Gastritis
Gastritis is a condition in which the stomach lining – known as the mucosa – is inflamed. Gastritis may be either acute or chronic. Sudden, severe inflammation of the stomach lining is called acute gastritis. Inflammation that lasts for a long time is called chronic gastritis. If chronic gastritis is not treated, it may
last for years or even a lifetime.
Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs. It can also be caused by a bacterium called Helicobacter pylori (H. pylori). H. pylori infection is the most common cause of chronic, nonerosive gastritis. The H. pylori bacterium is primarily transmitted from person-to-person, or in areas with poor sanitation, it may be transmitted through contaminated food or water.
Erosive gastritis is a type of gastritis that often does not cause significant inflammation but can wear away the stomach lining causing bleeding, erosion, or ulcers. Erosive gastritis may be either acute or chronic. The most common cause of erosive gastritis is prolonged use of NSAIDs, such as aspirin and ibuprofen. Other agents that can cause erosive gastritis include alcohol, cocaine, and radiation.
Common Symptoms
Many people with gastritis do not have any symptoms, but some people experience the following symptoms, called dyspepsia:
• Upper abdominal discomfort or pain
• Nausea
• Vomiting
Erosive gastritis may cause ulcers or erosion in the stomach lining that can bleed. Signs of bleeding in the stomach include the following:
• Blood in vomit
• Black stools
• Red blood in the stool
Most forms of chronic, nonspecific gastritis do not cause symptoms. However, chronic gastritis is a risk factor for peptic ulcer disease, gastric polyps, and benign and malignant gastric tumors.
Diagnosis
The most common diagnostic test for gastritis is an endoscopy with a biopsy of the stomach. An endoscope is used in order for your doctor to examine the lining of the esophagus, stomach, and first portion of the small intestine. If necessary, the doctor will use the endoscope to perform a biopsy, which involves collecting tiny samples of tissue. These tissue samples are then microscopically examined by a pathologist - a physician who specializes in the diagnosis of disease via microscopic examination of a tissue sample. The pathologist's diagnosis is often the key to determining the need for further treatment.
Other tests used to identify the cause of gastritis or any complications include the following:
• Upper gastrointestinal (GI) series. The patient swallows barium, a liquid contrast material that
makes the digestive tract visible in an X-ray. X-ray images may show changes in the stomach
lining, such as erosion or ulcers.
• Blood test. The doctor may check for anemia, a condition in which the blood’s iron-rich
substance, hemoglobin, is diminished. Anemia may be a sign of chronic bleeding in the stomach.
• Stool test. This test checks for the presence of blood in the stool, another sign of bleeding in
the stomach.
• Tests for H. pylori infection. The doctor may test a patient’s breath, blood, or stool for signs
of infection. H. pylori infection can also be confirmed with biopsies taken from the stomach
during an endoscopy.
Treatment Options
Treated with medications that reduce the amount of acid in the stomach can relieve symptoms that may accompany gastritis and promote healing of the stomach lining. These medications include the following:
• Antacids, such as aspirin, sodium bicarbonate, and citric acid (Alka-Seltzer); alumina and
magnesia (Maalox); and calcium carbonate and magnesia (Rolaids).
• Histamine 2 (H2) blockers, such as famotidine (Pepcid AC) and ranitidine (Zantac 75). H2
blockers decrease acid production.
• Proton pump inhibitors (PPIs), such as omeprazone (Prilosec, Zegerid), lansoprazole (Prevacid),
pantoprazole (Protonix), rabeprazole (Aciphex), esomeprazole (Nexium), and dexlansoprazole
(Kapidex). PPIs decrease acid production more effectively than do H2 blockers.
• Treatment of H. pylori gastritis may include a common triple therapy that combines a PPI and
two antibiotics – usually amoxicillin and clarithromycin – to kill the bacterium.
Questions To Ask Your Healthcare Provider
• What treat option is best for me?
• What are the potential side effects?
• What are my risks?
• What dietary or lifestyle changes do you recommend?