Gastritis: More than Just a Grumbling Stomach

Ever experienced vomiting blood or having coffee-ground like material and dark stool? Ever felt abdominal pain, nausea, vomiting, and constant hiccups? Then you might be one of the more than 10% of people who come to a hospital emergency department with gastritis. Gastritis is a common medical problem of the stomach.

The stomach is an organ of the digestive system, located in the abdomen just below the ribs. Swallowed food is mixed with gastric juices containing enzymes and hydrochloric acid. The lining of the stomach called the epithelium is layered with multiple folds. The epithelium is coated with mucus (gastric mucosa) secreted by special glands. Inflammation caused by gastritis occurs in this lining.

Gastritis occurs when a bacterium, Helicobacter pylori, or the chronic use of drugs or certain medications weakens the protective mucous coating of the stomach and duodenum, allowing acid to get through to the sensitive lining beneath. Helicobacter pylori bacterium is also responsible for most peptic ulcers.

However, gastritis is not just one disease but a group of conditions, all of which result in the inflammation of the stomach lining. Inflammation of the stomach means that white blood cells move into the wall of the stomach as a response to an injury to the stomach. Commonly, the inflammation results from infection with the same bacterium that causes most stomach ulcers. Yet other factors such as traumatic injury and regular use of certain pain relievers can also contribute to gastritis.

Gastritis may be caused by many factors including infection, alcohol, particular medications and some allergic and immune conditions. It can be either acute, with severe attacks lasting a day or two, or chronic, with long term appetite loss or nausea. In many cases, gastritis has no symptoms (asymptomatic). But, common symptoms may include:

Loss of appetite
Pain in the upper abdomen just under the ribs
Nausea or Indigestion
Hiccups
Blood in the bowel actions
Weight loss

Gastritis can be caused by many different factors, including:
Medications such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDS)
Bacterial infection
Alcohol
Protracted vomiting
Overproduction of gastric juices, which is a stress response in some people
The backflow of bile from the small intestine (duodenum)
Some allergic and immune conditions – for example, pernicious anaemia
Severe stress due to major surgery, traumatic injury or burns
Exposure to radiation.

Diagnosing gastritis involves a variety of tests, including endoscopy and biopsy. In endoscopy, a thin flexible tube is threaded down the esophagus into the stomach. The endoscope is fitted with a small camera so the physician can look at the stomach lining. If the gastric mucosa is reddened, this may indicate gastritis. A biopsy is needed for confirmation. Biopsy involves small tissue samples which are taken during an endoscopy and tested in a laboratory. The pathologist will look for changes, including the presence of inflammatory cells and epithelium damage. Treatment of gastritis varies from person to person and depends on the specific cause. For most types of gastritis, reduction of stomach acid is helpful. Stomach acid is reduced by medication and antibiotics are given for infection. Most people recover from gastritis. Depending on the many factors that affect the stomach lining, gastritis symptoms may flare up from time to time. Overall, gastritis is generally a common, mildly troubling ailment that responds well to simple treatments. On occasion, rare forms of gastritis can be serious or even life threatening. Severe, ongoing symptoms or internal bleeding should alert a physician to search for a more serious underlying cause.

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