Gastritis (Stomach Wall Inflammation)

Definition

Inflammation of the mucosal lining of the stomach is defined as gastritis. It may reach a point where isolated spots become open sores known as ulcers. Although erosion of the gastric lining is common in inflammatory conditions, it is not a necessary feature of gastritis. Both acute and chronic forms of gastritis can occur. Old age increases the risk of gastritis but the condition may also occur in children, although it is usually acute in early life. The condition may be termed erosive when open sores form on the inner stomach lining or it may be non-erosive where the wall is inflamed but still remains intact.

Symptoms

Symptoms of gastritis may manifest even though damage to the mucosal lining is minimal, and in some cases, no symptoms may be seen in spite of marked erosion of the gastric lining. The major symptoms are :

  • Heartburn
  • Dyspepsia
  • Belching
  • Nausea and vomiting
  • Bloating
  • Change in appetite

Brown, blood-containing stools with a foul-smell and vomiting blood are signs of severe gastritis with bleeding from the stomach wall. Chronic gastritis can develop into complications like peptic ulcers, gastric polyps and tumors. In very rare cases, the ulcers that have developed can contribute to tearing of the stomach wall (perforation) allowing stomach contents to spill into the abdominal cavity.

Causes

The most common causes and risk factors are :

  • Infection by I –this is the major cause of gastritis in developing countries.
  • Prolonged intake of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
  • Stress – associated with critical illness.
  • Alcoholism.
  • Cigarette smoking.

H. pylori infections could lead to gastric carcinomas and other debilitating gastrointestinal diseases and hence its treatment is extremely crucial. Gastritis could be a symptom of tuberculosis, syphilis, yeast infections or viral infections. Cancer patients develop gastritis after radiation therapy and the intake of medications for cancer chemotherapy. Gastritis can also be an outcome of autoimmune reactions against the gastric lining (eosinophilic gastritis) or pernicious anemia, although these are less common.

The corrosion of gastric lining is usually visualized by endoscopy. X-rays after swallowing barium solutions may be used as a diagnostic tool. This is augmented with blood and stool tests to check for Helicobacter pylori infections. Blood tests also help to identify anemia which indicates the severity of the condition.

Treatment

The basic treatment regime for gastritis is very similar to that for acid reflux /GERD. It involves administration of antacids, H2 (histamine 2) blockers and proton-pump inhibitors.

  • Antacids provide quick, symptomatic relief.
  • H2 blockers reduce acid production in the stomach.
  • Proton pump inhibitors like inhibit acid production and aid with the healing of the the erosions of the gastric lining.

Further modifications to this basic regime would depend on the exact cause of gastritis. H.pylori infections are treated with a combination of proton-pump inhibitors and antibiotics like amoxicillin and clarithromycin. Drugs that cause gastritis would be discontinued and substituted by a more suitable alternatives. Vitamin B12 injections will be administered if pernicious anemia was diagnosed.

Dietary modification should involve avoiding foods that worsen the condition. Patients should ensure that they do not drastically change their eating habits.

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