Gastritis: Causes, Symptoms, Treatment, and Prevention

Gastritis can be caused by various factors, including:

1. Helicobacter pylori infection: This bacterium is the most common cause of gastritis. It infects the stomach lining, leading to inflammation. H. pylori is usually contracted through contaminated food or water, and it can persist in the stomach for years if left untreated.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like aspirin, ibuprofen, and naproxen can irritate the stomach lining, leading to gastritis. Prolonged or high-dose NSAID use increases the risk.
3. Excessive alcohol consumption: Alcohol can irritate and damage the stomach lining, causing acute or chronic gastritis. Heavy and long-term alcohol consumption is particularly associated with an increased risk.
4. Stress: While stress itself may not directly cause gastritis, it can contribute to its development or exacerbate existing gastritis. Severe stress can increase stomach acid production, making the lining more susceptible to inflammation.
5. Autoimmune disorders: In some cases, the immune system mistakenly attacks the cells of the stomach lining, leading to chronic autoimmune gastritis. This condition is more common in individuals with other autoimmune disorders, such as Hashimoto’s thyroiditis or type 1 diabetes.
6. Bile reflux: When bile, a digestive fluid produced by the liver, flows back into the stomach, it can irritate and inflame the stomach lining, leading to gastritis.
7. Other causes: Gastritis can also be caused by viral or bacterial infections other than H. pylori, such as herpes simplex virus or cytomegalovirus. Certain digestive diseases, such as Crohn’s disease or pernicious anemia, can also contribute to gastritis.

Some individuals may have gastritis without a clear identifiable cause. Additionally, factors such as genetics, lifestyle choices, and overall health can influence an individual’s susceptibility to gastritis.

The symptoms of gastritis can vary in intensity and duration depending on the underlying cause, the severity of inflammation, and individual factors. Here are some common symptoms associated with gastritis:

1. Upper Abdominal Pain or Discomfort: This is one of the most common symptoms of gastritis. The pain is usually located in the upper central abdomen, just below the sternum (breastbone). It may be described as a burning, gnawing, or dull ache. The pain may worsen after eating or on an empty stomach.
2. Nausea and Vomiting: Gastritis can cause feelings of nausea and an urge to vomit. In some cases, vomiting may occur, which may provide temporary relief but does not address the underlying cause.
3. Indigestion or Bloating: Gastritis can lead to indigestion, characterized by a sense of fullness, discomfort, or bloating in the upper abdomen after eating a meal.
4. Loss of Appetite: Many individuals with gastritis experience a decreased appetite and may feel full even after eating small amounts of food.
5. Heartburn or Acid Reflux: Gastritis can cause the stomach acid to irritate the lower esophagus, leading to a burning sensation in the chest (heartburn) or acid reflux, where stomach acid flows back into the throat, causing a sour or bitter taste.
6. Dark or Black Stools: Gastrointestinal bleeding resulting from severe gastritis can lead to the passage of dark, tarry stools called melena. This indicates the presence of blood in the digestive tract.
7. Fatigue and Weakness: Chronic gastritis, particularly when associated with conditions like pernicious anemia, can lead to a deficiency in vitamin B12 and iron. This can cause fatigue, weakness, and general malaise.
8. Weight Loss: In chronic cases of gastritis, individuals may experience unintentional weight loss due to reduced appetite, malabsorption of nutrients, and overall inflammation affecting the body’s metabolic processes.

Not everyone with gastritis experiences the same set of symptoms. Additionally, some individuals with gastritis may be asymptomatic, especially in the early stages or in cases of mild inflammation.

Diagnosing gastritis involves a combination of medical history assessment, physical examination, and specific diagnostic tests. Here are the common steps involved in diagnosing gastritis:

1. Medical History Assessment: Your gastroenterologist will ask you about your symptoms, their duration and severity, any factors that worsen or alleviate the symptoms, and your medical history. Providing information about your diet, lifestyle, and any medications or supplements you are taking is important for identifying potential causes or risk factors for gastritis.
2. Physical Examination: A physical examination may be conducted to assess abdominal tenderness, bloating, or any other signs that may suggest gastritis or other related conditions.
3. Blood Tests: Blood tests can provide valuable information in diagnosing gastritis. These tests may include:
   • Complete blood count (CBC): It helps to evaluate for anemia or signs of infection.
   • Tests for H. pylori infection: These include antibody tests, stool antigen tests, or urea breath tests to detect the presence of H. pylori bacteria.
   • Vitamin B12 levels: Low levels may indicate pernicious anemia associated with autoimmune gastritis.
4. Stool Tests: Stool tests may be conducted to check for the presence of blood (occult blood) in the stool or to detect H. pylori infection.
5. Endoscopy: A commonly used procedure for diagnosing gastritis is an upper endoscopy (also known as esophagogastroduodenoscopy or EGD). It involves the insertion of a thin, flexible tube with a light and camera (endoscope) into the esophagus, stomach, and duodenum. This allows the doctor to visually examine the stomach lining for signs of inflammation, erosions, or ulcers. During the procedure, biopsies (small tissue samples) may be taken from the stomach lining for further examination under a microscope.
6. Imaging Tests: In certain cases, imaging tests such as X-rays or abdominal ultrasound may be recommended to evaluate the digestive system, rule out other conditions, or assess the extent of gastritis.
7. Other Tests: In some instances, additional tests such as a gastric emptying study or a pH monitoring test may be conducted to evaluate the movement of food through the stomach or measure the amount of acid reflux.