What is gastritis? (Overview)
Gastritis is characterised by a group of conditions causing inflammation that is most often the result of an infection. When there is inflammation, irritation, or erosion of the protective lining of the stomach, gastritis develops. Gastritis can be either acute or chronic, depending on the severity of the inflammation and for how long it is present in the body.
Acute gastritis occurs suddenly with more severe symptoms associated with inflammation. Chronic gastritis involves more long-term inflammation which may last for years if left untreated. Either form, if left untreated, can result in the development of ulcers or an increased risk of stomach cancer.
Erosive gastritis is another form of the condition, although it is less commonly diagnosed. Typically, erosive gastritis doesn’t cause such severe inflammation, however it can still cause bleeding and ulcers in the lining of the stomach.
The same bacterium that causes stomach ulcers can result in gastritis. Other known causes of this condition include injury, the habitual use of pain relievers (painkillers) or excessive alcohol consumption.
Gastritis isn’t too serious a condition and if treated, can quickly improve with little to no complications.
Symptoms of gastritis
Symptoms and severity do tend to vary from person to person, and in some cases, are so mild that they are hardly noticeable (or perceived as problematic).
Signs and symptoms that are most common are:
- An upset stomach, nausea and vomiting (which can include bringing up blood or ‘coffee ground-like material’)
- Indigestion (a gnawing or burning sensation – an ache or pain which worsens between meals or at night)
- A feeling of fullness or bloating in the upper abdomen (particularly after consuming a meal)
- Loss of appetite
When digestive juices in the lining of the stomach (a mucous-lined barrier that protects the stomach wall) react with any weaknesses, inflammation occurs, causing gastritis. Weaknesses occur when the stomach lining becomes thin or damaged due to any number of diseases, conditions (or infections) or other triggers present in the body.
Causes of gastritis
The nature of the condition centres around inflammation and as such, triggers with the potential to cause irritation in the stomach lining either through infection, or foods and medications consumed are the primary sources of the condition.
Excessive alcohol consumption (alcohol abuse), chronic vomiting (often a red flag for eating disorders such as bulimia), extreme stress, or the use of medications such as aspirin and other anti-inflammatory drugs may also cause gastritis.
Other common causes are:
- Helicobacter pylori (H. pylori): A bacteria that thrives in the mucous lining of the stomach. If left untreated, this infection can cause ulcers, and in more severe cases, stomach cancer. This bacterial infection is usually passed from person-to-person, although it can also be transmitted through contaminated water or food that is consumed.
- Gastrointestinal bacterial and viral infections
- Bile reflux: This is a backflow of bile from the bile tract into the stomach (connecting the liver and gallbladder).
Risk factors and complications
The risk of developing gastritis is at its highest when:
- A person indulges in extreme (and frequent) alcohol consumption. Alcohol irritates the stomach lining and thus causes disruptions when in contact with stomach juices. Excessive alcohol consumption usually causes acute cases of gastritis.
- A person regularly uses non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen. Regular use of these types of pain relievers can reduce a key substance in the body that naturally helps preserve the protective lining of your stomach.
- An individual is a regular cocaine user or addict.
- The stomach lining thins naturally as a person ages. Older adults are also typically more prone to Helicobacter pylori or autoimmune disorders than younger people are.
- A person experiences high levels of stress because of illness, a major surgery or severe injury (such as burns).
- Someone has an autoimmune disorder or digestive disorder. Autoimmune gastritis can develop when the body begins to ‘attack’ cells that make up the stomach lining. The immune system then reacts by wearing away the stomach’s protective barrier. Autoimmune gastritis is linked with a vitamin B-12 deficiency and is more common with those diagnosed with other autoimmune disorders (such as Hashimoto’s disease and type 1 diabetes).
- A person falls ill with a viral, parasitic or bacterial infection. A vulnerability to Helicobacter pylori can sometimes be inherited or caused by certain lifestyle choices exposing you to the bacteria or that which makes you more vulnerable. Such choices include smoking and allowing high levels of continuous stress in your life.
- A person with other medical conditions such as HIV/AIDS and Crohn’s disease.
When should you see a doctor?
Stomach irritation or inflammation and indigestion affects nearly everyone at some point in their lifetime. In most cases, mild indigestion symptoms are short-lived and don’t require medical care or intervention.
If signs and symptoms occur for at least of a week or longer, the inflammation being experienced could indicate gastritis and should be diagnosed by a medical professional.
Red flags include stomach discomfort that occurs after taking over-the-counter or prescription medications, vomiting of blood, the presence of blood in stools (faeces) or stools that appear black and tarry.
If you are concerned about anything you are experiencing or have any of the above red flag symptoms, it is recommended that you seek medical advice and / or assistance from your general healthcare provider (GP).
You can prepare for your appointment by ensuring in advance that you avoid any potential dietary (foods that are spicy, fried, acidic or fatty as well as alcohol) or medicinal triggers. It will also help to bring along a list of all medications and supplements you are taking, or even questions you feel strongly about asking your doctor. Key personal information such as major stresses or recent life changes are also worth mentioning during your appointment.
Diagnosis and tests
Your doctor will review your personal information (including family history) and likely ask you the following kinds of questions during your consultation:
- What are your symptoms?
- How long ago did your symptoms begin and have they been constant or occasional?
- Would you describe any pain as mildly uncomfortable or burning?
- Have you noted anything, such as eating certain foods, that seems to worsen your symptoms?
- Have you recently lost any weight?
- How often do you drink alcohol (and how much) or take pain relievers such as aspirin, ibuprofen or naproxen?
- How would you rate your levels of stress?
- Have you ever experienced or treated ulcers before?
Your doctor is then likely to perform a physical exam, and if gastritis is suspected, he or she will refer you to a specialist in digestive disorders (gastroenterologist) for further examination, possible diagnosis and a treatment plan.
If the specialist feels it necessary to check what’s going on inside you during their consultation with you, the following tests may be requested to determine a diagnosis:
- An upper endoscopy: An endoscope (a long thin tube containing a tiny camera lens at the tip) is inserted through the mouth and down through the oesophagus (throat) into the stomach. This tiny camera will assist your doctor in assessing the condition of your stomach lining and whether there is any inflammation. A small sample (or biopsy) of the stomach lining may be taken during this process if anything unusual is noted, and sent for analysis in a laboratory. A biopsy can also detect the presence of H. pylori bacteria in the stomach lining.
- Blood tests: Various blood tests may be performed, depending on what your doctor deems necessary. He or she may want to have your red blood cell count tested to determine whether or not you have anaemia (not enough red blood cells). Your doctor may also wish to screen you for the presence of infections (such as Helicobacter pylori) or pernicious anaemia (a type of vitamin B-12 anaemia).
- Stool test (faecal occult blood test): A possible red flag of gastritis is the presence of blood in the stool. As such, your doctor may request a sample to check this. Helicobacter pylori can also be detected in a stool test (and even a breath test).
- Breath test: Your doctor will ask you to drink a small glass of clear, tasteless liquid containing radioactive labelled urea. You will then be asked to blow into a bag, which is sealed.If your breath sample contains the radioactive carbon dioxide which is released after the bacteria has broken down the urea in the stomach, you will have a Helicobacter pylori bacterial infection.
- X-rays (barium swallow): You may be given a barium solution (barium sulphate) to swallow before an X-ray if your doctor would like to check for anything unusual happening in your upper digestive system. The solution enables your doctor to look at clear images taken of your oesophagus, stomach and small intestine, and see if there are any abnormalities or areas of concern. The clear / white metallic liquid coats the digestive tract and makes any abnormalities, such as ulcers, more visible on X-rays.
Treatments and medications
An appropriate treatment plan is directly linked to the cause of gastritis. For instance, if NSAID medications are determined as the cause of inflammation, avoiding them altogether may be enough to provide symptom relief (in mild / acute cases).
If a bacterial infection (such as H. pylori) is determined as the cause (such as in more chronic cases) antibiotics may be prescribed to clear up this cause of gastritis. If an antibiotic is prescribed, it is important to take the full course recommended by your doctor (this can be for a period of between 10 and 14 days) to fully clear the infection.
In most cases of gastritis, medications can be used to treat stomach acid by reducing symptoms and to promote healing of inflammation in the stomach.
Other types of medication prescribed for gastritis treatment are:
- Proton Pump Inhibitors:These medications work by blocking cells that cause stomach acid. Common medications prescribed are Prilosec (omeprazole), Prevacid (lansoprazole) or Nexium (esomeprazole). Long-term use of these medications, and particularly at high doses, can lead to an increased risk of fractures commonly occurring in the spine, hips and wrist. A calcium supplement can also be recommended as a way of reducing this risk (if necessary). The risk of fracture is undefined.
- Acid reducing medications / acid blockers (histamine / H-2 blockers): These medications (over-the-counter and prescription) are recommended as a means of reducing the amount of acid in your stomach that is released into the digestive tract. These medications can also help provide relief from any pain or discomfort associated with gastritis, allowing your stomach lining to heal (clearing inflammation).
- Antacids: These will be recommended for rapid-relief of pain or severe discomfort. Antacids work by neutralising acid in the stomach, but side effects such as diarrhoea or constipation can occur (depending on the main ingredients in the chosen antacid). Many are available over the counter at your local pharmacy.
Gastritis will generally clear completely once the underlying aggravation is discontinued or disappears. It is highly advisable to talk to your doctor before stopping any medications or starting any gastritis treatment on your own.
Gastritis homecare, remedies and diet
You can also be proactively involved in providing relief from symptoms (that flair up from time to time) or by avoiding possible occurrences altogether.
You can do this in the following ways:
- Your diet: If you tend to experience frequent indigestion, make an effort to eat smaller meals more often in the day (several small meals instead of 3 large ones) as this can help alleviate inflammation-related discomforts in your digestive system.
You may also note that specific foods (spicy, fatty, fried or acidic) aggravate your stomach and cause inflammation in your digestive system. These can be reduced significantly in your diet or completely avoided. The same applies to alcohol consumption. Excessive amounts of consumption on a frequent basis does tend to irritate the lining of your stomach.
- Medications for pain relief: If, for any reason you need to take pain relievers on a regular basis, it is advisable to discuss options with your doctor to determine which would be less likely to aggravate your digestive system.
- Stress management: No matter the physical cause of your gastritis, symptoms will worsen if there is something particularly stressful going on in your life. Stress, in this day and age, is difficult to avoid, but coping mechanisms can help to better manage it. Calming activities such as leisurely walking, meditation, yoga or tai chi are useful for encouraging relaxation, for instance.
There are things you can do in the way of prevention, especially when it comes to bacterial infections. As Helicobacter pylori is known to be transmitted from person to person or through contaminated water and food, preventative measures against infection include frequently washing hands with soap and water, and consuming foods that have been cooked completely.
What is the difference between gastritis and gastroenteritis?
Gastroenteritis is characterised by irritation and inflammation of the stomach, and also the intestines. This condition is typically caused by a viral or bacterial infection.
Parasites, food allergens (allergies), or adverse reactions to types of medications or antibiotics are also known causes.
Gastritis, however, only involves the inflammation, irritation, or erosion of the protective lining of the stomach.
Symptoms associated with gastroenteritis include watery diarrhoea, vomiting and nausea, cramping, fever and headaches. Dehydration can also occur because of vomiting and diarrhoea.
Treatment for gastroenteritis is generally the same as for gastritis, along with anti-microbial medications where more severe cases are diagnosed.
How long does gastritis last?
A bout of gastritis and how long it lasts depends on the source causing the inflammation. It can range from as little as a few hours to several weeks, depending on the cause and severity of damage to the stomach lining.
Usually, if the source of the problem is food or beverages, cutting out these irritants from your diet can alleviate symptoms within a few hours. If caused by a bacterial infection, the severity of the inflammation can take up to a few weeks to clear up with adequate treatment, as recommended by a medical professional.
Is Nexium good for gastritis?
Nexium is often recommended for relief of symptoms causing inflammation. Nexium is also known as esomeprazole and is classified as a proton pump inhibitor (PPI). This means that the medication works to suppress the production of stomach acid, and thus promote healing in the stomach. Nexium can also help clear other symptoms of indigestion and heartburn, as well as gastritis.