Current RMA Instruments
| Reasonable Hypothesis SOP | 101 of 2021 |
| Balance of Probabilities SOP | 102 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 535.1, 535.4
- CD-10-AM Codes: K29.4, K29.6
Brief description
This SOP covers chronic gastritis (inflammation of the stomach lining) due to infection and chronic gastropathy (damage to the stomach lining with minimal or no inflammation) due to non-infectious causes.
Confirming the diagnosis
The diagnosis needs to be confirmed by histology. This would normally be done from mucosal biopsy following endoscopy / gastroscopy. In addition, a diagnosis of chronic gastropathy requires the presence of symptoms, in the form of epigastric pain, nausea, bloating or burning for at least three months.
The relevant medical specialist is a gastroenterologist.
Additional diagnoses covered by SOP
- Chronic atrophic gastritis
Conditions excluded from SOP
- Acute gastritis#
- Acute gastropathy#
- Asymptomatic chronic gastropathy - not a disease or injury
- Autoimmune gastritis - part of underlying autoimmune condition
- Chronic non-infectious granulomatous gastritis#
- Eosinophilic gastritis#
- Gastric antral vascular ectasia#
- Gastric erosions#
- Gastric ulcer*
- Ischaemic gastritis#
- Lymphocytic gastritis#
- Portal hypotensive gastropathy#
- Uraemic gastritis#
* another SOP applies
# non-SOP condition
Clinical onset
Clinical onset will be at the time of diagnosis, or when symptoms, subsequently confirmed to be due to chronic gastritis or chronic gastropathy, developed. Onset should generally not be backdated to before the time that current, continuous symptoms developed. Any earlier gastric symptoms could have a variety of other causes.
Clinical worsening
Clinical worsening may be evidenced by worsening pathology, shown on repeat histology, or a deterioration in symptoms, provided that deterioration was not due to a sequela condition, such as ulceration.
Other information
The SOP has a factor, for chronic gastritis only, for having infection with Helicobacter pylori. An advisory note on relating Helicobacter pylori infection to military service is available - MILITARY SERVICE AND INFECTION WITH HELICOBACTER PYLORI