Symptoms of Chronic Gastritis

Chronic gastritis is a medical condition that causes long-term inflammation in the gastric mucosa (stomach lining). The most common cause of gastritis is an infection with a type of bacteria called Helicobacter pylori (H. pylori), often before the age of 12.

Frequent symptoms of chronic gastritis include indigestion, abdominal pain, bloating, nausea, vomiting, weight loss, and loss of appetite. Over time, gastritis can lead to complications such as ulcers and stomach cancer. 

This article will look at both common and rare symptoms of chronic gastritis, as well as causes, risk factors, and complications.

Frequent Symptoms

Many people with chronic gastritis don’t have symptoms, at least at first. 

The most common sign of chronic gastritis is indigestion, also known as dyspepsia. In fact, around 87% of people who visit a healthcare provider due to chronic gastritis say they have symptoms of indigestion. 

The most common symptoms of chronic gastritis include:

• Abdominal pain: Dyspepsia often causes abdominal pain and discomfort, such as a gnawing or burning sensation in the upper abdomen.
• Nausea: Chronic gastritis may lead to frequent nausea and/or vomiting with no apparent cause.
• Feeling overly full: People with chronic gastritis often say they feel full too quickly or that they feel uncomfortably full just after a meal. Some also experience bloating after eating.
• Reduced appetite: Over time, some people with chronic gastritis experience appetite loss due to their gastrointestinal symptoms.
• Weight loss: Some people with chronic gastritis start to avoid eating because of dyspepsia, which can cause unwanted weight loss.
  

Rare Symptoms

In some cases, chronic gastritis can lead to bleeding in the stomach lining. Symptoms of bleeding in the gastrointestinal (GI) tract include:

• Black or tarry stools: Black or tarry stools can indicate that there’s blood in your stool. You may also see dark or bright red blood in your stools. 
• Abdominal cramps: Internal bleeding can cause severe abdominal pain and/or stomach cramping.
• Shortness of breath: If you lose a significant amount of blood, you may experience difficulty breathing, dizziness, lightheadedness, or fatigue.
• Vomiting blood: In severe cases, you could throw up blood or notice that your vomit has the texture of coffee grounds.

Seek emergency medical help if you notice any of the above symptoms.

Causes

H. pylori infection is the most common cause of gastritis. However, around 21% of people with chronic gastritis have not been infected with H. pylori bacteria. Other causes include:

• Smoking
• Long-term use of non-steroidal inflammatory drugs (NSAIDs)
• Excessive alcohol or cocaine use
• Bile reflux (when bile, which is made by the liver, flows backward from the intestines into the stomach)
• Extreme stress on the body
• Kidney failure
• Major surgery
• Acute illness

People in the following subgroups are also more at risk of developing chronic gastritis:

• People with chronic pain: People who frequently take NSAIDs, such as aspirin or ibuprofen, have a significantly higher risk of developing reactive gastritis. Reactive gastritis is chronic gastritis in which the stomach lining is damaged over time by substances like NSAIDs or alcohol.
• People with autoimmune disorders: People with certain autoimmune disorders, such as pernicious anemia—which causes severe vitamin B12 deficiency—sometimes develop a rare kind of chronic gastritis known as autoimmune gastritis. In autoimmune gastritis, the body’s immune system destroys healthy parts of the stomach lining.
• People with cancer: You may have a higher risk of developing chronic gastritis if you are undergoing (or have undergone) treatment for cancer, such as chemotherapy or radiation therapy.
• Immunocompromised people: People with weakened immune systems have an increased risk of chronic gastritis due to viral infections, such as the herpes simplex virus (HSV).
• Older adults: The risk of chronic gastritis increases with age. About 50–60% of U.S. adults ages 60 and older are infected with H. pylori bacteria. Meanwhile, around 20% of American adults over 80 have reactive gastritis.

If left untreated, chronic gastritis can lead to atrophic gastritis, which is associated with the thinning of mucosal cells, changing the cells of the stomach to be more like those of the intestine. Atrophic gastritis result from environmental triggers such as H. pylori or an autoimmune reaction and lead to a condition called an acid-free stomach, in which you’re no longer able to produce stomach acid. Atrophic gastritis and an acid-free stomach are associated with the following serious health complications:

• Peptic ulcers: Some people with atrophic gastritis develop peptic ulcers and open sores in the stomach lining. Stomach pain is the most common symptom of peptic ulcers.
• Stomach cancer: Acid-free stomach and atrophic gastritis significantly increase the risk of gastric cancer, also known as stomach cancer. Stomach cancer shares many symptoms—such as abdominal pain, nausea, weight loss, and dark stools—with chronic gastritis. It can also cause fatigue, excessive burping, and feeling full after eating a small amount of food.
• Vitamin deficiencies: Atrophic gastritis can sometimes make it more difficult for your body to absorb certain vitamins and micronutrients, such as zinc, iron, calcium, vitamin B12, and magnesium.
  

When to See a Healthcare Provider

Early treatment for chronic gastritis is key to preventing long-term complications. Talk to your healthcare provider as soon as possible if you experience symptoms of indigestion that aren’t going away or seem to be getting worse. If you notice any signs of internal bleeding, such as black stools, seek medical help right away.

H. pylori gastritis is typically treated with antibiotics, histamine 2 (H2) blockers, and proton pump inhibitors (PPIs). You might need to take two or more antibiotics to make sure that your H. pylori infection has cleared up. Iron and vitamin B12 supplements can work to treat autoimmune gastritis. If your stomach lining has been severely damaged by chronic gastritis, you may need surgery.

Your healthcare provider may also recommend that you use over-the-counter (OTC) medicines, such as antacids, to reduce the amount of acid in your stomach. They may suggest certain lifestyle changes, such as cutting back on alcohol, quitting smoking, reducing your use of NSAIDs, and changing your eating habits.

Summary

Chronic gastritis is a long-lasting condition that causes inflammation in the stomach lining. The most frequent cause of gastritis is a bacterial infection called Helicobacter pylori (H. pylori) infection. Other causes include excessive use of non-steroidal inflammatory drugs (NSAIDs), excessive drinking, smoking, kidney failure, recent surgery, stress, bile reflux, viral infections, cancer treatment, and severe illness. In rare cases, chronic gastritis can lead to complications like stomach cancer, peptic ulcers, and vitamin deficiencies.

The most common symptoms of chronic gastritis are indigestion, nausea, vomiting, feeling overly full, abdominal pain, loss of appetite, and weight loss. If chronic gastritis leads to bleeding in the stomach lining, symptoms may include dark stools, vomiting blood, stomach cramps, and shortness of breath.