Gastritis - Symptoms, Causes, Types, Diet and Treatment

The inside of the stomach has a soft layer protecting it from digestive juices and breaking down food. Gastritis occurs when this inner lining becomes inflamed or irritated. The irritation can often lead to discomfort in the upper abdomen.

While the common symptom is inflammation in the stomach lining, the underlying cause and severity can vary. This variability leads to different forms of this condition. Let's delve into the four main types of gastritis to understand their specific characteristics.

1. Acute Gastritis: This gastritis condition develops suddenly and usually lasts for a short period (days or weeks). Irritants like spicy food, alcohol, or medications often cause it. Acute gastritis symptoms can be visible early and become intense.

2. Chronic Gastritis: It progresses slowly and persists for a long time (months or years). It is caused by factors, including H. pylori infection, autoimmune issues, or bile reflux. Symptoms may be mild or even absent in some cases.

3. Atrophic Gastritis: It is the progressive stage of chronic gastritis, also known as gastric precancerous lesion. It started with chronic inflammation leading to loss of stomach lining glands. 

4. Erosive Gastritis: This type involves erosion of the stomach lining, making it more susceptible to irritation and swelling. Factors like chronic NSAID use or severe acute gastritis can cause it.

5. Non-Erosive Gastritis: It is the most common type of gastritis where inflammation occurs without erosion of the stomach lining. It can be linked to H. pylori infection or other causes.

The condition can be further divided on the basis of the cause of the inflammation. Here are some examples:

• Infectious gastritis

• Drug-induced gastritis

• Alcohol-induced gastritis

• Stress-induced gastritis

• Autoimmune gastritis

• Eosinophilic gastritis

Stages of Gastritis

Chronic gastritis persists for a long time. It can be further classified based on the severity and degree of tissue damage in the stomach lining. This classification, known as the OLGA staging system, checks the damage and symptoms to assess the progression of the disease.

The symptoms may be different in each person, and some may not experience any noticeable signs. The following are the common signs and symptoms to watch for:

• Upper abdomen pain

• Burning or gnawing sensation in the abdomen

• Nausea and vomiting

• Feeling full after eating small amounts

• Loss of appetite

• Indigestion

It arises when the stomach's protective lining, a mucus barrier shielding the stomach wall, becomes inflamed. The weaknesses or injuries to the barrier leads to irritation and damage to the underlying tissue by digestive juices. Some medical conditions, such as Crohn's disease, and even cancer procedures like chemotherapy can increase the likelihood of gastritis.

Risk Factors of Gastritis

While anyone can develop gastritis, certain factors make a person more susceptible. The following are the risk factors that can influence the chances of experiencing this condition.

Modifiable Risk Factors

• H. Pylori Infection: A major risk factor, while not everyone infected develops this condition, lifestyle choices like smoking and diet may play a role.

• Regular Use of Pain Relievers: Overuse of NSAIDs can inflame the stomach lining, leading to both acute and chronic gastritis.

• Excessive Alcohol Use: Drinking irritates and damages the stomach lining, making it more susceptible to digestive juices. This is a risk factor for acute gastritis.

• Mental Health: Severe or chronic stress can contribute to inflammation and worsen the symptoms.

Non-Modifiable Risk Factors

• Older Age: The stomach lining naturally thins with age, increasing the risk of gastritis in older adults. They are also more likely to have H. pylori infection or autoimmune conditions.

• Autoimmune Gastritis: In rare cases, the immune system mistakenly attacks healthy stomach tissue, leading to chronic inflammation.

• Bile Reflux: Bile, a digestive juice produced by the liver, can flow back into the stomach, irritating the stomach lining.

While gastritis prevention depends on many underlying reasons, some changes can minimise the risk of flare-ups significantly. These are some key strategies to incorporate into daily routine:

Healthy Habits

• Practising good hygiene helps prevent H. pylori infection, a major risk factor.

• Manage stress through meditation, deep breathing, or yoga. 

• Eat smaller, more frequent meals, for easier digestion and reducing strain on the stomach lining.

• Maintain a healthy diet and limit processed foods, alcohol, caffeine, excessive salt, sugar, and spicy ingredients. These foods can irritate the stomach lining.

• Consider probiotics that benefit gut health and potentially reduce the risk of H. pylori infection.

A proper diagnosis is important for finding the cause and receiving the most effective treatment. Check out an overview of the steps a stomach doctor might take to diagnose this disease.

1. Medical History: Discussing the medical history, including past illnesses and medications, helps stomach doctors identify potential causes.

2. Physical Examination: It is used to check for abdominal tenderness or pain.

3. Blood Tests: These can check for anaemia, H. pylori infection, or other underlying conditions.

4. Stool Test (Faecal Occult Blood Test): This looks for blood in stool, a potential sign of gastritis.

5. Upper Endoscopy: This is considered the gold standard for diagnosing gastritis. During an endoscopy, a small tissue sample (biopsy) can be taken for further analysis. It confirms the presence of inflammation and its cause.

6. Upper GI Series (Barium Swallow): X-rays using a chalky liquid (barium) to visualise the upper digestive tract. This can reveal ulcers or erosions in the stomach lining.

How to prepare for a doctor visit?

Being prepared for a gastroenterologist doctor's appointment regarding gastritis can significantly improve the consultation's efficiency and lead to a quicker diagnosis and treatment plan. Following are some steps to be followed:

• Gather Symptom Details: Note down all the symptoms, including their onset, duration, severity, and frequency. 

• Prepare a Medical History: This includes past illnesses, medications taken, allergies, and any family history of gastritis. 

• Develop a List of Questions: Don't hesitate to ask questions to clarify the doubts and understand the condition better.

"I once treated a middle-aged farmer, initially diagnosed with gastritis. However, due to delayed treatment and the prolonged use of over-the-counter NSAIDs, his condition progressed to a peptic ulcer.

The ulcer eventually perforated, leading to a life-threatening peritonitis that required emergency surgery. Despite the challenges, we were able to perform timely medical care and save his life.”

- Dr Rishabh Prakash Jain
Gastroenterologist

Effective gastritis treatment is dependent on identifying the root cause. The following are the strategies a doctor might employ to manage symptoms, promote healing, and prevent future flare-ups.

Lifestyle Modifications

1. Dietary Changes: Avoid irritants like spicy, acidic, and greasy foods. Eat smaller, more frequent meals.

2. Stress Management: Chronic stress can worsen gastritis. Practice relaxation techniques like yoga or meditation.

3. Limited Alcohol and Caffeine: Excessive consumption can irritate the stomach lining.

4. Smoking Cessation: Tobacco weakens the stomach lining and increases gastritis risk. Quitting smoking is highly beneficial.

Gastritis Medication

1. Antibiotics (H. Pylori Infection): If H. pylori is the culprit, a combination of antibiotics is prescribed to eradicate the bacteria.

2. Proton Pump Inhibitors (PPIs): They will significantly reduce stomach acid production, promote healing and relieve discomfort. These are available over-the-counter and by prescription.

3. H2 Blockers: Such medications reduce stomach acid production but are less potent than PPIs. They can be purchased over the counter.

4. Antacids: These neutralise existing stomach acid and provide quick relief but are not a long-term solution. They sometimes lead to severe side effects like diarrhoea or constipation.

While it is often manageable, neglecting treatment can lead to complications. The potential risks associated with delayed treatment include:

Short-Term Risks

1. Internal Bleeding: Persistent inflammation can erode the stomach lining, increasing the risk of internal bleeding. This can cause symptoms like bloody vomit or black stools and requires immediate medical attention.

2. Severe Dehydration: Ongoing vomiting and nausea due to gastritis can lead to dehydration, especially in older adults or young children. Dehydration can manifest as fatigue, dizziness, and decreased urination.

3. Nutritional Deficiencies: Difficulty absorbing nutrients due to impaired stomach function can lead to deficiencies in iron, vitamin B12, and other essential nutrients.

Long-Term Risks

1. Peptic Ulcers: Untreated gastritis can worsen into peptic ulcers and open sores, generally in the stomach lining or upper part of the small intestine. Ulcers can cause significant pain and bleeding.

2. Increased Risk of Stomach Cancer: Chronic inflammation, particularly in cases like autoimmune gastritis, can raise the risk of stomach cancer over time. Early diagnosis and treatment are crucial to prevent such complications.

When to see a doctor?

While mild gastritis often resolves on its own with some lifestyle modifications, there are situations where seeking medical attention is crucial. Here are some warning signs to watch out for:

• Severe or persistent vomiting

• Bloody vomit or stool

• Severe abdominal pain

• Difficulty swallowing

• Unexplained weight loss

• Persistent symptoms (> 1-2 weeks)

• Risk factors for complications

Following a balanced diet that minimises irritation to the stomach lining is crucial for managing gastritis. Here's a breakdown of foods to favour and avoid:

Gastritis is a condition that creates inflammation of the stomach lining. While uncomfortable, it is often treatable with medication, dietary changes, and lifestyle modifications. Early diagnosis and accurate treatment can help combat the complications and ensure a faster recovery.

If you're experiencing any gastritis symptoms, consult a doctor to determine the underlying cause and get the most appropriate treatment plan. HexaHealth can help you find the best healthcare services. We offer a network of qualified doctors who can help you achieve the best health outcomes. Contact us today!

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