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Gastritis: Indigestion, Symptoms, Causes, Treatment, Diagnosis

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Your stomach has a protective lining of mucus called the mucosa. This lining protects your stomach from the strong stomach acid that digests food. When something damages or weakens this protective lining, the mucosa becomes inflamed, causing gastritis. A type of bacteria called Helicobacter pylori (H. pylori) is the most common bacterial cause of gastritis.


What’s the difference between gastritis and indigestion?

Gastritis symptoms can mimic indigestion symptoms. Indigestion is pain or discomfort in the stomach associated with difficulty in digesting food. It may be a feeling of burning between your lower ribs. You may hear indigestion referred to by its medical term, dyspepsia.

How common is gastritis?

Acute (sudden) gastritis affects about 8 out of every 1,000 people. Chronic, long-term gastritis is less common. It affects approximately 2 out of 10,000 people.

Who might get gastritis?

Your risk of developing gastritis goes up with age. Older adults have thinner stomach linings, decreased circulation and a slower metabolism of mucosal repair. Older adults are also more likely to be on medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) that can cause gastritis. About two-thirds of the world's population is infected with H. pylori. Fortunately, it is less common in the United States. In the United States, H. pylori is found more often in older adults and lower socioeconomic groups.

What are the types of gastritis?

There are two main types of gastritis:

  • Erosive (reactive): Erosive gastritis causes both inflammation and erosion (wearing away) of the stomach lining. This condition is also known as reactive gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or bacterial infections and stress from illnesses or injuries.
  • Non-erosive: Inflammation of the stomach lining without erosion or compromising the stomach lining.

What causes gastritis?

Gastritis occurs when something damages or weakens the stomach lining (mucosa). Different things can trigger the problem, including:

  • Alcohol abuse: Chronic alcohol use can irritate and erode the stomach lining.
  • Autoimmune disease: In some people, the body’s immune system attacks healthy cells in the stomach lining.
  • Bacterial infection: H. pylori bacteria are the main cause of chronic gastritis and peptic ulcer disease (stomach ulcers). The bacteria break down the stomach’s protective lining and cause inflammation.
  • Bile reflux: The liver makes bile to help you digest fatty foods. “Reflux” means flowing back. Bile reflux occurs when bile flows back into the stomach instead of moving through the small intestine.
  • Medications: Steady use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids to manage chronic pain can irritate the stomach lining.
  • Physical stress: A sudden, severe illness or injury can bring on gastritis. Often, gastritis develops even after a trauma that doesn’t involve the stomach. Severe burns and brain injuries are two common causes.

What are the symptoms of gastritis?

Many people with gastritis don’t have symptoms. People who do have symptoms often mistake them for indigestion. Other signs of gastritis include:

  • Black, tarry stool.
  • Bloating.
  • Nausea and vomiting.
  • Feeling extra full during or after a meal.
  • Loss of appetite.
  • Stomach ulcers.
  • Losing weight without meaning to.
  • Upper abdominal (belly) pain or discomfort.
  • Vomiting blood.

Is gastritis contagious?

Gastritis isn’t contagious, but the bacteria, H. pylori, can be contagious via the fecal-to-oral route. Good hand washing before handling of foods and proper sanitation (sewer and water systems) are the first line of defense against spread. Many people can develop gastritis after being infected with H. pylori bacteria.

How is gastritis diagnosed?

Your healthcare provider will ask about your symptoms and history and perform a physical exam. Your provider may also order one or more of these tests:

  • Breath test: During an H. pylori breath test, you swallow a capsule or liquid containing urea, a harmless radioactive material. You then exhale into a balloon-like bag. H. pylori bacteria change urea into carbon dioxide. If you have the bacteria, the breath test will show an increase in carbon dioxide.
  • Blood test: A blood test checks for antibodies titers that fight H. pylori bacteria.
  • Stool test: This test checks for H. pylori bacteria in your stool (poop).
  • Upper endoscopy: Your doctor uses an endoscope (a long thin tube with an attached camera) to see your stomach. The doctor inserts the scope through your esophagus, which connects your mouth to your stomach. An upper endoscopy procedure allows your provider to examine the stomach lining. You may also have a tissue sample (biopsy) taken from your stomach lining to test for infection.
  • Upper gastrointestinal (GI) exam: During an upper GI exam, you swallow a chalky substance called barium. The liquid coats your stomach lining, providing more detailed X-ray images.

How is gastritis treated?

Treatment for gastritis varies depending on the cause. Certain medications kill bacteria, while others alleviate indigestion-type symptoms. Your healthcare provider might recommend:

  • Antibiotics: Antibiotics can treat the bacterial infection. You may need to take more than one type of antibiotic for couple of weeks.
  • Antacids: Calcium carbonate medications reduce stomach acid exposure. They can help relieve inflammation. Antacids, such as Tums® and Rolaids®, also treat heartburn.
  • Histamine (H2) blockers: Cimetidine (Tagamet®), ranitidine (Zantac®) and similar medications decrease the production of stomach acid.
  • Proton pump inhibitors: These medications, such as omeprazole (Prilosec®) and esomeprazole (Nexium®), reduce the amount of acid your stomach produces. Proton pump inhibitors also treat stomach ulcers and gastroesophageal reflux disease (GERD).

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.

How can I prevent gastritis?

H. pylori is one of the top causes of gastritis, but most people don’t know they’re infected. The bacteria are easily transmitted. You can lower your risk of infection by practicing good hygiene, including hand-washing.

You also can take steps to minimize indigestion and heartburn. These conditions are linked to gastritis. Preventive measures include:

  • Avoiding fatty, fried, spicy or acidic foods.
  • Cutting back on caffeine.
  • Eating smaller meals throughout the day.
  • Managing stress.
  • Not taking NSAIDs.
  • Reducing alcohol consumption.
  • Not lying down for 2 to 3 hours after a meal.

What is the prognosis (outlook) for people with gastritis?

Most cases of gastritis improve quickly with treatment. For most people, medications relieve gastritis. Your healthcare provider will recommend the most appropriate treatment based on what’s causing gastritis. Antacids reduce stomach acid, while antibiotics clear up bacterial infections. You can also make changes like reducing your alcohol consumption and managing pain without NSAIDs.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • Blood in your stool (poop).
  • Bloody vomit.
  • Extreme weakness or fatigue that may indicate anemia.
  • Uncontrolled GERD.
  • Unexplained weight loss.
  • Signs of gastritis recurring (coming back).

What questions should I ask my doctor?

If you have gastritis, you may want to ask your healthcare provider:

  • Why did I get gastritis?
  • Should I get tested for H. pylori?
  • Should I get tested for anemia?
  • Can I get gastritis again?
  • What steps can I take to avoid getting gastritis again?
  • Should I make any dietary changes?
  • What medications or supplements should I avoid?
  • Do I need to cut out alcohol?
  • Should I look out for signs of complications?
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