The Updated Sydney System: Classification and Grading of Gastritis as the Basis of Diagnosis and Treatment

Abstract

In recent years, the importance of the histological diagnosis of gastritis on the basis of routinely obtained antral and corpus biopsies has increased enormously, which is owed not least of all to the discovery ofHelicobacter pylori. The introduction of the Sydney system made it possible, for the first time, to grade histological parameters, identify topographical distribution and, finally, make a statement about the etiopathogenesis of the gastritis. Of pathogenetic importance is, in the first instance, the differentiation between gastritis with and gastritis withoutH pyloriinfection. The group ofH pylori-associated gastritis can be further subdivided into forms of gastritis whose morphological distribution patterns usually identify them as sequelae ofH pyloriinfection, while the group of gastritis unassociated withH pylori, can be differentiated into autoimmune, chemically induced reactive gastritis, ex-H pylorigastritis,Helicobacter heilmanniigastritis, Crohn's gastritis and a number of special forms of gastritis.