Helicobacter pylori
Helicobacter pylori colonizes the stomachs of more than half of the worlds population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases. Colonization of the gastric mucosa with Helicobacter pylori results in the development of chronic gastritis in infected individuals and, in a subset of patients, chronic gastritis progresses to complications (e.g., ulcer disease, stomach cancers, and some distinct extragastric disorders). However, more than 80% of individuals infected with the bacterium are asymptomatic and it has been postulated that it may play an important role in the natural stomach ecology. Critical illness
Gastritis may also develop after major surgery or traumatic injury ("Cushing ulcer"), burns ("Curling ulcer"), or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Diet
Evidence does not support a role for specific foods, including spicy foods and coffee, in the development of peptic ulcers. People are usually advised to avoid foods that bother them. There is little specific advice on diet published by authoritative sources. The website of the National Health Service of the United Kingdom advises "avoiding foods that can irritate the stomach, such as spicy, acidic or fried foods", and suggests that "you may want to talk to a GP about this". Pathophysiology
Acute
Acute erosive gastritis typically involves discrete foci of surface necrosis due to damage to mucosal defenses.
On the other hand, the consumption of oily fish, in a diet similar to that which doctors recommend for age related macular degeneration, can be used to slow the progression of the disease.Advances in technology have brought devices that help Stargardt patients who are losing their vision maintain their independence. Low-vision aids can range from hand lenses to electronic devices and can allow those losing their vision to be able to carry out daily activities. Some patients may even opt for in-person services. Prognosis
The long-term prognosis for patients with Stargardt disease is widely variable and depends on the age of onset and genetic alleles.The majority of patients will progress to legal blindness, which means that central reading vision will be lost. However, perimetry and microperimetry studies indicate that the peripheral light sensitivity is preserved over a long time in a significant fraction of all patients (i.e., >50%). Stargardt disease has no impact on general health and life expectancy is normal. Some patients, usually those with the late-onset form, can maintain excellent visual acuities for extended periods and are therefore able to perform tasks such as reading or driving. Epidemiology
A 2017 prospective epidemiologic study that recruited 81 patients with STGD over 12 months reported an incidence of between 1 and 1.28 per 10 000 individuals. The median age of presentation was 27 years (range 5–64 years), most (90%) were symptomatic, with a median visual acuity of Snellen equivalent 20/66. History
Karl Stargardt (1875–1927) was a German ophthalmologist born in Berlin.