Gastritis

Gastritis by itself is rarely a serious problem. Gastritis is an inflammation of the lining of your stomach. Gastritis is not a single disease, but several different conditions that all have inflammation of the stomach lining. The inflammation of gastritis is often the result of infection with the same bacterium that causes most stomach ulcers. However, other factors — such as traumatic injury, regular use of certain pain relievers or drinking too much alcohol — also can contribute to gastritis.

Gastritis may occur suddenly (acute gastritis) or it can occur slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn’t serious and improves quickly with treatment.

The cause of most types of gastritis is known and effective treatment and preventive measures are available so that serious complications are unusual.
The causes of gastritis are varied. The symptoms can be acute and severe or chronic, low-grade or even absent. The diagnosis is usually easily made by endoscopy. In most instances, effective treatment is available and serious complications are unusual. By working with the physician, a good outcome usually occurs.

Gastritis causes

Gastritis is associated with various medications, medical and surgical conditions, physical stresses, social habits, chemicals, and infections. Gastritis usually develops when your stomach’s protective layer becomes weakened or damaged. A mucus-lined barrier protects the walls of your stomach from the acids that help digest your food. Weaknesses in the barrier allow your digestive juices to damage and inflame your stomach lining. A number of factors can contribute to or trigger gastritis, including:

  • Bacterial infection.
  • Regular use of pain relievers.
  • Excessive alcohol use.
  • Bile reflux disease.
  • Your own body attacking cells in your stomach.
  • Other diseases and conditions.

The immune system makes antibodies and other proteins that fight off infection and keep the body healthy. In some disorders, the body mistakenly targets one of its own organs as a foreign protein or infection. It makes antibodies against it and can severely damage or even destroy the organ. Diseases such as lupus, hypothyroidism, rheumatoid arthritis and the type of diabetes that requires insulin, are examples. The stomach lining also may be attacked by the immune system leading to loss of the stomach cells. This causes acute and chronic inflammation which can result in a condition called pernicious anemia. The anemia occurs because the body no longer can absorb vitamin B12 due to a lack of a key stomach factor, destroyed by the chronic inflammation. Stomach cancer can even occur later in life.

Alcohol and certain other chemicals can cause inflammation and injury to the stomach. This is strictly dose related in that a lot of alcohol is usually needed to cause gastritis. Social or occasional alcohol use is not damaging to the stomach although alcohol does stimulate the stomach to make acid. Excessive alcohol use is more likely to cause acute gastritis.

Bacterial infection – Helicobacter pylori bacteria that has learned to live in the thick mucous lining of the stomach. Although it doesn’t actually infect the underlying tissue, it does result in acute and chronic inflammation. It probably occurs early in childhood and remains throughout life unless antibiotics cure it. The infection can lead to ulcers and, in later life, even to stomach cancer in some people.

Gastritis symptoms

The symptoms of gastritis depend on how acute it is and how long it has been present. They may have no symptoms at all, such as an absence of vomiting or pain, until they are suddenly taken ill with internal bleeding. Pain in the upper abdomen is the most common symptom. The pain is usually in the upper central portion of the abdomen, the “pit” of the stomach. Gastritis pain can occur in the left upper portion of the abdomen and in the back. The pain seems to travel from the belly to the back. The pain is typically vague, but can be a sharp pain. The signs and symptoms of gastritis include:

  • A gnawing or burning ache or pain in your upper abdomen
  • Nausea
  • Vomiting
  • Loss of appetite
  • Belching or bloating
  • A feeling of fullness in your upper abdomen after eating
  • Weight loss

In more severe gastritis, bleeding may occur inside the stomach.

Gastritis diagnosis

The only certain way to make the gastritis diagnosis is by endoscopy and biopsy of the stomach lining. Endoscopy is an exam where, under mild sedation, a lighted flexible scope is passed into the stomach. Pictures can be taken but, more importantly, biopsies can be obtained for analysis under the microscope. An upper GI x-ray exam and certain blood studies may be helpful.

Gastritis treatment

The treatment of gastritis will depend on its cause. For most types of gastritis, reduction of stomach acid by medication is often helpful. Beyond that, a specific diagnosis needs to be made. Antibiotics are used for infection. Elimination of aspirin, NSAIDs or alcohol is indicated when one of these is the problem. For the more unusual types of gastritis, other treatments may be needed.

For most types of gastritis, treatment involves taking drugs to reduce or neutralize stomach acid, such as:

Antacids. Over-the-counter antacids (Maalox, Mylanta, others) in liquid or tablet form are a common treatment for mild gastritis. Antacids neutralize stomach acid and can provide fast pain relief.
Acid blockers. When antacids don’t provide enough relief, your doctor may recommend a medication, such as cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid) or famotidine (Pepcid), that helps reduce the amount of acid your stomach produces.
Medications to shut down acid ‘pumps.’ Medications called proton pump inhibitors reduce acid by blocking the action of tiny pumps within the acid-secreting cells of your stomach. This class of medications includes omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex) and esomeprazole (Nexium).

Most use medications to treat H. pylori infection a combination of two antibiotics and a proton pump inhibitor. Sometimes bismuth is added to the mix. The antibiotics help destroy the bacteria, and the proton pump inhibitor relieves pain and nausea, heals inflammation and may increase the antibiotics’ effectiveness.