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.

•          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) with symptoms lasting a long time.

Gastritis has many causes, but most causes result in similar symptoms. This 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 acutely and may progress to infect most or all of the stomach’s mucosa over time 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 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;

• Bacterial, viral and parasitic infections

• Certain drugs (cocaine)

• Alcohol

• Bile reflux

•  Fungal infections

• Allergic reactions

• Stress reaction

• Radiation

•          Certain food poisonings (infectious and chemical)

•          Trauma

In general, infectious agents, especially Helicobacter pylori, and NSAIDs are responsible for the majority of people with gastritis.

What are the symptoms of gastritis?

 In Many cases, 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 the following:

•          Abdominal pain (intermittent or constant burning, gripping or gnawing pain) often accompanied by nausea and vomiting

• Diarrhea

• Loss of appetite

• Bloating

• Burping

• Belching

How is gastritis diagnosed?

Gastritis is diagnosed based on the patient’s symptoms and history of a previous diagnosis and treatment of gastritis, alcohol consumption, and use of NSAIDs. Definitive diagnosis of gastritis 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.

medications 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 H. 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.

Other treatments often are 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 foods reduce stop H. pylori growth and or soothe gastritis symptoms?

Eating smaller, more frequent meals and avoiding foods that are spicy, acidic, fried or fatty will help reduce symptoms. Moreover, stress reductionis also recommended. Dietary changes such as ginger tea and/or chamomile tea with honey reportedly soothes gastritis symptoms while onions, garlic, cranberries, apples and celery may stop H. pylori
growth.

Foods that may stop H. pylori growth and soothes gastritis symptoms include:

• Teas (green and white in particular)

• Yogurt

• Peppermint

• Wheat bran

• Carrot juice

• Coconut water

• Green leafy vegetables

• Onions

• Garlic

• Apples

• Fresh fruits and berries

• Celery

• Cranberry juice

• Kale

• Broccoli

• Scallions

• Parsley

• Thyme

• Soybeans

• Soy foods

• Legumes (beans, peas, and lentils)

Although these home remedies may help reduce or soothe symptoms, home remedies seldom treat the underlying causes of gastritis.

What foods aggravate gastritis symptoms?

• Alcohol

• Spicy foods

• Fatty foods

• Fried foods

Moreover, anything that might be toxic or irritating to the stomach should also be avoided (for example cigarette smoking, acidic drinks like coffee, garlic powder, chili powder, peppers and tomato products).

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 of gastritis may include

• peptic ulcer,

• bleeding ulcers,

• anemia,

• gastric cancers,

• MALT lymphoma,

• gastric scarring and strictures with outlet obstruction,

• dehydration,

• renal problems, and

• 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 and people can get gastritis relief.

• If alcohol consumption, NSAIDs, or smoking causes an individual’s gastritis, treatment and prevention is stopping the consumption or use of these products.

• It may be more difficult to prevent some infectious causes of gastritis, 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.

For more information and consultation, contact Dr Rashmi Dhanuka, General Practitioner at Middle East Medical Center-Hidd, with 21 years of experience in medical field. For further information contact Middle East Medical Center-17464848