Gastritis

Gastritis has various causes; these have been enumerated below.

• Infection:
  • Bacterial infections: Helicobacter pylori (H. pylori) is the leading cause of gastritis. It can damage the protective lining of the stomach, leading to inflammation. It is known to cause both acute and chronic gastritis and is associated with the occurrence of peptic ulcers as well as gastric cancer.
  • Oher infections: Infections caused by other entities, such as viruses, fungi, or parasites can also cause inflammation, though they are less common.
• Medications:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Chronic (prolonged and persistent) use of NSAIDs like ibuprofen and aspirin is particularly problematic as they can irritate the stomach lining, leading to gastritis. These are linked to all three types of gastritis.
  • Corticosteroids: Medications like corticosteroids that reduce stomach acid can also contribute to the development of gastritis.
• Alcohol abuse: Alcohol acts as an irritant and can wear away the stomach lining, leading to all three types of gastritis. Alcohol also increases the risk of stomach bleeding.
• Bile reflux: When bile produced by the liver backflows into the stomach (bile reflux), the stomach lining gets inflamed, leading to gastritis. This condition is associated with both chronic and acute gastritis.
• Autoimmune reactions: Long-term (chronic) is caused when the body’s immune surveillance mechanism erroneously targets cells lining the stomach.
• Stress: Physical stress (due to surgery, injury, or illness) or emotional stress may exacerbate gastritis symptoms or contribute to its development, though it is not usually the primary cause.
• Other causes:
  • Smoking: Nicotine, the key component of tobacco, can increase stomach acid production even in the absence of food, resulting in higher acidity. Excess acid can irritate the stomach lining, thereby causing gastritis.
  • Dietary factors: Very spicy foods or large meals can irritate the stomach lining, especially when it is already inflamed, thereby causing gastritis.

Common symptoms of gastritis have been described below.

• Upper abdominal pain: The key features of gastritis, i.e., increased gastric acid production, irritation, inflammation, and damaged gastric lining result in a burning or gnawing pain in upper abdomen, a place where the stomach is situated.
• Nausea (feeling to vomit) and vomiting: Excess acid in the stomach causes the stomach to send signals to the brain to induce nausea and vomiting (possibly with blood in severe cases).
• Indigestion (dyspepsia): Irritation and inflammation of the stomach lining lead to an imbalance in stomach acid production and delayed gastric emptying, which contributes to symptoms of indigestion, like pain, bloating, feeling full, and nausea.
• Loss of appetite: The combination of irritation, inflammation, pain, acidity, nausea, and bloating might result in loss of appetite in some individuals.
• Black, tarry stools: Gastrointestinal bleeding due to excess gastric acid production might result in black tarry stools, which require immediate medical attention.
• Vomiting blood: In severe cases of gastritis due to excess gastric production and eroded gastric lining the stomach lining may bleed, leading to blood in the vomit.

Gastritis involves several tests and examinations; these include:

• Physical examination: Palpation (physical examination) might reveal bloating and tenderness in the abdomen, which along with medical history might indicate gastritis.
• Endoscopy (EGD): EGD can help identify inflammation, ulcers, or other abnormalities in the stomach.
• Biopsy: Tissue sample collected during endoscopy can help detect infections (e.g., H. pylori), autoimmune gastritis, or gastric cancer.
• Blood tests: Blood tests may help detect signs of anaemia (a sign of bleeding gastritis) or infections (e.g., H. pylori).
• Stool test: This test can provide information as to whether there is gastrointestinal bleeding (blood in the stool) or infection (pathogen in stool).
• Urea breath test: This test can detect H. pylori infection by measuring certain the carbon dioxide produced by the bacteria upon breaking down urea.

Common approaches to treat gastritis include:

• Medications:
  • Antibiotics: If H. pylori is the causative agent, antibiotics (such as clarithromycin, amoxicillin, or metronidazole) are prescribed to eradicate the bacteria.
  • Proton pump inhibitors (PPIs): Drugs, like omeprazole, lansoprazole, and esomeprazole decrease the amount of gastric acid produced, thereby providing relief in gastritis.
  • H2-receptor antagonists: Similar to PPIs, drugs like famotidine and ranitidine also decrease the amount of stomach acid produced and can provide relief in gastritis.
  • Antacids: Prescription-free medications, like calcium carbonate and magnesium hydroxide can help neutralise stomach acid, thereby providing relief from discomfort.
  • Cytoprotective agents: Medications like sucralfate may be used to help protect the stomach lining from further irritation.
  • Antiemetics: If nausea is a significant symptom, anti-nausea medications (like ondansetron) may be prescribed.
• Lifestyle modifications:
  • Avoiding alcohol and NSAIDs: Limiting alcohol consumption and avoiding drugs like ibuprofen or aspirin (unless otherwise directed by your doctor) can prevent further irritation of the stomach lining.
  • Eating smaller meals: Consuming smaller meals though, more frequently can help reduce stomach irritation.
  • Avoiding spicy, acidic, and fatty foods: Spicy, acidic, or fat-rich foods can exacerbate gastritis, therefore a bland diet, with foods like rice, oatmeal, and bananas, may be recommended during flare-ups.
  • Managing stress: Techniques for managing stress, such as deep breathing, meditation, yoga, and exercise can help reduce gastritis symptoms, especially in individuals with stress-related gastritis.
• Endoscopic treatment: If there is significant bleeding or ulcers, endoscopic procedures may be needed to stop the bleeding or remove damaged tissue.
• Surgery: In rare cases, if gastritis causes severe complications like perforation (a hole in the stomach lining), surgical intervention may be necessary.

Please consult a healthcare professional if you observe any symptoms of gastritis. Seek immediate medical attention if you experience any of the following:

• Persistent or severe abdominal pain
• Vomiting blood
• Black, tarry stools, which can indicate gastrointestinal bleeding

Gastritis can be prevented by taking the following steps:

• Limiting alcohol consumption: Avoid excessive drinking, which can irritate the stomach lining.
• Using NSAIDs cautiously: Take NSAIDs only as prescribed, and try to avoid long-term use. If you need pain relief, consider alternatives like acetaminophen.
• Washing hands regularly: This can help prevent H. pylori infection, especially in areas with poor sanitation.
• Avoiding spicy and irritating foods: Avoid foods that can aggravate an already inflamed stomach lining.