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Aim. The clinical guidelines are intended to supplement specialty decision-making for improved aid quality in patients with gastritis and duodenitis though acknowledging the latest clinical evidence and principles of evidencebased medicine.Key points. Gastritis is an inflammatory disease of stomach mucosa, with a separate definition of acute and chronic gastritis. Chronic gastritis is a cohort of chronic diseases uniting a typical morphology of persistent inflammatory infiltration, impaired cellular renewal with emergent intestinal metaplasia, atrophy and epithelial dysplasia of gastric mucosa. Oesophagogastroduodenoscopy (OGDS) or high-resolution OGDS with magnified or non-magnified virtual chromoendoscopy, including targeted biopsy for atrophy and intestinal metaplasia grading and neoplasia detection, are recommended to verify gastritis and duodenitis, precancer states and/or gastric mucosal changes. All chronic gastritis patients positive for H. рylori should undergo eradication therapy as aetiological and subsidiary for gastric cancer prevention. Chronic gastritis patients with symptoms of dyspepsia (epigastric pain, burning and congestion, early satiety), also combined with functional dyspepsia, are recommended proton pump inhibitors, prokinetics, rebamipide and bismuth tripotassium dicitrate in symptomatic treatment. With focal restricted intestinal metaplasia, follow-up is not required in most cases, mainly when advanced atrophic gastritis is ruled out in high-quality endoscopy with biopsy. However, a familial history of gastric cancer, incomplete intestinal metaplasia and persistent H. pylori infection render endoscopy monitoring with chromoendoscopy and targeted biopsy desirable once in three years. Patients with advanced atrophic gastritis should have high-quality endoscopy every 3 years, and once in 1–2 years if complicated with a familial history of gastric cancer.Conclusion. The recommendations condense current knowledge on the aetiology and pathogenesis of gastritis and duodenitis, as well as laboratory and instrumental diagnostic techniques, main approaches to aetiological H. pylori eradication and treatment of dyspeptic states.

Background: Heartburn occurs predominantly in the upper gastrointestinal tract and is associated with gastroesophageal reflux disease (GERD) and gastritis. Omeprazole is the most prescribed proton pump inhibitor class of medication to treat heartburn related clinical conditions. To compare the efficacy of omeprazole 40 mg (as a total daily dose) and 20 mg using patient-reported outcome measures (PROMs) in patients with heartburn due to various aetiologies like non-erosive reflux disease, GERD, gastritis, dyspepsia, functional heartburn, gastro-duodenal ulcer.Methods: Naïve patients presenting heartburn symptoms were treated with omeprazole. PROMs were assessed based on short-form-leeds dyspepsia questionnaires (SF-LDQ), work productivity activity impairment (WPAI), relief obtained using medication and, treatment satisfactory questionnaires (TSQ).Results: A total of 18,724 patients with heartburn (GERD and gastritis; n=10,509) were treated with omeprazole (Dr. Reddy’s omeprazole [DO]/generic omeprazole [GO]/branded omeprazole [BO]) 40 mg (as a total daily dose) and 20 mg. Statistical comparative analysis showed significant improvement with omeprazole 40 mg (as a total daily dose) compared to omeprazole 20 mg in SF-LDQ, relief obtained using medication among patients with heartburn. DO 20 mg showed a greater improvement under the ‘a lot’ and ‘complete’ relief category.Conclusions: Omeprazole 40 mg (as a total daily dose) presented better efficacy as compared to omeprazole 20 mg in patient reported outcomes. This study highlights omeprazole 40 mg as the preferred intervention for improving PROMs and quality of life in the treatment of heartburn related clinical conditions.

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