Gastritis

Patient Education > Stomach - Abdomen > Gastritis

What is gastritis?

Gastritis is an inflammation of the lining of the stomach. It is not a single disease, but rather a group of disorders. Gastritis can weaken the stomach lining and cause bleeding. In some cases gastritis does not damage the stomach lining, nor have a specific cause.

What are the signs and symptoms of gastritis?

The most common symptoms of gastritis are indigestion, heart burn, nausea, loss of appetite, and abdominal pain that is often worse after eating. Some patients exhibit gastrointestinal bleeding as manifested by vomiting material that looks like coffee grounds, or by having very dark, black, sticky, foul smelling stools.

What causes gastritis?

The causes of gastritis are many. Often more than one factor is present. This includes aspirin use, alcohol, or tobacco use. Gastritis can occur during a sudden or severe illness, as well as from reflux (regurgitation) injury, such as bile backing up into the stomach from its origin in the duodenum. Different types of trauma can cause gastritis including surgery, radiation, chemotherapy, severe vomiting, or swallowed foreign objects. Infections are known to cause gastritis, including certain bacteria (Helicobacter pylori), viruses, fungi, and parasites. Gastritis can result from nutritional or metabolic disorders such as pernicious anemia. In addition, gastritis can be seen as part of other systemic diseases such as Crohn’s disease.

How is gastritis diagnosed?

Your physician generally can diagnose gastritis based on your medical history and by conducting a physical examination. Sometimes a trial of medical therapy will help determine the presence or absence of gastritis. In some situations you will need to undergo upper GI endoscopy, also known as EGD (esophagogastroduodenoscopy). Endoscopy allows for direct viewing of the lining of the stomach to take photographs and perform biopsies (removal of tissue) to determine the cause of gastritis.

How is gastritis treated?

Gastritis treatment depends on the cause of the stomach inflammation. The most common cause is a bacterial infection called Helicobacter pylori, or H. pylori for short. This is a common bacterial cause of both gastritis and ulcers. It can be treated with multiple drug combinations given over a two week period. Examples of these medications include Pepto-Bismol, metronidazole, tetracycline, amoxicillin, and Biaxin. For some types of gastritis, you must stop ingesting all irritating substances, including alcohol, tobacco, aspirin, and any offending foods. Many patient’s symptoms can be controlled with over-the-counter (OTC) medications such as antacids, H2 blockers (Tagamet OTC, Pepcid OTC, Axid OTC, Zantac OTC). For some it will be necessary to utilize prescription strength H2 blockers (Tagamet, Pepcid, Axid, Zantac) or a group of medications called PPIs (proton pump inhibitors) such as Prevacid, Prilosec, Aciphex, Nexium, or Protonix.

Are there alternative therapies to treat gastritis?

Some patients experience reduced symptoms and improved healing of their gastritis by use of nutritional and herbal supplements. Data is still being gathered regarding their ability to heal the stomach lining, fight infection, and reduce recurrence.

Complimentary nutritional therapies include avoidance of dairy products, caffeine, alcohol, and sugar. Coffee, even decaffeinated, should be eliminated because it contains potentially irritating oils. Patients with known food allergies should eliminate them from their diet. Sulfur containing foods such as garlic, onions, broccoli, cabbage, brussels sprouts, and cauliflower help form a chemical call glutathione which helps provide protection to the stomach lining. Vitamin C reduces substances known as nitrosamines, which have been linked to stomach cancer. Zinc may also help heal your stomach lining.

As with any therapy, it is important to work with your physician on getting your problem properly diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerates (glycerin extracts), or tinctures (alcohol extracts). Unless otherwise indicated, tea should be made with 1 teaspoon of herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink two to four cups per day. Examples of such herbs include DGL (deglycyrrhizinized licorice) to increase circulation and healing to the stomach lining. Powders of slippery elm and marshmallow root may be taken singly or together to decrease inflammation and encourage healing. Ginger root tea increases circulation and enhances digestion.

Is there a link between gastritis and cancer?

There is no evidence that gastritis, frequently observed in patients with peptic ulceration, has any cancer (malignant) potential. The incidence of stomach cancer in a particular type of gastritis, called atrophic gastritis, increases with age. There seems to be a link between stomach cancer and patients with chronic or long-term gastritis associated with pernicious anemia. This is present in approximately 3% of people older than 60 years. For individuals in whom pernicious anemia has been active for more than five years, the risk of gastric cancer is twice that of similarly aged patients without pernicious anemia. Therefore, any patient with longstanding pernicious anemia who develops new symptoms should undergo upper GI endoscopy (EGD).

There is ongoing study to determine the possible role of H. pylori as a precursor for developing stomach cancer.

Is gastritis associated with stomach ulcers?

Chronic or longstanding gastritis and atrophic gastritis are commonly associated with stomach ulcers. However, it is not known whether the ulcer is the initial event with subsequent gastritis, or whether gastritis precedes ulceration.