GASTRITIS
Gastritis is inflammation of the lining of the stomach. Unfortunately, the term "gastritis" has been misused to include many different upper abdominal problems. However, true gastritis refers to an inflamed stomach lining (gastric mucosa). All or part of the gastric mucosa may be involved.
Gastritis has many causes, but most causes result in similar symptoms. This has led to some confusion and is why many health-care professionals now consider the term "gastritis" as a non-specific description of a cluster of symptoms.
Q. What is gastritis?
A. Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. There are different forms of gastritis. Acute, Chronic, and Erosive.
Acute gastritis involves sudden, severe inflammation.
Chronic gastritis involves long-term inflammation that can last for years if left untreated. It is determined by the appearance of the stomach lining (called histopathology), with symptoms lasting a long time.
Erosive gastritis is a less common form of the condition that typically does not cause much inflammation, but can lead to bleeding and ulcers in the stomach lining.
Although some have been proposed, there is no widely accepted classification system for gastritis.
Q. What causes gastritis?
A. Weaknesses in the mucus-lined barrier that protects the stomach wall allow digestive juices to damage and inflame the stomach lining. Many diseases and conditions can increase the risk of gastritis.
Q. What are the symptoms?
A. Symptoms include:
• Abdominal pain or indigestion
• Abdominal bloating
• Loss of appetite
• Hiccups
• Nausea or vomiting. Vomiting blood or coffee-ground like material, or bowel movements that produce dark stools.
Q. What causes gastritis?
A. Weaknesses in the mucus-lined barrier that protects the stomach wall allow digestive juices to damage and inflame the stomach lining. Many diseases and conditions can increase the risk of gastritis.
Q. What are the risk factors of gastritis?
A. Without treatment, the infection can lead to ulcers and, in some people, stomach cancer.
Common risk factors include:
• Helicobacter pylori bacteria, a type of bacteria often found in the stomach, throat.
• Medications such as aspirin or anti-inflammatory drugs known as NSAIDs (nonsteroidal anti-inflammatory drugs including aspirin and ibuprofen-based products)
• Alcohol, smoking
Other, less common, risk factors are:
• Eating or drinking acidic or corrosive substances
• Bile reflux
• Autoimmune disorders like Lupus, rheumatoid arthritis, etc.
• Excess stomach acid
• Viral infection
• Pernicious anemia. A form of anemia that occurs when the stomach lacks a naturally occurring substance needed to absorb and digest vitamin B12 properly
• Other diseases and conditions.
o Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease, and parasitic infections.
o Extreme physiological stress associated with severe, acute illness or trauma, such as recent heavy alcohol use, major surgery, head trauma, or failure of the kidneys, liver, or respiratory system.
Q. Are there complications linked to gastritis?
A. If gastritis is left untreated, it can cause bleeding in the stomach as well as ulcers. Certain forms of gastritis can increase stomach cancer risk, particularly in people with thin stomach linings.
In cases where the Helicobacter pylori bacteria cause gastritis, there may be an increased risk of stomach cancer or lymphoma (a type of cancer in the lymphatic system).
Q. Are there tests that can diagnose gastritis?
A. After reviewing personal and family's medical history as well as performing a thorough physical evaluation, the doctor may recommend any of the following tests to diagnose gastritis:
• Endoscopy: The doctor will check for inflammation and may perform a biopsy, a procedure in which a tiny sample of tissue is removed and then sent to the laboratory for analysis.
• Tests for H. pylori: The doctor may recommend tests to determine whether have the bacterium H. pylori is present. H. pylori may be detected in a blood test, stool test, breath test, or urine test.
• Blood test: The doctor may check red blood cell count to determine whether you have anemia.
• Stool test: This test checks for blood in the stool, a sign of gastritis.
• X-ray of the upper digestive system to look for abnormalities.
Q. Should I have my blood tested for levels of certain vitamins and minerals if I have gastritis?
A. If you have a gastrointestinal disease that leads to significant malabsorption, the doctor may measure some of the levels of vitamins and minerals in your blood. Atrophic gastritis, for example, is a condition that specifically leads to the malabsorption of vitamin B12.
Suppose your routine laboratory tests (including a complete blood count and a chemistry panel) are normal. In that case, you do not need a measurement of your blood vitamin or mineral levels.
Suppose you are found to be anemic, and your doctor believes it results from a nutrient deficiency. In that case, he or she may measure the level of iron in your blood. In fact, iron is the only mineral for which blood levels correlate with the total amount of iron stored in your body.
Q. How is it treated?
A. Depending on the cause, some cases of gastritis will resolve over time without treatment. For others, antacids or other medications are needed to decrease or neutralize stomach acid, eliminate symptoms, and promote healing. You will need specialized treatment if you have a gastric ulcer.
Your doctor will also recommend avoiding foods and beverages that aggravate symptoms (such as hot or spicy foods). Also, avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) could help.
For gastritis caused by Helicobacter pylori, your doctor will prescribe antibiotics. Once the underlying problem disappears, gastritis usually does, too. It would be best if you talked to your doctor before stopping any medicine or starting any gastritis treatment
Q. Can I prevent gastritis?
A. Eliminating or reducing alcohol and NSAIDs will reduce the risk. Gastritis caused by stress can be prevented by eliminating or reducing stress or medication (like a proton pump inhibitor) to decrease gastric acid production.
Q. What is the prognosis for gastritis?
A. Most cases of gastritis improve quickly once treatment has been started.
Jan 18, 2021
HUNG M. DO, MD, Ph.D