Definition
Gastritis is an inflammation, irritation or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).
Causes of gastritis
Gastritis can be caused by irritation due to excessive alcohol use, chronic vomiting, stress, or the use of certain medications such as aspirin or other anti-inflammatory drugs. It may also be caused by any of the following:
- Helicobacter pylori (H. pylori): A bacteria that lives in the mucous lining of the stomach; without treatment, the infection can lead to ulcers, and in some people, stomach cancer.
- Pernicious anaemia: A form of anaemia that occurs when the stomach lacks a naturally occurring substance needed to properly absorb and digest vitamin B12
- Bile reflux: A backflow of bile into the stomach from the bile tract (that connects to the liver and gallbladder)
- Infections caused by bacteria and viruses
If gastritis is left untreated, it can lead to a severe loss of blood and may increase the risk of developing stomach cancer.
Signs and symptoms of gastritis
Symptoms of gastritis vary among individuals, and in many people there are no symptoms. However, the most common symptoms include:
- Nausea
- Vomiting
- Indigestion
- Loss of appetite
- Vomiting blood
- Abdominal pain
- Unexplained weight loss
- Hiccups
- Heartburn
Diagnosis of gastritis
To diagnose gastritis, your doctor will review your personal and family medical history, perform a thorough physical evaluation, and may recommend any of the following tests:
- Upper endoscopy: An endoscope, a thin tube containing a tiny camera, is inserted through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may perform a biopsy, a procedure in which a tiny sample of tissue is removed and then sent to a laboratory for analysis.
- Blood tests: The doctor may perform various blood tests, such as checking your red blood cell count to determine whether you have anaemia, which means that you do not have enough red blood cells. He or she can also screen for Helicobacter pyroli ( pylori) infection and pernicious anaemia with blood tests.
- Faecal occult blood test (stool test): This test checks for the presence of blood in your stool, a possible sign of gastritis.
- X-rays
- Endoscopy: To check for stomach lining inflammation and mucous erosion
- Stomach Biopsy: To test for gastritis and other conditions.
Morphological pattern
- Acute: Erosive gastritic mucosal erosion caused by mucosal defenses. cyclooxygenase-1, or COX-1, an enzyme responsible for the biosynthesis of eicosanoids in the stomach, which increases the possibility of peptic ulcers forming. Also, aspirin, reduce a substance that protects the stomach called prostaglandin. These drugs used in a short period are not typically dangerous. However, regular use can lead to gastritis.
- Chronic: Chronic gastritis refers to a wide range of problems of the gastric tissues. The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining. In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis. Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn’s disease, certain connective tissue disorders, and liver or kidney failure. Since 1992 chronic gastritis lesion are classified according to the Sydney system.
Nutritional management of gastritis
For decade, doctors have recommended dietary changes to prevent or treat gastritis common suggestions have included spicy foods, coffee and alcohol or increase consumption of bland food milk.
While these suggestions have seemed reasonable, some have not stood up well in controlled trials. For example, milk ingestion tends to increase acid production. And although certain spices (black pepper, chili powder, and red pepper) may cause indigestion, they have not been shown to contribute to gastritis.
The following factors have been associated with reduced risk of gastritis in studies:
- High–fibre diets: A large study at the Harvard School of Public Health found that high–fibre diets were associated with reduced risk of developing ulcers. Over a six–year period, the risk was 45 percent lower for those with the highest fibre intake, compared with those with the lowest. Food sources of soluble fibre (oats, legumes, barley, certain fruits and vegetables) were especially protective, resulting in a 60 percent lower risk in this group. However, supplementation with dietary fibre in the form of wheat bran had no effect on ulcer recurrence. Similarly, high–fibre diets appeared to have no benefit on ulcer healing rates compared with diets low in fibre.
- Diets high in vitamin A: In the same Harvard study, total vitamin A intake (from food and supplements) was associated with lower risk. The risk was 54 percent lower among persons consuming the most vitamin A, compared with those consuming the least.
- Green tea: Several studies show that regular green tea consumption is associated with a 40 to 50 percent lower risk for gastritis.
- Avoiding alcohol: The relationship between alcohol and gastritis and ulcers is complex and may be related to the amounts consumed. Chronic alcohol abuse favours Helicobacter pylori infection and also slows the rate of healing in existing gastritis. However, in combination with smoking, alcohol in any amount increases the risk for gastritis.
In addition, the following are under study for their role in disease management:
- Probiotics: Some studies have shown that probiotics also increase the effectiveness of antibiotic treatment for Helicobacter pylori and may reduce the side effects of treatment. However, further study is necessary before probiotics can be recommended for prevention or treatment of gastritis.
These steps may also help:
- Eat food containing flavonoids like apple.
- Avoid high fat food. In animal studies, high fat foods increase inflammation in the stomach lining.
- Eat foods high in vitamin B and calcium.
- Avoid refined foods such as white breads, pasta and sugar.
- Reduce or eliminate trans-fatty acid found in commercially baked foods such as cookies, crackers, French fries, onion-rings, donut and margarine.
- Drink 6-8 glasses of water daily.
- Exercise at least 30 minutes daily for five days in a week.
Conclusion
Gastritis is an inflammation of the lining of the stomach. Gastritis is a common condition most frequently caused by and infection of a type of bacteria called Helicobacter pylori which is also called peptic ulcer. Typical symptoms of gastritis include heartburn, nausea and vomiting. Gastritis is a treatable condition bit it can lead to dehydration and other complications such as developing a peptic ulcer, if left untreated.
Another cause of gastritis is long term physical and mental stress that result in the production of excessive amounts of stomach acid, gastritis also occur after or within a few days after a stressful even, such as illness, surgery or injury and result in peptic ulcers.
Smoking, alcoholism and excessive alcohol use can also cause gastritis. Drinking of coffee and acidic beverages can also underlie gastritis. Diagnosing gastritis and its root cause begin with taking a thorough personal and family medical history including symptoms and completing a physical examination. Diagnostic testing generally includes an endoscopy procedure, in this procedure, a special lighted instrument is inserted through the mouth and throat into the stomach. This treatment is called endoscopy. An endoscope takes picture of the stomach and/or send images to the computer monitor. Diagnosis may also include a complete blood count, which can help to determine if anaemia or an infectious process is present.
References
Dajani, E.Z. & Islam, K. (2008). “Cardiovascular and gastrointestinal toxicity of selective cyclo-oxygenase-2 inhibitors in man” (PDF). J Physiol Pharmacol 59(2), 117–33.
Joan, G. (2012). Oxford handbook of nutrition and dietetics (2nd ed. ed.). Oxford: Oxford University Press.
Kandulski, A., Selgrad, M. & Malfertheiner, P. (2008). “Helicobacter pylori infection: a clinical overview”. Digestive and Liver Disease 40 (8, 619–26.
Stephen Hauser (2014). Mayo Clinic Gastroenterology and Hepatology Board Review. Oxford: Oxford University Press.
Varbanova, M., Frauenschläger, K. & Malfertheiner, P. (2014). “Chronic gastritis – an update.”. Best Pract Res Clin Gastroenterol 28 (6), 1031–42.
Zajac, P., Holbrook, A., Super, M.E. & Vogt, M. (2013). “An overview: Current clinical guidelines for the evaluation, diagnosis, treatment, and management of dyspepsia”. Osteopathic Family Physician 5 (2),79–85.
