Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers and drinking too much alcohol also can contribute to gastritis.
Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).
Erosive gastritis is a less common form of the condition. It typically doesn’t cause much inflammation, but can lead to bleeding and ulcers in the lining of the stomach.
Chronic gastritis is a common problem, and sources estimate that more than 50% of the world’s population have it to some degre. This is an important public health concern, as the condition is linked with complications including stomach ulcers and stomach cancer.
Gastritis may occur suddenly (acute gastritis), or appear slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn’t serious and improves quickly with treatment.
However, strictly speaking, gastritis is a formal medical term for a diagnosis made by a pathologist when evidence of inflammation and damage to the stomach lining is seen in a biopsy specimen taken during an upper endoscopy. And it may sound odd to say, but in the true use of the term, “gastritis” —at least the chronic type (see below)— usually does not cause episodes of indigestion.
What Is Gastritis?
Gastritis is inflammation and irritation of the stomach lining, or mucosa. Normally, the stomach lining has a protective layer to shield it from the effects of normal stomach acid. The irritation and inflammation of gastritis make the stomach lining more vulnerable to the acidity inside the stomach. This can result in abdominal pain, loss of appetite, and possibly bleeding.
Gastritis can be acute, coming and going quickly, or chronic, in which case the disease can last months or even years. Acute gastritis is the most common form in the United States. About 8 in 1,000 Americans will get acute gastritis. Chronic gastritis is less common, affecting about 1 in 10,000 Americans.
Gastritis can also fall into one of the following categories based on the extent of injury to the stomach lining:
- Erosive, which means the inflammation wears away the stomach lining, eventually causing lesions or ulcers. It is usually a form of acute gastritis that develops suddenly. It is a more serious form of gastritis compared to nonerosive gastritis. Gastrointestinal bleeding is more common with erosive gastritis.
- Nonerosive, which means the lining is not worn away, but it can degenerate, or atrophy. The lining can also undergo a process called metaplasia. This means it turns into a different type of tissue, usually intestinal tissue. The inflammation can affect all of the stomach or just parts of it. Nonerosive gastritis is usually a form of chronic gastritis and is often asymptomatic (no symptoms).
One person with gastritis may have no noticeable symptoms, while another may have severe symptoms.
Typically, people report sharp, stabbing, or burning pain in the upper-center or upper-left abdomen. The pain often radiates to the back.
Other common symptoms include bloating and nausea. When gastritis causes vomiting, the vomit may be clear, yellow, or green.
Symptoms of severe gastritis include:
- shortness of breath
- chest pain
- vomit that contains blood
- severe stomach pain
- foul-smelling bowel movements
Seek urgent medical attention for any of the following symptoms:
- a rapid heartbeat
- excessive sweating
- shortness of breath
- abdominal pain with a fever
- vomit that contains blood
- a large amount of yellow or green vomit
- black or bloody stool
- dizziness and fainting
What Causes Gastritis?
Gastritis is associated with various medications, medical and surgical conditions, physical stresses, social habits, chemicals, and infections. Some of the more common causes of gastritis are listed.
Medications (only the most common medications are listed)
Aspirin (more than 300 drug products contain some form of aspirin)
Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil and others] or naproxen)
Prescription steroids (for example, prednisone)
Cancer chemotherapy medications
Swallowing chemicals or objects
- Corrosives (acid or lye)
- Swallowed foreign bodies (paper clips or pins)
Medical and surgical conditions
- People who are critically ill or injured can develop gastritis.
- After medical procedures (such as endoscopy, in which a specialist looks into the stomach with a small lighted tube)
- After an operation to remove a part of the stomach
- After radiation treatment for cancer
- Autoimmune diseases
- Chronic vomiting
- Bacterial infections H pylori infection is the most common.
- Viral infections
- Fungal (yeast) infections
- Parasites and worms
- Alcohol consumption
- Autoimmune gastritis: your body attacks the cells that line your stomach. This is usually found in people with underlying autoimmune disorders.
- Eosinophilic Gastroenteritis: An uncommon form of gastritis due to eosinophilic infiltration of the stomach wall.
- Bile reflux gastritis: This condition is a post-gastrectomy complication leading to stomach pain, vomiting bile and weight loss.
How Is Gastritis Diagnosed?
Your healthcare provider will give you a physical exam and ask about your past health. You may also have tests including:
- Upper GI (gastrointestinal) series or barium swallow. This X-ray checks the organs of the top part of your digestive system. It checks the esophagus, stomach, and the first part of your small intestine (duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on the X-ray.
- Upper endoscopy, also called EGD (esophagogastroduodenoscopy). This test looks at the inside of your esophagus, stomach, and duodenum. It uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed.
- Blood tests. You will have a test for H. pylori, a type of bacteria that may be in your stomach. Another test will check for anemia. You can get anemia when you don’t have enough red blood cells.
- Stool spectrum. This test checks to see if you have stomach bacteria that can cause gastritis. A small sample of your stool is collected and sent to a lab. Another stool specimen can check for blood in your stool which may be a sign of gastritis if there has been bleeding.
- Breath test. You may have a test where your breath is collected and analyzed for a stomach bacteria.
How Is Gastritis Treated?
The treatment for gastritis depends on the cause of the condition. If you have gastritis caused by NSAIDs or other drugs, avoiding those drugs may be enough to relieve your symptoms. Gastritis as a result of H. pylori is routinely treated with antibiotics that kill the bacteria.
In addition to antibiotics, several other types of medication are used to treat gastritis:
Proton pump inhibitors
Medications called proton pump inhibitors work by blocking cells that create stomach acid. Common proton pump inhibitors include:
- omeprazole (Prilosec)
- lansoprazole (Prevacid)
- esomeprazole (Nexium)
However, long-term use of these medications, especially at high doses, can lead to an increased risk of spine, hip, and wrist fractures. It can also lead to increased risk of renal failure, dementia, and nutrient deficiencies.
Speak to your doctor before beginning one of these medications to create a treatment plan that is right for you.
Acid reducing medications
Medications that reduce the amount of acid your stomach produces include:
- famotidine (Pepcid)
By lowering the amount of acid that’s released into your digestive tract, these medications relieve the pain of gastritis and allow your stomach lining to heal.
Your doctor may recommend that you use antacids for rapid relief of gastritis pain. These medications can neutralize the acid in your stomach.
Some antacids may cause diarrhea or constipation, so talk to your doctor if you experience any of these side effects.
Probiotics have been shown to help replenish digestive flora and heal gastric ulcers. However, there’s no evidence that they have any impact on acid secretion. There are currently no guidelines supporting the use of probiotics in ulcer management.
What Are the Complications Of Gastritis?
If left untreated, gastritis can lead to serious problems, such as:
- Anemia: H. pylori can cause gastritis or stomach ulcers (sores in your stomach).that bleed, thereby lowering your red blood counts (called anemia).
- Pernicious anemia: Autoimmune gastritis can affect how your body absorbs vitamin B12. You’re at risk of pernicious anemia when you don’t get enough B12 to make healthy red blood cells.
- Peritonitis: Gastritis can worsen stomach ulcers. Ulcers that break through the stomach wall can spill stomach contents into the abdomen. This rupture can spread bacteria, causing a dangerous infection called bacterial transloction or peritonitis. It also can lead to a widespread inflammation called sepsis. Sepsis can be fatal.
- Stomach cancer: Gastritis caused by H. pylori and autoimmune disease can cause growths in the stomach lining. These growths increase your risk of stomach cancer.
Reducing Your Risk of Gastritis
It is not entirely clear if you can reduce your risk of contracting H. pylori, the most common cause of chronic gastritis. Experts believe it may spread from person to person or by consuming contaminated food or water. Practicing good hygiene can help protect against infections in general. This includes washing your hands regularly, especially before eating. Practice food safety by eating foods that are thoroughly cooked and kept at a safe temperature.
Other steps you can take to help lower your risk of gastritis include:
- Keeping autoimmune diseases controlled with effective treatments
- Limiting alcoholic beverages and seeking help for alcohol abuse or addiction. Avoid drinking on an empty stomach, enjoy your drink with some food
- Stopping smoking or tobacco use
- Using NSAIDs and aspirin for short-term pain or symptom relief unless you are under a doctor’s care and see your doctor regularly
If you have risk factors for gastritis, talk with your doctor about your stomach health. Ask about ways to protect your stomach from damage. If you take aspirin or NSAIDs on a regular basis, tell your doctor if you have symptoms after taking a dose. Find out if you should be taking an acid-blocking drug with your NSAID.