Last updated date: 10-Apr-2023
Originally Written in English
What helps gastritis?
The stomach wall's membranes protect it from acid and bacteria. This protective coating might become inflamed if it is irritated or injured. Long-term inflammations can cause more damage to the stomach lining and eventually lead to stomach (gastric) ulcers.
Gastritis is among the common diseases of the stomach in the general population. Although this condition is sometimes regarded as “a simple stomach ache” and ignored, it may lead to serious problems. If your gastritis becomes chronic and the membrane lining is always damaged, you may become anemic as well. Cancerous tumors can form, however this is extremely rare.
Epidemiologic studies show that gastritis is very common. It accounts for around 1.8-2.1 million visits to doctors' offices in the United States each year.
Gastritis affects people of all ages; however, it is more frequent in persons over the age of 60. The prevalence of H. pylori infection rises with age.
What are the causative factors of Gastritis?
Many factors may lead to the onset of gastritis. These are:
- Non-steroidal anti-inflammatory drugs (NSAIDs)
Acetylsalicylic acid (the active ingredient in Aspirin), diclofenac, ibuprofen, and naproxen are all members of this class of medications. When these medicines are used for a short period of time to treat acute pain, side effects are uncommon. However, if taken for an extended period of time, such as several weeks or months, they may impair the protective function of the stomach lining because they inhibit the synthesis of the hormone prostaglandin.
Prostaglandin regulates the synthesis of gastric (stomach) mucus and chemicals that neutralize stomach acid, among other things. If there is insufficient prostaglandin, the stomach wall is no longer adequately protected against stomach acid. When painkillers are used with steroids, the harmful effect is exacerbated.
- Some alcoholic drinks (Whisky, gin, vodka, etc.),
- Bacterial infections (Helicobacter pylori) is the most common and significant causative agent, but other rare bacteria include Helicobacter heilmannii, streptococci, and staphylococci, Proteus species, Clostridium species, tuberculosis, and syphilis),
- Viral infections (for example, Cytomegalovirus infections),
- Fungal infections (For example, Candida infections),
- Parasitic infestations (For example, Strongyloides, Schistosoma),
- Acute stress (Shock conditions),
- Exposure to radiation,
- Allergy or food intoxications,
- Increased biliary content in the stomach (diseases of bile ducts and gallbladder),
- Poor blood supply to the stomach due to various reasons (ischemia),
- Autoimmune etiology (autoimmune gastritis),
- Diseases that form granuloma (Crohn’s disease, sarcoidosis, foreign bodies, vasculitis, lymphoma, and various infections – tuberculosis, histoplasmosis, mucormycosis, blastomycosis),
- Diseases that cause lymphocytosis (lymphocytic gastritis and Celiac disease),
- Allergic conditions (eosinophilic gastritis).
Helicobacter pylori bacteria
Helicobacter bacteria disrupt the acid-production equilibrium in the stomach. As a result, far too much acid is produced. This can harm the stomach lining and wall. However, Helicobacter infections are only infrequently associated with gastritis: Although Helicobacter pylori is found in the stomachs of around 40 out of every 100 persons in Germany, only about 4 to 8 of them develop gastritis or a peptic (stomach or duodenal) ulcer.
Bacteria can enter the body through saliva, vomit, excrement, drinking water, or food. Most persons are assumed to have gotten infected as children via intimate contact with family members.
Gastritis from alcohol
The stomach lining is inflamed, irritated, or eroded as a result of alcoholic gastritis. It can strike abruptly or gradually, causing heartburn, ulcers, and digestive discomfort, which is exacerbated by frequent drinking. Treatment programs for persons suffering from alcoholism and alcoholic gastritis can significantly reduce or eliminate symptoms.
Although alcoholic gastritis may not often cause obvious symptoms, it can eat away at the body's digestive tract over time. Long-term alcohol consumption will continue to impose strain on the body, perhaps resulting in ulcers, bleeding, and general discomfort. These gastrointestinal problems may result in one or more of the following symptoms: discomfort, burning, vomiting, gas, bloating, and a lack of desire to eat.
Types of Gastritis
Gastritis can be classified as acute or chronic gastritis depending on the onset and persistence of the complaints. If the gastric complaints develop suddenly secondary to an inflammatory etiology, the condition is usually acute gastritis (it is commonly caused by infections, use of medicines, and ischemia).
If the inflammatory etiology continues destruction of the gastric mucosa for a long interval, the condition is called chronic gastritis. Chronic gastritis is classified according to the underlying cause such as Helicobacter pylori gastritis, alkaline gastritis caused by bile reflux, drug-induced gastritis, autoimmune gastritis, and allergic gastritis. Gastritis is also classified according to pathological findings, such as lymphocytic gastritis, atrophic gastritis, and eosinophilic gastritis. Another classification is based on the endoscopic appearance and the damaged part of the stomach. These are called antral gastritis, pangastritis (if the stomach is entirely involved), varioliform gastritis, and erosive gastritis. However, one should always remember that ‘gastritis’ is a pathological definition or in other words, diagnosis of gastritis is established when the cellular damage in the gastric mucosa is seen under a microscope.
Acute gastritis is a wide term that refers to a variety of conditions that cause inflammatory alterations in the stomach mucosa. Several etiologies share the same overall clinical appearance; yet, they differ in their distinct histologic features. The inflammation might affect the entire stomach (e.g., pangastritis) or a specific portion of the stomach (eg, antral gastritis).
There are two types of acute gastritis: erosive (e.g., superficial erosions, profound erosions, hemorrhagic erosions) and nonerosive (caused by Helicobacter pylori)
- Acute erosive gastritis can be caused by a variety of substances or conditions. This is known as reactive gastritis. Nonsteroidal anti-inflammatory medicines (NSAIDs), alcohol, cocaine, stress, radiation, bile reflux, and ischemia are examples of these agents/factors. Hemorrhages, erosions, and ulcers develop on the gastrointestinal mucosa. The most prevalent agents related to acute erosive gastritis are nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. This is due to the use of these drugs orally and systemically, in therapeutic or supratherapeutic quantities.
- Another cause of acute gastritis is a bacterial infection. The most prevalent cause of gastritis is the corkscrew-shaped bacteria H pylori, and problems occur from a chronic infection rather than an acute illness. The prevalence of H pylori in otherwise healthy people varies according to age, socioeconomic status, and place of origin. The illness is frequently contracted as a youngster. The number of persons infected with H pylori grows with age in the Western world.
- H pylori infection can be identified in 20% of people under the age of 40 and 50% of those over the age of 60. It is unclear how the bacteria spreads, however, it is most likely transmitted from person to person via the oral-fecal route or by the intake of infected water or food. As a result, persons from lower socioeconomic groups and in underdeveloped nations have a greater frequency. H pylori is responsible for 60% of gastric ulcers and 80% of duodenal ulcers.
Acute gastritis can cause a variety of symptoms, the most frequent of which is nonspecific epigastric pain.
Nausea, vomiting, lack of appetite, belching, and bloating are some of the other symptoms. Acute abdominal pain can be a presenting sign in some situations, such as phlegmonous gastritis (gastric gangrene), which can cause severe abdominal pain, nausea, and vomiting of possibly purulent gastric contents. Fever, chills, and hiccups are also possible.
Acute gastritis might be suspected based on the patient's history and verified histologically by biopsy specimens obtained during endoscopy.
Chronic gastritis is one of the most prevalent long-term, chronic, and pernicious diseases in humans. More than half of the world's population is estimated to have this condition in some form or another, implying that hundreds of millions of individuals worldwide may have chronic gastritis in some form or another.
Even while the function of gastritis in the etiology of ordinary peptic ulcers and stomach malignancies is known, the relevance of chronic gastritis as a dangerous illness is usually underestimated in clinical practice. It is possible that millions of people die prematurely each year as a result of cancer and ulcers caused by chronic gastritis.
Chronic gastritis can manifest as either nonatrophic or atrophic. They are gastritis variants and phenotypes that represent distinct phases of the same life-long illness. The morphological appearances of gastritis documented are quite comparable everywhere, implying that chronic gastritis is essentially the same condition with its consequences all over the world.
Autoimmune Chronic Gastritis
Although H. pylori is the most common cause of gastritis (in more than 90% of cases), a chronic mononuclear inflammation (gastritis) without an ongoing H. pylori infection, but with severe atrophic corpus gastritis and achlorhydric stomach, as well as the presence of auto-antibodies against parietal cells (proton pump) and/or intrinsic factor, is a well-established entity.
However, it is unclear if this "autoimmune" gastritis is a separate condition or whether H. pylori causes autoimmune responses in certain people who have a normal H. pylori infection. It is possible that the original H. pylori infection would spontaneously clear when atrophic gastritis progresses to the highly atrophic and achlorhydric stage, creating the erroneous impression of a pure autoimmune genesis of the disease.
Most common symptoms of gastritis are epigastric burn, bleeding, and pain. Bloating, nausea and vomiting are also likely. Gastric complaints are usually aggravated by eating and therefore, the patient becomes beware of eating. The physical examination by the physician is usually unremarkable, but mild epigastric tenderness can be detected. If complications of gastritis have already developed (peptic ulcer secondary to Helicobacter pylori infection, stomach cancer, or gastric lymphoma), signs and symptoms may exacerbate.
Atrophic gastritis may cause Vitamin B12 deficiency and signs and symptoms of the deficiency may emerge before the gastritis-related complaints (hematological or neurological signs; skin rashes, anemia, tinnitus, vertigo, palpitation, chest pain or heart failure, feeling of burn-in tongue, numbed arms and feet, and impaired memory). Endoscopic examination may demonstrate hyperemia, small round or linear superficial wounds (erosions) and edema in the gastric pili)
Some of these symptoms may also indicate other illnesses such as gastroesophageal reflux disease (GERD), an upset stomach or intestine, and diarrhea. Chronic gastritis patients may have relatively moderate symptoms if any at all. They may, however, exhibit symptoms similar to those associated with acute gastritis.
The doctor will first feel your stomach and upper abdominal area to see what is causing the discomfort. Depending on the nature of your symptoms, your stomach may be inspected from the inside to learn more. This evaluation lasts between five and ten minutes. It is performed with the use of a gastroscope, which is softly placed into your stomach via your mouth and food pipe.
The gastroscope camera allows doctors to examine the walls of your food pipe (esophagus), stomach, and duodenum. They can detect changes in the stomach lining, such as inflammation or bleeding, in this manner. They can also use the gastroscope to remove tissue from the lining, which will subsequently be tested for Helicobacter pylori bacteria or cell abnormalities such as cancer.
A particular breath test is sometimes used to establish the existence of a Helicobacter pylori infection. A blood test or a stool test can also be used to detect these germs.
If you discover that specific foods, stress, alcohol, or nicotine aggravate your stomach troubles, you can try modifying your diet, avoiding alcohol, stopping smoking, and/or minimizing your everyday stress. If these lifestyle modifications are insufficient to alleviate the symptoms, medication may be explored.
Medication treatment is started for gastritis if required. Excluding Helicobacter pylori infection, there is no specific treatment for acute gastritis. Medical treatment should be started and planned according to the underlying cause and the pathological findings. Surgical treatment is extremely rare in gastritis.
The principal goal of the medical treatment in the management of the underlying disease; gastric acid secretion should be reduced with drugs to give the gastric mucosa a chance of healing. However, reduction of the gastric acid secretion will not help the gastritis secondary to the bile reflux (alkaline gastritis) or cases of normal or low gastric secretion (atrophic gastritis). The causes that increase the secretion of gastric should be treated in all patients, if possible (avoiding the foods and drinks that increase secretion of the gastric acid; cessation of certain drugs, such as painkillers, if possible; reducing or stopping alcohol consumption; alleviating the stress).
If Helicobacter pylori infection is detected, multi-drug antibiotherapy is the most commonly recommended medical treatment. If Helicobacter pylori are not identified, proton pump inhibitors, H2 receptor blockers, and anti-acid medicines are recommended that suppress gastric acid production or reduce the concentration of acid in the stomach. However, the interaction of drugs that suppress production of gastric acid with other drugs should be taken into consideration, when such treatments are recommended (especially patients who continuously take anticoagulants (such as Clopidogrel) for cardiac or chronic rheumatoid diseases).
Balanced electrolyte solutions are also recommended to manage the electrolyte imbalances that are secondary to vomiting in acute gastritis. If the causative infectious agent is identified that caused the onset of gastritis, antibiotic agent, anti-parasitic agent, or antifungal agent is started depending on the cause of the infection.
Typically, acid-lowering therapy is used to treat gastroenteritis. The following medications can be utilized depending on the nature and severity of the symptoms:
- Proton pump inhibitors (PPIs) like omeprazole or pantoprazole reduce the production of stomach acid.
- H2 blockers such as ranitidine and famotidine also reduce acid production.
- Antacids like aluminum hydroxide or magnesium hydroxide neutralize the acid already in your stomach.
Patients with gastritis can easily cope with this condition especially by adopting healthy eating habits.
Healthy, clean, and regular eating is a must and certain foods should be avoided that increase the production of gastric acids, such as too spicy foods, sour sauces, acidic fruits, fizzy drinks, alcohol, fried foods, and fatty meals.
Gastritis home treatment
You must pay attention to following advices, if you have gastritis!
- Smoking should be decreased or stopped.
- Stressful life conditions should be avoided, if possible.
- Painkillers should not be taken as long as it is possible, but patients should contact their physicians to protect the stomach if they are necessarily taken.
- If Helicobacter pylori infection or gastric complications of the infection (peptic ulcer, atrophic gastritis, stomach cancer, and gastric lymphoma) are detected and the patient’s family history is notable for the stomach cancer, it is strongly recommended that treatment of Helicobacter pylori infection is followed by regular doctor visits and endoscopic examination.
If the gastritis is caused by Helicobacter pylori infection and it is left untreated (especially patients with a family history positive for chronic gastric complaints or stomach cancer), complications of chronic Helicobacter pylori infection may emerge, such as peptic ulcer, atrophic gastritis, and stomach cancer, over years. If the patient has no response to drugs that suppress acid secretion, further examinations should be considered to detect the underlying cause. Otherwise, chronic bacterial, viral, or parasitic infections may lead to complications, such as vitamin deficiencies and anemia.
Complications of acute gastritis can include the following:
- Bleeding from erosion or ulcer
- Gastric outlet obstruction due to edema restricting proper food transport from the stomach to the small intestine.
- Dehydration from vomiting
- Renal insufficiency as a result of dehydration
Gastritis in pregnancy
Pregnancy might raise your chances of getting gastritis. If you are pregnant and have symptoms of gastritis, it might be related to all of the changes that are taking on in your body.
Women who already have gastritis will have their symptoms worsen during pregnancy. This is due to changing hormone levels along with the pressure that a developing fetus exerts on the body.
Gastritis usually resolves on its own. The mortality rate of phlegmonous gastritis is 65% when treated.
When to see a doctor?
Almost everyone has experienced indigestion and stomach distress. Most occurrences of dyspepsia are transient and may not necessitate medical attention. Consult your doctor if you experience signs and symptoms of gastritis for more than a week. Inform your doctor if you experience stomach discomfort after using prescription or over-the-counter medications, particularly aspirin or other pain medicines.
If you are vomiting blood, have blood in your stools, or have black stools, contact your doctor as soon as possible to establish the cause.
Experts are unsure how to prevent gastritis. However, you may reduce your chances of contracting the condition by doing the following:
- Maintaining good hygiene, particularly handwashing. This can keep the H. pylori bacteria at bay.
- Avoid foods and beverages that may irritate your stomach lining. Alcohol, caffeine, and spicy meals are examples of such substances.
- Avoid aspirin and other over-the-counter pain and fever relievers. NSAIDs (nonsteroidal anti-inflammatory drugs) are among them.
Gastritis is a set of disorders caused by inflammation, irritation, or erosion of the stomach's protective lining. It is most usually caused by an infection with the same bacteria that causes stomach ulcers.
Gastritis can be classified into two types based on the intensity of the inflammation and the duration of the incubation period. Acute and chronic gastritis share symptoms such as lack of appetite, frequent nausea and vomiting, indigestion, and bloating, especially after a meal.
Acute gastritis pain, on the other hand, is more severe but short-lived, whereas chronic gastritis pain is duller and lasts longer. Both, if left uncontrolled, can result in ulcers or an increased risk of stomach cancer.
Helicobacter pylori is the most common cause of chronic gastritis globally. The degree of inflammation and progression of this kind of chronic gastritis can be greatly influenced by bacterial virulence factors, host susceptibility factors, and environmental variables. Autoimmune gastritis is another source of persistent stomach inflammation that can affect people of all ages.