What is gastritis?
Gastritis is inflammation of the lining of the stomach. Unfortunately, the term "gastritis" has been misused to include many different upper abdominal problems, but true gastritis refers to the stomach lining (gastric mucosa) that is inflamed. All or part of the gastric mucosa may be involved.
Gastritis may be classified as acute or chronic. Acute gastritis maybe characterized as erosive (damaged areas where mucosal cells are disrupted or missing) and nonerosive. Chronic gastritis is determined by histopathology (appearance of the gastric mucosa).
This article will focus on true gastritis. Gastritis has many causes, but most causes result in similar symptoms. This has leads to some confusion and is the reason why many health care professionals now consider the term "gastritis" as a non-specific description of a cluster of symptoms.
What causes gastritis?
A major cause of both acute and chronic gastritis is infection of the stomach mucosa by a bacterial species named < Helicobacter pylori. Usually, this bacterium first infects the stomach antrum (stomach mucosa without acid-producing cells) acutely and may progress to infect most or all of the stomach's mucosa over time (chronic gastritis) and remain there for years. This infection generates an initial strong inflammatory response and eventually, a long-term chronic inflammation with intestinal cell changes may develop. Another major cause of acute and chronic gastritis is the use (and overuse) of nonsteroidal anti-inflammatory drugs (NSAIDs).
However, there are many other causes of gastritis; the following is a list of common causes of both acute and chronic gastritis; chronic gastritis may occur with repeated or continual presence of most of these causes:
Bacterial, viral and parasitic infections
Certain drugs (cocaine)
Certain food poisonings (infectious and chemical)
In general, infectious agents, especially Helicobacter pylori, and NSAIDs are responsible for the majority of gastritis patients.
What are the symptoms of gastritis?
Surprisingly in many people, gastritis often produces no symptoms and is diagnosed only when samples of the stomach mucosa are examined for other suspected diseases. However, when gastritis symptoms occur, the most common symptoms include abdominal pain (intermittent or constant burning, gripping or gnawing pain), often accompanied by nausea and vomiting and occasionally, diarrhea. Other symptoms such as loss of appetite, bloating, and burping or belching may occur. These latter symptoms come and go over time especially with chronic gastritis. Indigestion (dyspepsia) is another term that encompasses this cluster of symptoms.
How is gastritis diagnosed?
Gastritis is presumptively diagnosed by the patient's symptoms and history of a previous diagnosis and treatment of gastritis, alcohol consumption, and use of NSAIDs. Definitive diagnosis is made by identifying the underlying cause of the gastric mucosal inflammation and/or by tissue (gastric) biopsy. For example, the major infective cause of gastritis is Helicobacter pylori (H. pylori). This bacterium can be detected by breath, blood, stool, immunological and biopsy tests. Although the bacterium can be cultured from the patient, this is seldom attempted. Other pathogens can be identified using culture, stool and immunological tests.
Biopsy of the stomach mucosa, done during endoscopy examinations, is often used in patients to identify the causes of chronic gastritis and may allow visualization of mucosal erosions and other stomach mucosal changes. Abdominal X-rays or barium studies (upper or lower) may demonstrate the presence of thickened mucosa and folds that are signs of inflammation in the stomach.
Your doctor can help determine which tests should be done, including ancillary tests that may help identify other causes of the non-specific symptoms commonly found with gastritis.
What are the treatment medications and home remedies for gastritis?
Treating the underlying cause of gastritis is the most effective way to reduce or resolve gastritis. For example, if the cause of gastritis is Helicobacter pylori, then treatment with appropriate antibiotics (usually a combination of amoxicillin and clarithromycin [Biaxin, Biaxin XL] plus bismuth subsalicylate [Pepto-Bismol]) should be effective.
If NSAIDs are the cause, then stopping the drug should be effective. However, other treatments are often used in addition to those that treat the specific cause. These treatments may reduce or stop symptoms of gastritis and allow gastric mucosal healing to begin regardless of the underlying cause. These medications include antacids (Maalox , Rolaids, and Alka-Seltzer), histamine (H2) blockers (famotidine [Pepcid AC], ranitidine [Zantac 75]) and PPI's or proton pump inhibitors (omeprazole [Prilosec], pantoprazole [Protonix], esomeprazole [Nexium]). They all function by different mechanisms to reduce acid in the stomach but usually do not treat the underlying cause of gastritis.
What are the complications of gastritis?
The complications of gastritis may occur over time, especially if gastritis becomes chronic and the underlying causes are not treated. Complications may include peptic ulcer, bleeding ulcers, anemia, gastric cancers, MALT lymphoma, gastric scarring, and strictures with outlet obstruction, dehydration, renal problems, and even death.
What is the prognosis of gastritis?
Most people that get gastritis have few or short-term symptoms and recover completely. Those people with underlying causes that are appropriately treated often recover completely. The prognosis of individuals with chronic disease and those who develop serious complications like bleeding ulcers, obstruction and cancer is more guarded.
How is gastritis prevented?
If the underlying cause of gastritis is preventable, then gastritis can be prevented. For example, if alcohol consumption or NSAIDs cause an individual's gastritis, prevention is accomplished by stopping the consumption of these agents. Avoidance may be preventive in situations where chemicals, radiation or some toxin ingestion could occur. It may be more difficult to prevent some infectious causes, but proper hygiene, hand washing, and eating and drinking only adequately cleaned or treated foods and fluids are healthy ways to decrease your risk of getting gastritis from infectious agents.