Gastritis, Symptoms, Causes, and Treatment: Gastritis is a group of medical conditions in which the lining of the stomach is affected the most. This results in the inflammation of the lining of the stomach.
It can be acute, which means it occurs suddenly and lasts for a short period of time, or it can be chronic, which indicates a long-term condition. Gastritis can range from mild to severe and may be associated with various symptoms. If left untreated for a long period can result in the loss of a lot of blood and even stomach cancer, up to the non-recoverable stage.
What are the associated symptoms of gastritis?
- Abdominal pain: Gastritis commonly presents with upper abdominal pain or discomfort. The pain may be dull, burning, or gnawing in nature. It can range from mild to severe and may be aggravated by eating or drinking.
- Nausea and vomiting: Gastritis often causes a feeling of nausea, which may or may not be accompanied by vomiting. Vomiting can provide temporary relief but may not alleviate the underlying inflammation.
- Bloating and gas: Many individuals with gastritis experience bloating and excessive gas formation. This can lead to a sensation of fullness or distention in the abdomen.
- Loss of appetite: Gastritis can cause a decrease in appetite and a feeling of early satiety. The inflammation and discomfort associated with gastritis may make it difficult to eat a regular meal.
- Belching and burping: Excessive belching or burping is another symptom that some people with gastritis may experience. This is often a result of increased gas production in the stomach.
- Heartburn: Gastritis can lead to the reflux of stomach acid into the esophagus, causing a burning sensation in the chest known as heartburn. This symptom is more common in individuals with severe or chronic gastritis.
- Indigestion: Gastritis can disrupt the normal digestive process, leading to indigestion or dyspepsia. This may manifest as a feeling of discomfort, heaviness, or a sense of incomplete digestion after eating.
- Blood in vomit or stool: In some cases, gastritis can cause bleeding in the stomach, leading to the presence of blood in the vomit (hematemesis) or black, tarry stools (melena). This indicates a more severe form of gastritis and requires immediate medical attention.
What is the pathophysiology of gastritis?
The presence of one or more of these causes does not necessarily result in gastritis for everyone. Some individuals may have a higher susceptibility to gastritis due to genetic factors, lifestyle choices, or other underlying health conditions. Additionally, multiple factors can contribute to the development of gastritis simultaneously or over time.
Helicobacter pylori infection
The primary cause of gastritis is infection with a bacterium called Helicobacter pylori (H. pylori). This bacterium is commonly acquired during childhood and can persist in the stomach for many years if left untreated. H. pylori infection is usually transmitted through oral-oral or fecal-oral routes, such as sharing food or utensils with an infected individual or consuming contaminated water or food.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Prolonged or excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a common cause of gastritis. Medications such as aspirin, ibuprofen, naproxen, and others can irritate the stomach lining and disrupt the protective mechanisms of the gastric mucosa, leading to inflammation.
In some cases, gastritis can be caused by an autoimmune response, where the body’s immune system mistakenly attacks the cells in the stomach lining. This type of gastritis is known as autoimmune gastritis. It is associated with the production of autoantibodies that target specific cells in the stomach, such as parietal cells or intrinsic factors, which play a role in the production of stomach acid and absorption of vitamin B12.
When bile, a digestive fluid produced in the liver, flows back into the stomach, it can cause irritation and inflammation of the stomach lining. This condition is known as bile reflux, and it can contribute to the development of gastritis.
Excessive alcohol consumption can irritate the stomach lining, leading to acute or chronic gastritis. Alcohol can disrupt the normal protective mechanisms of the stomach, increase stomach acid production, and impair the healing process of the stomach lining.
Severe stress, such as major surgery, traumatic injury, severe burns, or critical illness, can disrupt the blood flow to the stomach and contribute to the development of gastritis. This type of gastritis is often referred to as stress-related gastritis.
Besides H. pylori infection, other infections can also cause gastritis, although they are less common. Viral infections, such as cytomegalovirus (CMV) or herpes simplex virus (HSV), and fungal infections can lead to inflammation of the stomach lining.
Gastritis can also be caused by other factors such as radiation therapy, prolonged use of corticosteroids, severe illness or injury, autoimmune conditions (besides autoimmune gastritis), certain cancers, and certain digestive disorders.
For Reference:- https://en.wikipedia.org/wiki/Gastritis
Mechanism of inflammation in gastritis!
This involves several mechanisms:
- Increased acid secretion: In response to inflammation, there is an increase in the production of gastric acid by the stomach lining. This acid contributes to the erosion of the mucosal lining, exacerbating the inflammation.
- Impaired mucosal barrier: Gastritis disrupts the protective barrier formed by the stomach lining, making it more susceptible to damage from acid and other irritants. This leads to further inflammation and tissue injury.
- Activation of the immune response: When H. pylori or other triggers induce gastritis, the immune system is activated. Immune cells infiltrate the stomach lining and release inflammatory substances, including cytokines, which perpetuate the inflammation.
- Reactive oxygen species (ROS): Inflammation generates ROS, which are chemically reactive molecules that can damage cells and exacerbate the inflammatory response. ROS contributes to tissue injury and can lead to chronic gastritis if not adequately controlled.
Treatment and management!
Medications to reduce stomach acid production:
Proton pump inhibitors (PPIs): PPIs are commonly prescribed medications that reduce the production of stomach acid. They work by blocking the enzyme responsible for acid secretion in the stomach. Examples include omeprazole, esomeprazole, lansoprazole, and pantoprazole. PPIs are often prescribed for a few weeks to several months, depending on the severity of gastritis.
Histamine-2 receptor blockers (H2 blockers): H2 blockers reduce the production of stomach acid by blocking the action of histamine, which stimulates acid secretion. Commonly prescribed H2 blockers include ranitidine, famotidine, and cimetidine. They are generally used for short-term relief of gastritis symptoms.
If gastritis is caused by an infection with Helicobacter pylori (H. pylori), a combination of antibiotics is typically prescribed to eradicate the infection. The most commonly used antibiotics for H. pylori eradication include amoxicillin, clarithromycin, metronidazole, and tetracycline. These antibiotics are usually taken in combination with a PPI or H2 blocker for a specified duration, usually 7 to 14 days.
Antacids provide temporary relief from symptoms by neutralizing stomach acid. They can help alleviate heartburn, indigestion, and abdominal pain associated with gastritis. Antacids are available over-the-counter and contain ingredients like aluminum hydroxide, magnesium hydroxide, calcium carbonate, or sodium bicarbonate. It’s important to follow the recommended dosage and not use antacids excessively or long-term without medical supervision.
Cytoprotective agents help protect the stomach lining and promote healing. They may be prescribed in cases of severe or erosive gastritis. Commonly used cytoprotective agents include sucralfate and misoprostol. Sucralfate forms a protective barrier over the stomach lining, while misoprostol reduces acid secretion and enhances the production of protective mucus.
Making certain lifestyle changes can help manage and prevent gastritis symptoms. These include avoiding triggers like spicy and acidic foods, alcohol, and caffeine. Eating smaller, more frequent meals and practicing stress reduction techniques can also be beneficial. Quitting smoking, maintaining a healthy weight, and avoiding NSAIDs unless necessary are also important lifestyle modifications for gastritis management.
Treatment of underlying conditions:
If gastritis is caused by an underlying condition, such as an autoimmune disorder or another digestive disorder, treatment of the underlying condition is crucial. This may involve immune-suppressing medications or other specific treatments based on the underlying cause.
- Maintain good hygiene: Wash your hands thoroughly with soap and water before eating and after using the restroom. This helps prevent the transmission of Helicobacter pylori (H. pylori) infection, which is a common cause of gastritis.
- Avoid H. pylori exposure: Avoid sharing utensils, food, or drinks with individuals who have H. pylori infection, as the bacteria can be transmitted through saliva and fecal-oral routes. Be cautious when consuming food or water from potentially contaminated sources.
- Practice food safety: Ensure proper food handling and storage to prevent bacterial contamination. Cook foods thoroughly, especially meats, and avoid consuming undercooked or raw foods that may harbor bacteria that can cause gastritis.
- Limit or avoid NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate the stomach lining and contribute to gastritis. Whenever possible, limit the use of NSAIDs or consult your healthcare provider for alternative pain relief options that are less likely to cause gastritis.
- Moderate alcohol consumption: Excessive alcohol consumption can irritate the stomach lining and contribute to the development of gastritis. Limit your alcohol intake and practice moderation to reduce the risk of gastritis.
- Avoid tobacco smoking: Smoking can increase the risk of gastritis and interfere with the healing process. Quitting smoking or avoiding tobacco products can help prevent gastritis and improve overall digestive health.
- Manage stress: Chronic stress can disrupt the normal function of the stomach and contribute to gastritis. Adopt stress management techniques such as exercise, relaxation exercises, meditation, or engaging in activities you enjoy to reduce stress levels.
- Maintain a healthy diet: Follow a balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive consumption of spicy, acidic, or greasy foods that can irritate the stomach lining. Additionally, maintain regular meal times and avoid skipping meals to help prevent gastritis.
- Use medications cautiously: If you need to use NSAIDs or other medications that can potentially irritate the stomach lining, consult your healthcare provider for guidance. They may recommend alternative medications or provide additional medications to protect the stomach lining while using these medications.
- Regular medical check-ups: Regular medical check-ups can help identify and manage underlying health conditions that may contribute to gastritis. It allows for early detection and treatment, reducing the risk of complications associated with gastritis.
For Reference:- https://www.urmc.rochester.edu/encyclopedia/
The healing time for gastritis varies depending on the underlying cause, severity of inflammation, and individual factors. Acute gastritis usually resolves within a few days to weeks with appropriate treatment. Chronic gastritis may require long-term management and can take weeks to months to heal.
In some cases, chronic untreated gastritis can lead to the development of stomach ulcers. However, not all cases of gastritis progress to ulcers or cancer. If left untreated, Gastritis caused by H. pylori infection may increase the risk of stomach ulcers or, in rare cases, stomach cancer.
Yes, diet plays a role in managing gastritis. Spicy, acidic, and greasy foods can irritate the stomach lining and worsen gastritis symptoms. Following a balanced diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats is advisable. Avoiding trigger foods and practicing portion control can help manage gastritis symptoms.
Severe stress can contribute to the development of stress-related gastritis. Stress does not directly cause gastritis but can disrupt the normal function of the stomach and increase the risk of developing gastritis or exacerbating existing gastritis.
No, gastritis itself is not contagious. However, if gastritis is caused by an H. pylori infection, the bacterium can be transmitted from person to person through close contact, such as sharing food or utensils. Proper hygiene practices can help prevent the spread of H. pylori infection.