Gastritis: an overview and more

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Gastritis is an often bothersome and unpleasant condition with inflammation of the stomach lining. Symptoms can include pain in the upper abdomen and sometimes nausea, vomiting, and / or feeling full shortly after eating. Although there are many potential causes of gastritis, infection with the Helicobacter pylori bacteria is one of the most common. Other common causes of gastritis are the overuse of non-steroidal anti-inflammatory drugs (NSAIDs) or alcohol .

Get Medication Information / Gary Foerster

Types of gastritis

The symptoms of gastritis can appear suddenly and last for a short time. This is called acute gastritis . Others have chronic gastritis , which means that symptoms persist for months or even years.

Gastritis can also be classified as erosive or non-erosive depending on the severity of the damage to the stomach lining.

  • Erosive gastritis is more serious than non-erosive gastritis because it wears down the stomach lining and causes ulcers called erosions. If left untreated, these ulcers can penetrate deeper into the stomach lining and form painful ulcers.
  • In non-erosive gastritis , the gastric mucosa changes as a result of the underlying inflammation; however, the coating does not wear away, so no erosion or ulceration develops.

The symptoms of gastritis.

The most common sign of gastritis is discomfort or pain in the upper abdomen, which is often described as an unpleasant burning or gnawing sensation.

Besides pain, other potential gastritis symptoms include :

  • Belching
  • Swelling
  • Loss of appetite
  • Nausea or vomiting
  • Feeling full after a small meal.

Blood in vomit, dark or tarry stools can be a sign of stomach bleeding, as gastritis can contribute to ulcers (ulcers within the lining of the stomach) .

Additional signs and symptoms of gastric bleeding (all of which are associated with iron deficiency anemia ) include :

  • Fatigue
  • Difficulty breathing
  • Dizziness
  • Soft spot
  • Pale skin
  • Fast heartbeat

If you experience any signs or symptoms of stomach bleeding, it is important to seek immediate medical attention. Severe or worsening abdominal pain is another sign that you should seek immediate medical attention.

Chronic gastritis is much more likely to cause complications such as ulceration and iron deficiency anemia due to bleeding. In rare cases, some people with chronic gastritis develop stomach cancer .

Causes

There are several possible causes of gastritis. One of the most common causes is infection with the bacteria Helicobacter pylori (H. pylori) , which can result from improper hand washing and other causes .

Other possible causes include:

  • Drinking too much alcohol
  • Of smoking
  • Long-term use of non-steroidal anti-inflammatory drugs ( NSAIDs )
  • Infection with other bacteria, viruses, or fungi.

Also, gastritis can develop after major surgery, injury, burns, radiation, or serious illness. Certain medical conditions, such as pernicious anemia ( an autoimmune disease ) and chronic bile reflux, can also cause gastritis.

Sometimes the exact cause of gastritis in humans is unknown .

Diagnostics

Although your healthcare provider can perform some tests and diagnose gastritis, they may also refer you to a gastroenterologist , a medical professional who specializes in diseases of the esophagus, stomach, and intestines, for further testing. This is especially likely if your diagnosis is unclear or if you have severe or persistent gastritis.

If gastritis is suspected, after a complete history and physical examination, blood tests and possibly a series of x-rays called upper gastrointestinal (GI) series will likely follow. After this, an additional exam, such as an upper gastrointestinal endoscopy, may be required.

For persistent gastritis symptoms, upper gastrointestinal endoscopy has replaced the upper gastrointestinal tract series as the primary diagnostic test.

Blood test

To determine if you have iron deficiency anemia due to possible stomach bleeding, your healthcare provider will order the following blood tests:

Your healthcare provider can also monitor your vitamin B12 levels to diagnose pernicious anemia. In this condition, the immune system mistakenly attacks the vitamin B-12 binding protein (intrinsic factor) produced by stomach cells. Sometimes a person's immune system attacks the stomach's own cells.

As a result of this attack, the absorption of vitamin B-12 is impaired, which leads to a decrease in its level in the blood. Another blood test used to diagnose pernicious anemia is intrinsic factor (IF) autoantibodies.

Finally, an antibody blood test can be used to detect H. pylori infection, although other tests (see below) are more sensitive and specific.

Superior GI Series

To do this, you must first drink barium, a chalky white substance mixed with water. The barium covers the esophagus, stomach, and the first part of the small intestine, so the doctor can visualize the digestive tract while they take the next series of X-rays.

In various diseases of the upper gastrointestinal tract, various abnormalities associated with gastritis can be observed, including ulcers and inflammation.

Upper endoscopy

If the diagnosis of gastritis is unclear and / or you have severe or persistent symptoms, an upper gastrointestinal endoscopy may be performed.

During an upper endoscopy, a gastroenterologist inserts an endoscope, a thin tube with a tiny camera, through the mouth (or sometimes through the nose) into the stomach. They use a camera to check for inflammation and can take a small sample of tissue for testing. This is called a stomach biopsy .

Other tests

Additionally, other tests may be performed to confirm or confirm the diagnosis of gastritis :

  • A breath test to detect H. pylori may be recommended . With this test, you drink a special liquid and then examine the exhaled air for bacteria waste present in your stomach.
  • Stool antigen testing for Helicobacter pylori may also be recommended. With this test, the scientist will look for an antigen that is usually found on the surface of bacteria.
  • A fecal occult blood test looks for blood in a stool sample; a positive test result (that is, the presence of blood) suggests that there is some type of bleeding in the digestive tract.

Differential diagnosis

Many other health conditions can cause symptoms similar to gastritis, including:

Additionally, conditions other than the gastrointestinal tract can be mistaken for acute gastritis, such as:

Acute coronary syndrome, such as unstable angina or acute myocardial infarction (heart attack), is a sham gastritis that requires urgent diagnosis and treatment. An electrocardiogram ( EKG ) and cardiac enzymes (blood tests) are needed to distinguish perceived stomach pain from heart-related pain .

This is the reason why a full evaluation with all of the above tests is often required to confirm your diagnosis .

Watch out

The treatment of gastritis is mainly associated with the elimination of the root cause.

For example, if alcohol or NSAIDs are the cause of gastritis, they should be stopped.

If the cause is a Helicobacter pylori infection , your doctor will prescribe a two-week treatment regimen, usually consisting of two antibiotics and a proton pump inhibitor (PPI) .

Stomach acid irritates inflamed stomach tissues. PPIs such as Prilosec (omeprazole) and Nexium (esomeprazole) reduce stomach acidity, which reduces gastritis symptoms and promotes tissue healing.

Once the cause of gastritis is gone, the pain and other symptoms will go away. Of course, be sure to visit your doctor before you stop taking any medications or start treating gastritis on your own.

After identifying and eliminating the underlying cause (if known), acid-reducing medications may be recommended.

In addition to a proton pump inhibitor, a histamine blocker such as Pepcid (famotidine) or Zantac (ranitidine) may be recommended. Sometimes an antacid is included in the treatment plan for quick relief.

Update April 1, 2020: The Food and Drug Administration (FDA) announced the recall of all drugs that contain the ingredient ranitidine, known under the brand name Zantac. The FDA has also recommended not taking over-the-counter ranitidine and that patients taking prescription ranitidine discuss other treatment options with their healthcare provider before stopping the drug. For more information, visit the FDA website .

Note that these acid-reducing medications are generally only recommended for a short period of time. This is especially true with proton pump inhibitors, as long-term use is associated with adverse health effects .

Prophylaxis

In addition to preventing or minimizing possible causes of gastritis (such as smoking, regular use of NSAIDs, and excessive alcohol consumption), the researchers studied the possibility of preventing H. pylori infection by considering how often this bacteria is the cause of gastritis. Improving hygiene has reduced infection rates in children, according to a study published in 2014 .

Because Helicobacter pylori infection is often transmitted in early childhood and is often passed from person to person through the fecal-oral or oral-oral route, teaching parents and their children good hygiene habits can help. to prevent gastritis in the future.

In addition to washing your hands (and your baby's) regularly with soap and water, other hygiene habits include:

  • Make sure your water comes from a clean and safe source
  • Eat food that is well washed and cooked.
  • Do not use shared utensils, toothbrushes, glasses or cups
  • For mothers of babies: Do not touch the baby's nipple or bottle with your mouth or taste his food.

Get the word of drug information

Gastritis is an unpleasant disease, although short-lived and, in many cases, easy to treat. If you've been diagnosed with gastritis, be sure to see your doctor as instructed. Sometimes repeat testing is necessary to ensure effective treatment. And if a modifying habit (such as drinking alcohol) is believed to have contributed to your disease, remember that it is best to continue any changes that improve your gastritis so that you can keep the condition under control.

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