An Overview of Gastritis

Inflammation of the stomach lining with multiple potential causes

In This Article

Man with indigestion
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Gastritis, which means inflammation of the stomach lining, can be a distressing and uncomfortable medical condition. If symptoms do occur, they often include upper abdominal pain, and sometimes, nausea, vomiting, and/or a feeling of fullness soon after eating. While there are many potential causes of gastritis, infection with a bacteria called Helicobacter pylori is one of the most common ones. Excessive nonsteroidal anti-inflammatory (NSAID) or alcohol use are additional common causes of gastritis.

Diagnosis of gastritis involves a detailed medical history and physical exam, along with blood tests, and sometimes an upper endoscopy, which allows your doctor to visualize your stomach lining. The good news is that once gastritis is diagnosed, it can usually be treated effectively. While your precise treatment regimen will depend on the underlying cause, an acid-reducing medication, like a proton pump inhibitor is often recommended.

Symptoms

The most common symptom of gastritis is upper abdominal upset or pain, often described as an uncomfortable "burning" or "gnawing" sensation.

Besides pain, other potential symptoms of gastritis include:

  • Belching
  • Abdominal bloating
  • Loss of appetite
  • Nausea or vomiting
  • Feeling of fullness after eating only a small meal

Blood in your vomit or dark or tar-colored stools may be a sign of bleeding in the stomach, as gastritis can promote ulcers to form, which are sores within the lining of the stomach

Additional signs and symptoms of bleeding in the stomach (all of which stem from iron deficiency anemia) include:

  • Fatigue
  • Trouble breathing
  • Dizziness
  • Weakness
  • Pale skin
  • Fast heartbeat

Important Point

If you are experiencing any signs or symptoms of bleeding in your stomach, it is important to seek immediate medical attention. Severe or worsening abdominal pain is another indication to seek attention right away.

Lastly, it's important to note that the symptoms of gastritis can come on suddenly and last for a short time—this is called "acute" gastritis. On the other hand, some people have "chronic" gastritis, which means the symptoms persist for months, even years.

Chronic gastritis is much more likely to lead to complications like ulcer formation and iron deficiency anemia from bleeding. Rarely, some people with chronic gastritis go on to develop gastric cancer.

Causes

There are multiple possible causes of gastritis. One of the most common causes is an infection with the bacteria, Helicobacter pylori.

Other potential causes include:

  • Drinking too much alcohol
  • Smoking
  • Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Infection with a virus, fungus, or bacteria (other than Helicobacter pylori)

In addition, gastritis may develop after major surgery, traumatic injury, burns, radiation, or a severe illness. Certain diseases, such as pernicious anemia (an autoimmune disease) and chronic bile reflux, can also cause gastritis. Sometimes, the precise cause of a person's gastritis remains unknown.

Diagnosis

After a careful medical history and physical examination, if your doctor suspects gastritis as a potential diagnosis, he will likely order blood tests and potentially, a set of X-rays called an upper gastrointestinal series.

If the diagnosis still remains in question, or if your gastritis is severe or persistent, your doctor will likely refer you to a gastroenterologist (a doctor who specializes in disease of the esophagus, stomach, and intestines). A gastroenterologist may then perform a procedure called an upper endoscopy.

Blood Tests

In order to evaluate for iron deficiency anemia from potential stomach bleeding, your doctor will order the following blood tests:

Your doctor may also check a vitamin B12 level to help diagnose pernicious anemia, a less common cause of gastritis. With pernicious anemia, a person's immune system misguidedly attacks a vitamin B-12 binding protein (called intrinsic factor), which is made by stomach cells. Sometimes, a person's immune system attacks the stomach cells themselves.

As a result of this immune system attack, vitamin B-12 absorption is impaired, causing low blood levels. Besides a vitamin B-12 level, another blood test used to diagnose pernicious anemia is autoantibodies to intrinsic factor (IF).

Lastly, a blood antibody test may be used to evaluate for Helicobacter pylori infection; although, other tests (see below) are more sensitive and specific.

Other Tests

Besides blood tests, other tests may be performed to support or confirm a diagnosis of gastritis.

  • A breath test may be recommended to test for Helicobacter pylori. With this test, a person drinks a special liquid and then their exhaled breath is examined to see if Helicobacter pylori breakdown products are present in the stomach.
  • A stool antigen test may also be recommended to test for Helicobacter pylori. With this test, a scientist will look for a protein (called an antigen) that is normally located on the surface of the bacteria.
  • A fecal occult blood test looks for blood in a stool sample; a positive test (meaning blood is present) suggests that there is some sort of bleeding within the digestive tract.

Upper Gastrointestinal Series

During an upper gastrointestinal series, a person first drinks "barium" (a chalky white substance mixed with water). Then, a series of X-rays will be taken. The barium coats a person's esophagus, stomach, and the first part of their small intestines, so a doctor can visualize the digestive tract. Various gastritis-related abnormalities can be seen with an upper gastrointestinal series, including ulcers and inflammation.

Upper Endoscopy

If the diagnosis of gastritis remains unclear, and/or if your symptoms are severe or persistent, an upper endoscopy may be performed. During an upper endoscopy, a gastroenterologist eases an endoscope, a thin tube containing a tiny camera, through your mouth (or occasionally nose) and into your stomach. With the camera, your doctor will check for inflammation and then, he may remove a tiny sample of tissue for tests (called a stomach biopsy).

Differential Diagnoses

Many other health conditions can cause symptoms similar to that found with gastritis. This is why a comprehensive evaluation with all of the above tests are often needed to confirm the diagnosis.

Below are examples of disease that can mimic gastritis:

In addition, non-gastrointestinal conditions can be mistaken for acute gastritis, such as:

Acute coronary syndrome, such as unstable angina or an acute myocardial infarction (heart attack), is a gastritis-mimicker that requires emergent diagnosis and treatment. An electrocardiogram (ECG) and cardiac enzymes (a blood test) are required to distinguish "stomach" pain from heart-related pain.

Treatment

Treatment of gastritis first entails addressing the underlying cause.

For example, if alcohol or NSAIDs are the culprits behind your gastritis, then stopping them is essential.

If a Helicobacter pylori infection is the cause, your doctor will prescribe you a two-week medication regimen that usually consists of two antibiotics and a proton pump inhibitor. Proton pump inhibitors work by reducing stomach acid, thereby easing gastritis symptoms and promoting tissue healing. (Stomach acid irritates the inflamed tissue in the stomach.)

Important Points

Once the underlying gastritis culprit disappears, your pain and other symptoms should subside. Of course, be sure to see your doctor before stopping any medicine or starting any gastritis treatment on your own.

Once identifying and eliminating the underlying cause (if known), an acid-reducing medication may be recommended.

Besides a proton pump inhibitor, such as Prilosec (omeprazole) or Nexium (esomeprazole), a histamine blocker, like Pepcid (famotidine) or Zantac (ranitidine), may be recommended. Sometimes, an antacid is included in your treatment plan for rapid relief.

Keep in mind, these acid-reducing medications are generally only recommended for a short period of time. This is especially true for the proton pump inhibitors, as they have been linked to adverse health effects with long-term use.

Prevention

Besides avoiding or minimizing the potential causes of gastritis (e.g., smoking, regular NSAID use, and excessive alcohol intake), researchers have looked into whether preventing Helicobacter pylori infection is possible, considering this bacteria is a very common cause of gastritis.

Since infection with Helicobacter pylori is often acquired during early childhood and often spread from person to person through the fecal-oral or oral-oral route, teaching parents and their children to practice good hygiene habits may help prevent future gastritis.

Besides washing your (and your child's) hands regularly with soap and water, other hygiene habits include:

  • Ensuring your water comes from a safe, clean source
  • Eating food that is properly washed and cooked
  • Not sharing utensils, toothbrushes, glasses, or cups
  • For mothers of infants, avoiding putting your mouth on your child's pacifier, bottle, or tasting their food

A Word From Verywell

Gastritis is an unpleasant health condition; albeit in many cases, it's short-lived and easily treated. If you are diagnosed with gastritis, be sure to follow-up with your doctor as instructed. Sometimes repeat tests are needed, such as a stool or breath test for infection with Helicobacter pylori, to ensure effective treatment.

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