Gastritis: A Short Appraisal of Classification and the Sydney System

Abstract

The confusion surrounding the classification of gastritis conjures up that in the biblical story of the Tower of Babel. There are many classifications in use [1–11], but there is limited common language. For example, type B gastritis according to Wyatt and Dixon [10] is aetiological, referring to a bacterial gastritis, but Yardley’s type B gastritis [9] is morphological and indeed specifically excludes a bacterial pathogenesis, in particular Helicobacter pylori. Indeed, for clinicians and pathologists alike, especially those without a detailed knowledge of the field, the situation is nearly as confusing as the classification of lymphomas. To try and solve that dilemma an expert group was set up and produced a working formulation: a simple system which acted as a matrix on which the various classifications could be interrelated. The Working Party on Gastritis, set up by the 9th World Congress of Gastroenterology in Sydney, produced the Sydney System for the Classification of Gastritis [12]. This was prompted by the contradictions between existing classifications and the acute need for widely acceptable terminology following the deluge of new data, the result of the discovery of H. pylori: [13] as one of the main causes of chronic gastritis.