Gastritis

Gastritis is inflammation of the stomach lining resulting in abdominal pain, possible bleeding, and other gastrointestinal symptoms. Gastritis can be acute, coming and going quickly, or chronic, in which case the disease can last months or even years. Gastritis can also be characterized as erosive, meaning that it wears away at the stomach lining, or non-erosive.

Erosive gastritis is most commonly caused by alcohol use, tobacco use, and prolonged use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS). Severe illness and consumption of caustic substances have also been associated with the development of erosive gastritis. The most common cause of chronic, nonerosive gastritis is a stomach infection caused by Helicobacter pylori ( H. pylori), a type of bacteria found in up to half of all people in industrialized nations (Source: NDDIC).

The signs and symptoms of gastritis can be constant or sporadic, and the disease course varies among individuals. If infection with H. pylori bacteria is the cause, symptoms will remain as long as the infection is untreated. Some people with gastritis have no symptoms at all, while others may have burning abdominal pain, nausea, and vomiting.

In the case of H. pylori-related gastritis, the infection can be treated successfully with antibiotics. For gastritis not caused by H. pylori, medications that reduce stomach acid can be an effective treatment. You can reduce your risk of H. pylori infection by following commonsense hygiene practices such as washing your hands regularly with soap and water. Lifestyle changes, such as limiting alcohol consumption and your use of nonsteroidal anti-inflammatory drugs (NSAIDs), can reduce the risk of gastritis that is not related to H. pylori.

Seek immediate medical care (call 911) for serious symptoms such as severe abdominal pain; bloody or black, tarry stools; or bloody or black vomit.

Seek prompt medical care if you are being treated for gastritis but mild symptoms recur or are persistent.

Gastritis causes inflammation and swelling of the stomach lining that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

You may experience gastritis symptoms daily or just once in a while. At times, any of these common symptoms can be severe:

• Abdominal burning
• Abdominal pain
• Loss of appetite
• Nausea with or without vomiting

In some cases, gastritis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Bloody stool (blood may be red, black, or tarry in texture)
• Severe abdominal pain
• Vomiting blood or black material (resembling coffee grounds)

The most common cause of gastritis is H. pylori infection. Other causes include acid reflux, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDS), alcohol use, and tobacco use, all of which can irritate the lining of the stomach. Severe illness and radiation therapy can also cause gastritis.

A number of factors increase the risk of developing gastritis. Not all people with risk factors will get gastritis. Risk factors for gastritis include:

• Alcohol abuse

• H. pylori bacterial infection

• History of radiation therapy

• Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), or aspirin

• Stress or severe illness

• Tobacco use

Treatment for gastritis begins with seeking medical care from your health care provider. To determine if you have gastritis, your health care provider may ask you to undergo diagnostic tests.

If your gastritis is caused by H. pylori infection, antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Examples of antibiotic treatments include:

• Amoxicillin
• Clarithromycin (Biaxin)
• Metronidazole (Flagyl)
• Tetracycline

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be effective treatments for gastritis.

Proton pump inhibitors that are effective in the treatment of gastritis include:

• Esomeprazole (Nexium)
• Lansoprazole (Prevacid)
• Omeprazole (Prilosec)
• Pantoprazole (Protonix)
• Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of gastritis include:

• Cimetidine (Tagamet)
• Famotidine (Pepcid)
• Nizatidine (Axid)
• Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of gastritis include:

• Internal hemorrhaging (bleeding)
• Perforated gastric ulcer, which can lead to bleeding
• Severe discomfort or pain
• Spread of infection
• Stomach cancer
• Stomach ulcers