What is gastritis?
Gastritis is an inflammation and erosion of the stomach lining, due to various causes such as bacterial infection (caused by the bacteria called Helicobacter pylori), regular consumption of certain painkillers, drinking too much alcohol, regularly eating very spicy food, etc.
Gastritis is usually mild and resolves without any treatment. Some dietary and lifestyle changes with over-the-counter antacid medicines are usually all that is required.
However, severe or recurring gastritis can be a problem and requires immediate treatment. If left untreated it can lead to stomach ulcer and anemia.
How does gastritis occur?
The food we eat passes down the oesophagus into the stomach. The stomach creates acid which is necessary to digest the food and to kill any germs. The food mixes with the acid in the stomach and then moves into the first part of the small intestine.
Since the acid is corrosive, some of the cells in the inner lining of the stomach produces mucous as a natural barrier to protect the lining of the stomach and the first part of the small intestine. Under normal conditions, there is a perfect balance between the amount of acid produced and the amount of mucus produced to protect the stomach lining.
Gastritis occurs when there is an imbalance between the acid, and the mucous produced, and the acid manages to erode and damage the stomach lining.
The imbalance can occur due to many reasons such as, bacterial infection especially caused by the Helicobacter pylori bacteria, overindulging in alcohol and smoking, eating very spicy food and so on.
At times, gastritis can also be caused due to an autoimmune reaction, i.e. when the body’s immune system instead of protecting the body, mistakenly attacks the body's own cells and tissues, in this case, the stomach lining, and cause gastritis. This is especially common among people who have an autoimmune condition such as Hashimoto's thyroid disease or diabetes type 1.
Based on the different causes there are various types of gastritis such as:
- Acute gastritis: occurs when the stomach lining gets inflamed. This occurs due to the overuse of Non-Steroidal Anti-Inflammatory (NSAID) drugs, alcohol abuse, corticosteroids, chemotherapy, a myocardial infarction, and even stress. The patient when suffering from acute gastritis can complain of indigestion and stomach irritability. In more serious cases tissue death or necrosis of stomach glands may occur.
- Chronic gastritis: occurs when stomach lining becomes inflamed repeatedly or for an extended period of time. Chronic gastritis erodes away the stomach lining. The symptoms of chronic gastritis include upper abdominal pain, bloating, vomiting, loss of appetite, and indigestion. There are different types of chronic gastritis:
- Type A chronic gastritis is caused by dying stomach cells and can increase the risk of cancer, anemia, and vitamin deficiencies.
- Type B chronic gastritis is caused by the Helicobacter pylori bacteria, and is the most common among the three.
- Type C chronic gastritis is caused by chemical irritants such as anti-inflammatory drugs, alcohol, or bile and can lead to stomach lining erosion.
- Atrophic gastritis: is a subtype of chronic gastritis. In this condition death of the stomach glands occur, which stops the production of essential chemicals like hydrochloric acid, and pepsin, which help in food digestion. This condition can lead to Vitamin B12 and iron deficiencies.
- Antral gastritis: Antral gastritis can be caused by a virus, bacteria, stomach injury, or erosive medications. Patients suffering from this condition complain of indigestion and burning sensation, bloating, flatulence, and changes in stool colour.This type of gastritis occurs in the lower portion of the stomach and is very common among older adults.
- Erosive gastritis: A less common form of gastritis, this condition leads to the formation of ulcers and bleeding in the lining of the stomach instead of inflammation. Erosive gastritis occurs due to consumption of certain drugs like steroids, or due to medical conditions like Crohn’s disease, infections from bacteria like E.coli, and food allergies. To diagnose this form of gastritis, the doctor may have to take an x-ray of the stomach.
- Autoimmune gastritis: This occurs when the body’s immune system instead of protecting the body, mistakenly attacks the body's own cells and tissues, in this case, the stomach lining, and cause gastritis. This is especially common among people who have an autoimmune condition such as Hashimoto's thyroid disease or type 1 diabetes.The main symptoms of autoimmune gastritis are nausea, vomiting, a feeling of “fullness” in the upper abdomen after eating, and/or abdominal pain; This condition can also lead to more serious complications like folate, iron, and/or B12 deficiency and stomach cancer.
- Alcoholic gastritis: is caused by overindulging in alcohol which can limit the stomach’s ability to produce acids, resulting in inflammation of the stomach lining.
- Duodenitis: This condition happens when inflammation occurs within the first section of the small intestine. The main causes of this condition are Helicobacter pylori bacteria and certain drugs such as ibuprofen. The symptoms patients suffering from duodenitis complain of are abdominal pain, bloating, discoloured stool and nausea.
Who is prone to gastritis?
Some people are more prone to gastritis than others. They include:
- people who overindulge in drinking alcohol
- people who suffer from any bacterial infection such as Helicobacter pylori
- people who undergo chemotherapy
- people who take iron and potassium supplements
- people who take nonsteroidal anti-inflammatory drugs
- people who take steroids
- elderly people whose stomach lining thins due to ageing
- people suffering from high levels of stress
What are the causes of gastritis?
The causes of gastritis include:
- Bacterial Infection such as being infected by Helicobacter pylori.
- Regularly using pain relievers which can erode the protective lining of the stomach.
- Aging, since in older adults the stomach lining tends to thin with age and older people also tend to suffer from autoimmune disorder
- Drinking alcohol excessively which can irritate the stomach lining,
- Severe stress can cause acute gastritis.
- Viral infections like the herpes simplex virus(seen in people with low immunity levels)
- fungal infections
- Allergic reactions
- Certain food poisonings
- An autoimmune reaction, i.e.,when the immune system mistakenly attacks the body's own cells and tissues, in this case, the stomach lining. (This is common among patients who suffer from autoimmune conditions, such as Hashimoto's thyroid disease or type 1 diabetes.)
- A stressful event, such as a bad injury or critical illness, or major surgery which can result in decreased blood flow to the stomach
What are the symptoms of gastritis? How is gastritis diagnosed?
The symptoms of gastritis includes:
- a burning ache or pain in your upper abdomen just before eating
- loss of appetite
- abdominal pain and bloating
- incessant hiccups
- vomiting blood
- loss of appetite, feeling very full quickly and possibly experiencing changes in weight
- hiccups and burping
- changes in bowel movements and the appearance of stools, such as darker stools or bloody coloured stools
If you observe any of the symptoms of gastritis you can consult a general practitioner. He will ask you about your symptoms, your medical history and history of a previous diagnosis and treatment of gastritis, alcohol consumption, and is you take any medicines regularly.
He may also recommend a breath, blood, or stool test to check for the Helicobacter pylori bacteria.
He may also ask you to undergo endoscopy to look into your esophagus and stomach and check for inflammation. If he finds anything unusual he may take a small sample of your stomach lining for biopsy.
What are the complications of gastritis?
The complications of gastritis include:
- Anemia which can result from chronic bleeding due to erosive gastritis
- Atrophic gastritis which occurs due to loss of both the stomach lining and glands
- Gastric or peptic ulcers which form in the lining of the stomach and duodenum
- Growths in the stomach lining which can be benign or cancerous. If the gastritis is caused by Helicobacter pylori bacteria, it also increases the risk of stomach cancer.
What is the treatment for gastritis?
The first line of treatment depending on severity and duration of your symptoms, is different types and combinations of medications. The doctor will also you to make dietary and lifestyle changes.
Questions answered by trusted doctors
Did you know?
Gastritis in India
The annual mortality rate per 100,000 people from gastritis and duodenitis in India has decreased by 41.5% since 1990, an average of 1.8% a year.
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