Gastritis

• Upper abdominal discomfort or pain
• Nausea
• Vomiting
• Blood in vomit
• Black, tarry stools
• Red blood in the stool

Any signs of blood in vomit or stools indicate an ulcer that may be bleeding in the stomach. Seek medical attention if any blood is present.

Acute gastritis. Inflammation that comes on suddenly and is severe is known as acute gastritis. The most common cause of acute gastritis is the overuse of NSAIDs such as ibuprofen or sodium naproxen.

Chronic gastritis. Occurs when the inflammation does not go away or lasts for a prolonged period.

Erosive gastritis. Prolonged inflammation of the stomach can cause the stomach lining to wear away and lead to erosive gastritis.

Non-erosive gastritis. Occurs when there is inflammation of the stomach lining without any wearing away.

Atrophic gastritis. A type of gastritis that destroys the cells in the stomach lining that produce digestive enzymes and acids. Occurs when gastritis is left untreated.

Helicobacter pylori (H. pylori) gastritis. Most cases of chronic non-erosive gastritis are caused by infection with the H. pylori bacteria. This bacterium is typically transmitted from person to person and is found in areas with poor sanitation. In the United States, 20-50% of people are infected with H. pylori. In poor countries, infection rates are much higher due to poor sanitation and contamination of the food and water supplies with the bacteria.

Autoimmune gastritis. An autoimmune disorder of the digestive system that causes the immune system to attack the healthy cells of the stomach lining.

Stress gastritis. Occurs when a stressor causes acute erosive gastritis. Surgery, traumatic injuries, severe burns, and a critical illness can all lead to developing gastritis.

Other causes of gastritis include:

• Bile acid reflux
• Crohn’s disease
• Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs)
• Medications
• Alcohol
• Cocaine
• Radiation
• Ménétrier disease

• Age (risk increases with age)
• Using pain relievers regularly
• History of bacterial infections
• Drinking alcohol excessively
• Stress
• HIV/AIDS
• Crohn’s disease
• History of parasitic infections

Before any tests are ordered, your doctor will take your medical history and give you a physical exam that involves palpating your stomach for tenderness and/or pain. If your doctor suspects you have gastritis, the following procedures and tests may be ordered:

Gastroscopy. In this procedure, the doctor uses an endoscope to look closely at the lining of your gastrointestinal tract. An endoscope has a light and a camera on one end that sends images of your esophagus, stomach, and duodenum (top part of your small intestine) to a monitor.

Urease breath test. A noninvasive test that checks for H. pylori infection. This test requires you to ingest urea in a pill or liquid (sometimes a pudding is available). If there are H. pylori bacteria present, the urea will be changed to carbon dioxide due to the bacteria breaking down the chemical. You will then be asked to breathe into a container that can detect the labeled chemical in your breath.

Fecal antigen test. Stool samples are tested to check for H. pylori infection and determine if there is bleeding in the stomach (blood in the stool).

Blood tests. These are ordered to rule out other causes of gastritis or signs of complications.

Mucosal biopsy. Usually taken during the gastroscopic exploration. In this procedure, a small piece of tissue from your stomach lining is taken and examined by a pathologist for abnormalities such as cancer cells or infections.

Treatment is based on the cause, but mild cases generally respond to antacids. Resistant varieties may need prescription medication to help reduce the amount of acid the stomach produces, or antibiotics to help fight any infections that might be present. Drugs commonly prescribed include:

• Proton-pump inhibitors
• Amoxicillin
• Clarithromycin
• Metronidazole

Essential oils. Studies have shown that lemongrass and lemon verbena essential oils may help to clear gastric H. pylori infection. Ginger, peppermint, and clove essential oils can positively affect the digestive system. Do not ingest essential oils and be sure to dilute your oils in a carrier oil.

Garlic extract. Louis Pasteur first discovered that garlic (and onion) juices were antibacterial in the lab, but garlic has been used for centuries to fight bacterial infections. Studies have shown that garlic extract inhibits the growth of H. pylori bacteria and may protect against infection.

Manuka honey and green tea. Drinking green tea with manuka honey has a double benefit. Green tea may reduce the number of H. pylori bacteria in the digestive tract while Manuka honey has antibacterial properties.

Probiotics. These good bacteria help to facilitate digestion and allow for smooth bowel movements. Many foods contain probiotics including fermented foods like sauerkraut and cultured foods and drinks (i.e., yogurt, kombucha, kefir).

Stress-relieving techniques. Stress can increase your risk for gastritis. There are many options for you to help manage stress. Breathing exercises, yoga, guided meditation, and prayer can help reduce your stress.

• Limit alcohol intake
• Do not smoke
• Minimize use of NSAIDs such as aspirin and ibuprofen
• Eat small meals
• Wash hands before and after eating

Some foods may trigger inflammation of the stomach lining. If you suspect that acertain food may be causing inflammation, then keep a food diary that includes symptoms that arise after eating. Some foods are known to increase inflammation. These include processed foods, gluten, and foods that are spicy, sugary, or acidic. Consider eating lighter meals to allow your digestive system time and space to digest food. Lastly, find a practice or activity that helps reduce your stress.

• Peptic ulcer disease
• Internal bleeding
• Obstruction
• Perforation
• Peritonitis
• Gastric polyps
• Benign gastric tumors
• Malignant gastric tumors
• Atrophic gastritis
• Gastric cancer
• Gastric mucosa-associated lymphoid tissue (MALT) lymphoma

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Cleveland Clinic Writing Staff. (2020, September 08). Gastritis. Retrieved from Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/10349-gastritis

Mayo Clinic Staff. (2020, April 03). Gastritis. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807

National Institute of Diabetes and Digestive and Kidney Diseases. (2019, August).  Diagnosis of gastritis and gastropathy. Retrieved from National Institute of Health: https://www.niddk.nih.gov/health-information/digestive-diseases/gastritis-gastropathy/diagnosis

National Institute of Diabetes and Digestive and Kidney Diseases. (2010, January).  Gastritis. Retrieved from Syracuse Gastroenterological Association: http://www.syracusegastro.com/docs/Gastritis_508.pdf

Pietrangelo, A. (2018, September 17). Gastric tissue biopsy and culture. Retrieved from Healthline: https://www.healthline.com/health/gastric-tissue-biopsy-and-culture#1