Gastritis

About gastritis

Gastritis is inflammation (irritation) of the stomach lining.

This may be caused by many factors including infection, alcohol, particular medications and some allergic and immune conditions.

Gastritis can be either acute (with severe attacks lasting a day or 2) or chronic (with long-term appetite loss or nausea). In many cases, gastritis has no symptoms (asymptomatic).

Some forms, including chronic atrophic gastritis, have been associated with an increased risk of stomach cancer. Treatment options include avoiding exposure to known irritants and taking medication to reduce the amount of gastric juices.

Symptoms of gastritis

In many cases, gastritis has no symptoms. Common symptoms can include:

• loss of appetite
• pain in the upper abdomen just under the ribs
• nausea or indigestion
• hiccups
• vomiting
• blood in the vomit
• blood in the bowel actions, if the stomach lining has ulcerated (this turns stools black and is called melaena)
• weight loss.

The stomach

The stomach is an organ of the digestive system, located in the abdomen just below the ribs.

Swallowed food is mixed with gastric juices containing enzymes and hydrochloric acid.

The lining of the stomach, called the epithelium, is layered with multiple folds. The epithelium is coated with mucus (gastric mucosa) secreted by special glands. Inflammation caused by gastritis occurs in this lining.

Causes of gastritis

Gastritis can be caused by many different factors, including:

• medication such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDS)
• infection with the Helicobacter pylori bacteria, the organism responsible for the majority of stomach and duodenal ulcers
• alcohol
• protracted vomiting
• overproduction of gastric juices, which is a stress response in some people
• the backflow of bile from the small intestine (duodenum)
• some allergic and immune conditions – for example, pernicious anaemia
• exposure to radiation.

Diagnosis of gastritis

Diagnosing gastritis involves a variety of tests, including:

• Endoscopy – a thin flexible tube is threaded down the oesophagus into the stomach. The endoscope is fitted with a small camera so the physician can look at the stomach lining. If the gastric mucosa is reddened, this may indicate gastritis. A biopsy is needed for confirmation.
• Biopsy – small tissue samples are taken during an endoscopy and tested in a laboratory. The pathologist will look for changes, including the presence of inflammatory cells and epithelium damage.

Treatment for gastritis

Treatment for gastritis may include:

• Identifying the cause – once the cause is identified, steps can be taken to avoid exposure. For example, if alcohol is triggering the inflammation, you can abstain or reduce the amount of alcohol you drink. Anti-inflammatory drugs taken to help manage other conditions may need to be stopped or replaced with an alternative.
• Medication – tablets are available to reduce the acid content in the gastric juices. You may need to take these medications for a few weeks or months, depending on your situation.
• Dietary modifications – such as limiting or avoiding alcohol and caffeine, which can irritate the stomach lining.
• No treatment – often gastritis is found by chance during an endoscopy. If Helicobacter pylori is not present, and there are no other features seen on biopsy, there is usually no need to treat the gastritis.

Helicobacter pylori infection

The Helicobacter pylori bacterium causes gastritis and is also responsible for most peptic ulcers. A peptic ulcer is a hole in the lining of the stomach, duodenum or oesophagus.

Helicobacter pylori bacterium is thought to be a cause of indigestion and a contributing factor in the development of stomach cancer.

The germs live in the lining of the stomach and the chemicals they produce cause irritation and inflammation.

Diagnosis includes a special breath test to check for gaseous by-products of the bacteria.

Treatment includes a combination of different antibiotics, followed by breath tests to make sure the medication has worked.

Where to get help

• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Gastroenterologist
• Priority Primary Care Centre