Gastritis

Introduction

Gastritis is an inflammation of the stomach lining. Many things can cause gastritis, but most often it is caused by an infection of the bacteria H pylori. Gastritis may come on suddenly (acute gastritis) or gradually (chronic gastritis). In most cases, the damage to the stomach lining isn’t permanent and will get better with treatment.

Signs and Symptoms

 The most common symptoms of gastritis are pain and an upset stomach; however, there are many other symptoms to be aware of including:

• dyspepsia (indigestion)

• heartburn

• abdominal pain

• hiccups

• nausea

• loss of appetite

• vomiting

• dark stools

Causes

Infection, irritation, autoimmune disorders, backflow of bile into the stomach and pernicious anemia are all causes of gastritis.

Infections

Infections are caused by any of the following:

• bacteria

• virus

• parasite

• fungi

Irritation

There are many reasons the stomach lining can be irritated:

• long term or excessive use of alcohol

• cigarette smoking

• long term use of NSAIDs (like ibuprofen or naproxen)

• coffee and other acidic beverages in excess

• stress (stress causes an increased production of stomach acid)

• trauma (swallowing a foreign object)

• radiation treatment

Risk Factors and Diagnosis

When a patient is suspected of having gastritis, the physician will assess a patient’s risk potential. Some of these risks include:

• Infection with H pylori

• Acquired immune deficiency syndrome (AIDS)

• Any patient requiring narcotics or regular use of NSAIDs for pain control

• Alcoholism

• Cigarette smoking

• Age 65 and older

• Patient has the herpes simplex virus or cytomegalovirus

• History of inflammatory bowel disease

There are several tests used for diagnosis of gastritis, but the most common is endoscopy. Endoscopy involves using a long thin tube with a light and a camera on the end of it. The tube is passed down the throat to the stomach so that the physician may visualize the damage done to the lining of the stomach.  A biopsy is usually taken at this time to test for the presence of H. pylori. H. pylori may also be detected by a breath test if an endoscopy is not ordered. A blood test or stool guaiac test are other useful diagnostic measures.

Prevention

Making healthy choices can go a long way in avoiding gastritis. Some ways a patient can reduce their risk of infection include:

• alcohol abstinence

• smoking cessation

• avoiding unnecessary medications

• limiting caffeinated beverage intake

• avoiding stress

• eating healthy meals

• not eating late at night

Diet and Nutrition

It is now known that the patient does not need to be on a special bland diet to treat gastritis and peptic ulcer. However a high-fiber, low-fat diet is found to be beneficial. Below are some additional nutritional suggestions:

• Foods containing flavonoids inhibit the growth of H. pylori.

  • celery, cranberries, apples, onions, garlic, and tea (black or green)

• Foods high in Vitamin B and calcium are good for reducing symptoms.

  • almonds, dark leafy greens, beans, whole grains and sea vegetables

• Eat foods rich in antioxidants.

  • acai berries, blueberries, cherries, tomatoes, bell peppers and squash

• Avoid fatty foods especially fatty meats. Instead eat lean sources of protein.

  • wild caught cold water fish, soy tofu or beans

• Use healthy oils for cooking.

  • olive oil or canola oil

• Reduce or eliminate trans fats in the diet.

  • french fries and commercially baked goods are high in trans fats

• Avoid foods made with refined sugar and wheat.

  • white flour, granulated white sugar, pastas and breads

• Avoid coffee and all other caffeinated products, alcohol or carbonated drinks.

• Drink 6 – 8 glasses of water every day.

• Identify any food allergies and eliminate them from the diet.

Some daily supplements can also help decrease the risk of developing gastritis:

• Multivitamins

• Probiotic supplements

• Omega 3 fatty acids supplements

• Vitamin C supplements

Treatment

Treatment is dependent upon the cause of the gastritis. If the cause is infection, the physician will prescribe antibiotics. If lifestyle is the cause it will be up to the patient to make some changes in their diet, routine and choices. Some other treatments commonly used are:

• Antacids – found over the counter (OTC), will treat the heartburn and indigestion but not an ulcer

• H2 blockers – reduce the amount of gastric acid secreted

• Proton pump inhibitors –  decrease the amount of gastric acid produced

• Coating agents – coat the lining of the stomach to protect it

• Antiemetics – control a patient’s nausea and vomiting.  Antiemetics are not a treatment for gastritis, they only help control the symptoms.

Prognosis

Permanent damage to the lining of the stomach is very rare. With treatment and willingness of the patient to change behaviors that may be causing the gastritis, a full recovery is likely.

References:

Gastritis. (2015). Retrieved from https://www.niddk.nih.gov/health-information/digestive-diseases/gastriti…

Gastritis. Retrieved from https://medlineplus.gov/ency/article/001150.htm. 

Park, Yo Han, and Kim, Nayoung. (2015). Review of Atrophic Gastritis and Intestinal Metaplasia as a Premalignant Lesion of Gastric Cancer. J Cancer Prev., 20 (1), 25-40. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4384712/.