Gastritis

Gastritis Overview
Gastritis, an infammation or irritation of the lining of the stomach, is not a
single disease. Rather, gastritis is a condition that has many causes.
Common to all people with gastritis is pain or discomfort in the upper part
of the belly (abdomen), sometimes called dyspepsia.
Gastritis can be a brief and sudden illness (acute gastritis), a longer-
lasting condition (chronic gastritis), or a special condition, perhaps as part
of another medical illness.
An eample of acute gastritis is stomach upset that may follow the
use of alcohol or aspirin.
Helicobacter pylori is a type of bacteria that infects the stomach.
!nfection with this bacteria may lead to chronic gastritis.
Gastritis is a common medical problem. "p to #$% of people who come to
a hospital emergency department with abdominal pain ha&e gastritis.
Gastritis Causes
Gastritis is associated with &arious medications, medical and surgical
conditions, physical stresses, social habits, chemicals, and infections.
'ome of the more common causes of gastritis are listed here.
Medications
Aspirin (more than ($$ drug products contain some form of aspirin)
)onsteroidal anti-infammatory drugs ()'A!*s, such as ibuprofen or
naproen)
'teroids (prednisone is one eample)
+otassium supplements
!ron tablets
Cancer chemotherapy medications
Swallowing poisons or objects
Corrosi&es (acid or lye)
Alcohols of &arious types
'wallowed foreign bodies (paper clips or pins)
Medical and surgical conditions
+hysical stress in people who are critically ill or in,ured
After medical procedures (such as endoscopy, in which a specialist
loo-s into the stomach with a small lighted tube)
After an operation to remo&e part of the stomach
After radiation treatment for cancer
Autoimmune diseases
+ernicious anemia
Chronic &omiting
Infections
.uberculosis
'yphilis
/acterial infections0 H pylori infection is the most common. 1any
other bacteria2e&en those that usually cause pneumonia or bladder
infections2can cause gastritis.
3iral infections
4ungal (yeast) infections
+arasites and worms
Gastritis Symptoms
'ymptoms of gastritis do not always correspond to the etent of physical
changes in the lining of the stomach.
.he stomach lining can be eamined with an endoscope, a thin
probe with a tiny camera on the end that can be inserted into the
stomach.
'e&ere gastritis may be present when the stomach is &iewed
without symptoms being present.
'e&ere gastritis symptoms may be present despite only minor
changes in the stomach lining.
5lderly people in particular ha&e a much higher li-elihood of
de&eloping painless stomach damage. .hey may ha&e no symptoms
at all (no nausea, &omiting, pain) until they are suddenly ta-en ill
with internal bleeding.
!n people who ha&e gastritis symptoms, pain or discomfort in the upper
abdomen is the most common.
.he pain is usually in the upper central portion of the abdomen (the
6pit6 of the stomach).
Gastritis pain occurs in the left upper portion of the abdomen and in
the bac-. .he pain seems to 6go right straight through6 a person as
it tra&els from the belly to the bac-.
+eople often use the terms burning, aching, gnawing, or sore to
describe the pain. "sually, a &ague sense of discomfort is present,
but the pain may be sharp, stabbing, or cutting.
7ther symptoms of gastritis include the following0
/elching0 /elching usually either does not relie&e the pain or
relie&es it only briefy.
)ausea and &omiting0 .he &omit may be clear, green or yellow,
blood-strea-ed, or completely bloody, depending on the se&erity of
the stomach infammation.
/loating
4eeling of fullness or burning in the upper part of the belly
!n more se&ere gastritis, bleeding may occur inside the stomach. Any of
the following symptoms can be seen as well as those already mentioned.
+allor, sweating, and rapid (or 6racing6) heart beat.
4eeling faint or short of breath
Chest pain or se&ere stomach pain
3omiting large amounts of blood
/loody bowel mo&ements or dar-, stic-y, &ery foul-smelling bowel
mo&ements
Any or all of these symptoms can occur suddenly. .his is particularly true
in adults older than 89 years.
When to Seek Medical Care
'ee your health care pro&ider if your symptoms are new, long-lasting, or
worsening despite self-care.
.here is little need to see a medical professional in the following cases0
!f there is an ob&ious cause for your gastritis symptoms such as
ta-ing aspirin on an empty stomach
!f your symptoms are mild
!f you are able to ta-e medications to relie&e your symptoms
!f you are better in a short period of time
'ee- immediate medical attention if you ha&e any of the following
symptoms. :our decision to call ;## or to see- medical care will be based
on your ,udgment of how sic- you feel. .hin- of the following symptom list
as a general guideline.
+ain that is se&ere or di<erent than your usual gastritis pain
/lood in bowel mo&ements
*ar-, stic-y, foul-smelling bowel mo&ements0 .his may mean there
is blood in the bowel mo&ement e&en if it is not bright red.
'ymptoms that continue e&en though you are following your health
care pro&ider=s recommendations
3omiting that does not allow you to ta-e food, fuids, and
medications
4e&er with abdominal pain
4ainting or feeling faint
Rapid heartbeat
"neplained sweating
+allor
Repeated &omiting of green or yellow material
3omiting any amount of blood
'hortness of breath
Chest pain
!ams and "ests
>hether you see your own health care pro&ider in his or her o?ce or go to
an emergency department, the e&aluation is the same.
.he health care pro&ider @rst inter&iews you about your symptoms,
medical history, habits and lifestyle, and the medications you ta-e.
.his information is enough to ma-e the diagnosis in many people.
/e sure to tell him or her about all the medications you ta-e,
including nonprescription drugs, herbal and botanical preparations,
and supplements such as &itamins.
Also report any measures you ha&e ta-en to relie&e the symptoms
and how well those measures wor-ed.
Aaboratory testing0 )o laboratory tests can pinpoint a diagnosis of
gastritis.
7ften, no tests are necessary.
!f your health care pro&ider orders tests, it is probably to rule out
certain medical conditions.
!f all other possibilities are ruled out, that lea&es gastritis as the
most li-ely cause of your symptoms.
.he following tests are most li-ely to be ordered0
/lood cell counts (loo-ing mostly for anemia, a low blood count)
Ai&er and -idney functions
"rinalysis
Gallbladder and pancreas functions
+regnancy test
H pylori tests
'tool, for blood
B-rays @lms or other diagnostic images may be ordered, although they are
usually not necessary.
An 5CG (a heart wa&e tracing) is usually performed if your heartbeat is
rapid or you are ha&ing chest pain.
:ou may be referred to a gastroenterologist, a doctor who specialiCes in
diseases of the digesti&e system.
.he gastroenterologist may in turn recommend an endoscopy.
*uring the endoscopy, a thin, feible probe with a tiny camera on
the end is sent into your stomach for a direct loo-.
At the same time, samples of your stomach lining can be ta-en to
test for a wide &ariety of conditions.
Gastritis "reatment
7nce the diagnosis of gastritis has been con@rmed by a medical
professional, treatment can begin. .he choice of treatment depends to
some etent on the cause of the gastritis. 'ome treatments target the
eact cause of a particular type of gastritis. 1ost treatments aim at
reducing symptoms. :our stomach often will heal o&er time if it is
protected.
Self#Care at $ome
!f you -now what causes your gastritis, the simplest way to a&oid the
disease is to a&oid the cause.
Aspirin and alcohol are D widely used substances that cause
gastritis.
!f you de&elop an upset stomach and nausea after drin-ing alcohol
or using aspirin, then a&oid these substances.
'ometimes you cannot a&oid certain substances that cause gastritis.
:our health care pro&ider may ha&e a good reason to recommend
aspirin, iron, potassium, or some other medication that causes
gastritis.
!f you de&elop minor gastritis symptoms, it may be wisest to
continue the recommended medication and treat the gastritis
symptoms.
Consult your health care pro&ider before stopping any medication.
!n the case of aspirin, coated aspirin may not cause the same symptoms.
.his is because coated aspirin does not dissol&e in the stomach.
Chec- the contents of any other o&er-the-counter medication you
are ta-ing because more than ($$ medications contain aspirin in
some form.
)onsteroidal anti-infammatory drugs ()'A!*s) such as ibuprofen (Ad&il,
1otrin, )uprin) also cause gastritis.
:our health care pro&ider may recommend that these medications
be ta-en with food or with antacids.
*oing this may lessen the chance of de&eloping gastritis symptoms.
'witching from aspirin or )'A!*s to another pain relie&er may help as
well. Acetaminophen (AiEuiprin, .ylenol, +anadol) is not -nown to cause
gastritis.
.al- with your health care pro&ider before simply switching to
acetaminophen, howe&er.
Fe or she may ha&e recommended aspirin or an )'A!* for a speci@c
purpose.
Acetaminophen and aspirin are both pain relie&ers, but they
are di<erent medications.
!f gastritis symptoms continue, antacids are sometimes
recommended. .hree main types of antacids are a&ailable. All ( are about
eEual in e<ecti&eness.
1agnesium-containing antacids may cause diarrhea. +eople with
certain -idney problems should use these cautiously or not at all.
Aluminum-containing antacids can cause constipation.
Calcium-containing antacids ha&e recei&ed a great deal of attention
for their ability to control stomach acid and also supplement body
calcium. Calcium supplementation is most important for
postmenopausal women. Calcium-based antacids can also lead to
constipation, howe&er.
Antacids may also change your body=s ability to absorb certain other
medications.
!f you reEuire an antacid more than occasionally, let your health
care pro&ider decide which one is best for you.
Fistamine (FD) bloc-ers ha&e recei&ed a lot of attention for stomach
problems.
'ome of these medications2cimetidine (.agamet) and ranitidine
(Gantac) are D eamples2are a&ailable without a prescription.
Fistamine bloc-ers wor- by reducing acid secretion in the stomach.
.his reduces gastritis pain and other symptoms.
!f you need one of these medications regularly, you should consult
your health care pro&ider for a recommendation.
'tronger medications that protect the stomach=s lining or lessen acid
production in the stomach are a&ailable by prescription. .al- to your
health care pro&ider if the nonprescription medications do not wor- for
you.
Medical "reatment
.he safest treatment is to a&oid substances that trigger gastritis
symptoms.
Almost all health care pro&iders would recommend this as the @rst
step in pre&enting gastritis.
4irst, you ha&e to identify what these triggers are for you.
1ost people are fairly aware of their triggers before see-ing medical
care.
!f you do not -now your triggers, your health care pro&ider can help
you @gure them out.
Common a&oidable triggers of gastritis symptoms include the following.
'ee Causes for a more complete list.
Certain medications and poisons
Cigarette smo-ing
Alcohol
Co<ee and other be&erages that contain ca<eine, such as cola and
tea
Medications
Fistamine (FD) bloc-ers0 4our histamine bloc-ers are a&ailable in the
"nited 'tates. 'ome are a&ailable without a prescriptionH others reEuire a
prescription.
All wor- by bloc-ing the release of acid from specialiCed glands in
your stomach.
.he idea is that producing less acid allows your stomach to heal.
7nce healed, the pre&iously infamed stomach then causes no
further symptoms.
Commonly prescribed FD-bloc-ers include cimetidine (.agamet),
famotidine (+epcid), niCatidine (Aid), and ranitidine (Gantac).
+roton pump inhibitors (++!s)0 .hese medications are &ery powerful
bloc-ers of the stomach=s ability to secrete acid.
A health care pro&ider who prescribes one of these medications to
treat your gastritis may be doing so in consultation with a
gastroenterologist.
.hese medications include lansopraCole (+re&acid) and omepraCole
(+rilosec, Aosec).
Coating agents0 .hese medications protect the stomach=s lining.
'ucralfate (Carafate) I Coats and protects the stomach lining
1isoprostol (Cytotec) I Also protects the stomach lining, used as a
pre&enti&e measure for people ta-ing )'A!*s who are at high ris-
for de&eloping stomach damage
Antibiotics0 An antibiotic may be prescribed if H pylori is demonstrated to
be the cause of your gastritis.
Antiemetics0 .hese medications help control nausea and &omiting. A
number of di<erent antiemetics can be used in the emergency
department to control those symptoms. 'ome these medications are
a&ailable by prescription for home use as well.
%e!t Steps &ollow#up
!n general, follow-up care for gastritis is &ery straightforward.
A&oid those things that irritate your stomach or cause your
symptoms to fare up.
.a-e your medications as prescribed by your health care pro&ider.
Return for medical attention if your symptoms worsen or persist.
Report any new symptoms to your health care pro&ider.
'revention
.he mainstay of gastritis pre&ention is to a&oid those things that irritate or
infame your stomach=s lining.
Aspirin (use coated aspirin if you must ta-e aspirin)
)'A!*s such as ibuprofen (1otrin, Ad&il) or naproen ()aprosyn)
'mo-ing
Ca<eine and other ca<eineli-e substances
Alcohol
!f your health care pro&ider has prescribed a medication that you thin- is
causing gastritis symptoms, tal- to him or her before you stop ta-ing the
medication. .he medication may be &ery important for your health.
Outlook
1ost people reco&er from gastritis. *epending on the many factors that
a<ect your stomach lining, gastritis symptoms may fare up from time to
time. 7&erall, gastritis is generally a common, mildly troubling ailment
that responds well to simple treatments.
7n occasion, rare forms of gastritis can be serious or e&en life threatening.
'e&ere, ongoing symptoms or internal bleeding should alert your health
care pro&ider to search for a more serious underlying cause.