Problematic issues of chronic gastritis studies

The article defines chronic gastritis as a polyetiological and polypathogenetic stomach disease with a chronic, slowly progressing course, which is based on a specific inflammatory process with lymphoplasmocytic infiltration of its mucosa and neutrophilic component indicating its activity, and with development of disregenerative, dystrophic changes, leading to its secretory insufficiency, manifested hypo- and achlorhydria and gastric achilia. The history of studying chronic gastritis from the beginning of the 19th century till present days is briefly described. It is proposed to distinguish between causal (Helicobacter pylori, etc.) and predisposing (alcohol, smoking, coarse food, etc.) factors in the development of chronic gastritis. The analysis of various classifications of gastritis is carried out: based on etiology, pathogenesis, functional features, clinic, endoscopic and histological characteristics. The Sydney, Houston classifications, the OLGA system are described. Particular attention is paid to diagnosis, biopsy technique of the gastric mucosa, ratio of diagnoses of chronic gastritis and functional dyspepsia, as well as the role of gastric microflora in development of gastritis. It is revealed that gastric microflora in chronic gastritis is represented by numerous types of bacteria (more often in the form of bacterial associations), moreover, Helicobacter pylori is not the dominant microorganism colonizing the stomach, and the mucosal microflora found in the stomach has adhesiveness, invasiveness and pathogenic properties, including its urease activity.