacter pylori infection – the Maastricht V/Florence Consensus Report. Gut, 2017; 66(1): 6–30.
- Rugge M. et al.: Gastritis: The clinico-pathological spectrum. Digestive and Liver Disease, 2011; 43(2): 83–93.
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