Gastritis

Gastritis is an inflammation of the stomach lining. It can be acute (sudden and severe) or chronic (developing slowly over time). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer.

Causes:

Gastritis occurs when the protective lining of the stomach becomes inflamed. Several factors can cause or contribute to this inflammation:

• Bacterial infection: The most common cause of chronic gastritis is infection with Helicobacter pylori (H. pylori). This bacterium can live in the stomach lining and cause inflammation and ulcers.
• Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen, naproxen, and aspirin can irritate the stomach lining and cause both acute and chronic gastritis.
• Excessive alcohol consumption: Alcohol can irritate and erode the stomach lining.
• Stress: Severe physical stress from major surgery, burns, or severe infections can cause acute gastritis.
• Autoimmune gastritis: The body’s immune system mistakenly attacks cells in the stomach lining.
• Bile reflux: A backflow of bile from the small intestine into the stomach.
• Other infections: Viral, fungal, or parasitic infections, though less common.
• Cocaine use: Can damage the stomach lining.
• Radiation therapy: To the stomach area.
• Crohn’s disease: An inflammatory bowel disease that can affect the stomach.
• Aging: The stomach lining tends to thin with age, making it more susceptible to damage.

Symptoms:

Symptoms of gastritis can vary and some people may experience no symptoms at all. When symptoms do occur, they may include:

• Gnawing or burning ache or pain (indigestion) in your upper abdomen: This pain may worsen or improve with eating.
• Nausea.
• Vomiting.
• Feeling of fullness in your upper abdomen after eating.
• Loss of appetite.
• Bloating.
• Black, tarry stools (melena) or vomiting blood: These are signs of bleeding in the stomach and require immediate medical attention.

Diagnosis:

Diagnosing gastritis typically involves a combination of medical history, physical examination, and diagnostic tests:

• Medical history and physical exam: Your doctor will ask about your symptoms, lifestyle, medication use, and any relevant medical conditions.
• Tests for H. pylori:
  • Breath test: You drink a clear liquid, and then breathe into a bag.
  • Stool test: Checks for H. pylori antigens in your stool.
  • Blood test: Checks for H. pylori antibodies (less common for active infection).
• Endoscopy with biopsy: A thin, flexible tube with a camera (endoscope) is inserted down your throat into your stomach to visualize the stomach lining. A small tissue sample (biopsy) may be taken for microscopic examination to check for inflammation, H. pylori, or other abnormalities.
• Upper gastrointestinal (GI) series (barium swallow): X-rays are taken after you swallow a barium solution, which coats the stomach lining, making it visible on X-rays. This is less common for gastritis diagnosis but can help identify ulcers or other structural issues.
• Stool test: To check for blood in the stool, which can indicate bleeding in the stomach.

Treatment:

Treatment for gastritis depends on the specific cause.

• Treating H. pylori infection:
  • A combination of antibiotics and a proton pump inhibitor (PPI) is typically prescribed for 10-14 days to eradicate the bacteria.
• Avoiding irritants:
  • Discontinue or reduce the use of NSAIDs.
  • Reduce or eliminate alcohol consumption.
  • Avoid spicy, acidic, or fatty foods that can aggravate symptoms.
• Medications to reduce stomach acid:
  • Antacids: Over-the-counter medications that neutralize stomach acid for quick relief.
  • H2 blockers: Reduce acid production (e.g., famotidine, cimetidine).
  • Proton pump inhibitors (PPIs): Block acid production more powerfully than H2 blockers (e.g., omeprazole, lansoprazole, esomeprazole).
• Lifestyle changes:
  • Eat smaller, more frequent meals.
  • Manage stress through relaxation techniques.
  • Avoid smoking.
  • Identify and avoid personal food triggers.
• Vitamin B12 supplements: For autoimmune gastritis, as it can impair B12 absorption.

With appropriate treatment, gastritis often improves rapidly. Chronic gastritis may require long-term management to prevent complications.