Chronic gastritis and chronic gastropathy — DVA SoP factors

Reasonable Hypothesis (RH) — Statement of Principles No. 101 of 2021

At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting chronic gastritis or chronic gastropathy or death from chronic gastritis or chronic gastropathy with the circumstances of a person's relevant service:

1. (1)
   for chronic gastritis only: (a) having a Helicobacter pylori infection of the gastric mucosa before the clinical onset of chronic gastritis; (b) having Helicobacter heilmannii sensu lato infection of the gastric mucosa before the clinical onset of chronic gastritis; (c) having an infection of the gastric mucosa from the specified list of infections at the time of the clinical onset of chronic gastritis; (d) being in an immunocompromised state as specified at the time of the clinical onset of chronic gastritis; or (e) taking an immune checkpoint inhibitor for at least the 4 weeks before the clinical onset of chronic gastritis;

   Note: Helicobacter heilmannii sensu lato is defined in the Schedule 1 - Dictionary.

   Note: specified list of infections is defined in the Schedule 1 - Dictionary.

   Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

   Note: Examples of immune checkpoint inhibitors include ipilimumab, tremelimumab, nivolumab and pembrolizumab.

2. (2)
   for chronic gastropathy only: (a) having reflux of bile acids into the stomach at the time of the clinical onset of chronic gastropathy; (b) taking a non-topical, non-steroidal, anti-inflammatory drug, including aspirin, on more days than not for a continuous period of at least 2 weeks, within the 30 days before the clinical onset of chronic gastropathy; (c) taking a drug from the Specified List 1 of drugs for at least the 4 weeks before the clinical onset of chronic gastropathy; (d) consuming an average of at least 350 grams of alcohol per week for at least the 2 years before the clinical onset of chronic gastropathy; (e) undergoing a course of therapeutic radiation for cancer, where the stomach was in the field of radiation, within the 1 year before the clinical onset of chronic gastropathy; or (f) having received yttrium-90 microspheres as therapy for primary and metastatic liver tumours, within the 1 year before the clinical onset of chronic gastropathy;

   Note: Examples of circumstances in which reflux of bile acids into the stomach can occur include post-gastrectomy, post-biliary surgery and decreased gastric or duodenal motility.

   Note: Specified List 1 of drugs is defined in the Schedule 1 - Dictionary.

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

3. (3)
   having reflux of bile acids into the stomach at the time of the clinical worsening of chronic gastritis or chronic gastropathy;

   Note: Examples of circumstances in which reflux of bile acids into the stomach can occur include post-gastrectomy, post-biliary surgery and decreased gastric or duodenal motility.

4. (4)
   taking a non-topical, non-steroidal, anti-inflammatory drug, including aspirin, on more days than not for a continuous period of at least 8 days, within the 30 days before the clinical worsening of chronic gastritis or chronic gastropathy;
5. (5)
   taking a drug from the Specified List 2 of drugs at the time of the clinical worsening of chronic gastritis or chronic gastropathy;

   Note: Specified List 2 of drugs is defined in the Schedule 1 - Dictionary.

6. (6)
   consuming an average of at least 350 grams of alcohol per week for at least the 6 months before the clinical worsening of chronic gastritis or chronic gastropathy;

   Note: Alcohol consumption is calculated utilising the Australian Standard of 10 grams of alcohol per standard alcoholic drink.

7. (7)
   undergoing a course of therapeutic radiation for cancer, where the stomach was in the field of radiation, within the 1 year before the clinical worsening of chronic gastritis or chronic gastropathy;
8. (8)
   having received yttrium-90 microspheres as therapy for primary and metastatic liver tumours, within the 1 year before the clinical worsening of chronic gastritis or chronic gastropathy;
9. (9)
   for chronic gastritis only: (a) having a Helicobacter pylori infection of the gastric mucosa before the clinical worsening of chronic gastritis; (b) having Helicobacter heilmannii sensu lato infection of the gastric mucosa before the clinical worsening of chronic gastritis; (c) having an infection of the gastric mucosa from the specified list of infections at the time of the clinical worsening of chronic gastritis; (d) being in an immunocompromised state as specified at the time of the clinical worsening of chronic gastritis; or (e) taking an immune checkpoint inhibitor for at least the 4 weeks before the clinical worsening of chronic gastritis;

   Note: Helicobacter heilmannii sensu lato is defined in the Schedule 1 - Dictionary.

   Note: specified list of infections is defined in the Schedule 1 - Dictionary.

   Note: immunocompromised state as specified is defined in the Schedule 1 - Dictionary.

   Note: Examples of immune checkpoint inhibitors include ipilimumab, tremelimumab, nivolumab and pembrolizumab.

10. (10)
    inability to obtain appropriate clinical management for chronic gastritis or chronic gastropathy;

Aggravation-only factors: the factors in subsections 9(3) to 9(10) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.