Introduction-

Gastritis and gastropathy are two common stomach ailments. Gastritis is inflammation of the gastric mucosal lining of the stomach. This infection is caused by a bacterium Helicobacter pylori, which also causes stomach ulcers. As a result, there occurs upper gastrointestinal bleeding. There are many factors that contribute to the development of gastritis. One of them is alcohol. Certain diseases like crohn’s disease, HIV etc., also increases the risk of gastritis. Gastritis may occur suddenly, this type is called acute gastritis while the type that appears slowly over time is chronic gastritis. For most cases, gastritis is not a serious complication and improves by treatment. In some cases however, it causes ulcers and even becomes the cause of stomach cancer. Gastropathy is a condition in which stomach lining is damaged but no inflammation occurs. Inflammation of the whole stomach is called PANGASTRITIS and inflammation of a part of the stomach is called ANTRAL GASTRITIS.

Mechanism of injury of stomach lining in gastritis-

There occurs an imbalance between the aggressive and defensive factors that maintain the integrity of the gastric lining. The continuous mucosal injury due to H. pylori infection which is long-standing, leads to stomach atrophy. This pathological process leads to ulceration and erosion of mucosa leading to destruction of glandular layer and followed by fibrous replacement. The gastric mucosa is protected from high acidity of hydrochloric acid in the stomach by mucus secretion. Mucosal damage occurs through hyper secretion of acid, reduction of mucus production and as a result generalized inflammation results. Where the acute type leads to necrosis, scarring and perforation.

Signs and symptoms of gastritis –

• Burning ache or pain in upper abdomen that gets worse with eating
• Nausea
• Vomiting
• Feeling of fullness after eating in upper abdomen 
• Weight loss
• Black tarry stools
• Hiccups

 

But gastritis does not always cause signs and symptoms. It is required to see a doctor when there occurs-

• If indigestion or stomach irritation lasts for a week or longer
• Dizziness
• Vomiting 
• Severe pain in stomach
• Black stools
• Blood in vomit or stools 
• Belching
• Abdominal bleeding
• Loss of appetite

The cause of inflammation of the lining of the stomach occurs due to weakness or injury to the muscle-lined barrier of the stomach that protects the stomach wall, allowing digestive juices to damage and inflame the stomach lining. Factors that increase risk of gastritis are-

• Bacterial infection
• Regular use of pain relieving drugs
• Smoking and alcohol
• Older age
• Stress
• Cancer treatment 
• Other diseases and conditions
• Lower socioeconomic groups
• Viral infection
• Corticosteroid drugs
• Bile reflux
• Autoimmune disease
• Radiation gastritis
• Menetrier disease 

 

Rare symptoms and causes of gastritis are sarcoidosis, collagenous gastritis, eosinophilic gastritis and lymphocytic gastritis. Other bacteria that cause gastritis are Mycobacterium avium intracellulare, Herpes simplex and cytomegalovirus.

Types of gastritis –

• Acute gastritis
• Chronic gastritis
• Autoimmune gastritis
• Erosive gastritis 
• Non-erosive gastritis

In the erosive type, there is inflammation and erosion of stomach lining called reactive gastritis. In non-erosive type inflammation occurs without wearing away or erosion of stomach lining. In autoimmune gastritis, a special type, body’s attacks the cells that make up the stomach lining. It is usually seen in people with autoimmune disorders. This reaction can wear away the stomach's protective barrier and inflame the lining. Vitamin B12 deficiency also causes autoimmune gastritis which is mostly seen in younger women. All types of gastritis can sometimes mimic indigestion symptoms. But both differ. Alcohol, smoking, stress etc., all cause erosive gastritis. Indigestion occurs due to gastritis. Gastritis is a very common but treatable condition. 

Gastritis is not contagious however, the causative agent is contagious via feco-oral route. Good hand washing and sanitation are protective measures. Gastritis can be diagnosed by these tests-

• Breath test
• Stool test
• Blood test
• Upper endoscopy
• Upper gastrointestinal examination

Treatment of gastritis-

It includes medications such as:

• Antibiotics- treat bacterial infections
• Antacids- calcium carbonate remedies reduce gastric acid vulnerability. They help treat inflammation and treat heartburn.
• Histamine blockers- they decrease acid production in stomach 
• Proton pump inhibitors – they treat stomach ulcers and gastroesophageal reflux illnesses
• Surgical intervention is not recommended in management of gastritis.

Gastritis can cause a plethora of complications if not treated. These include anemia, pernicious anemia, peritonitis, stomach ulcer and stomach cancer.

How to relieve gastritis pain at home-

• Follow an anti-inflammatory diet
• Take a garlic extract supplement
• Try probiotics
• Drink green tea with manuka honey
• Eat lighter meals
• Avoid smoking
• Avoid use of painkillers
• Reduce stress

Some foods and drinks that ease the symptoms of gastritis-

• High fiber foods
• Low fat foods
• Foods with low acidity
• Non-carbonated drinks
• Caffeine free drinks

Prevention of gastritis includes-

• Good hand washing
• Sanitation
• Avoid fried spicy and acidic foods
• Eat smaller meals throughout the day
• Managing stress
• Not taking pain relievers too much
• Not lying down immediately after consumption of meals
• Reduce alcohol intake
• Keep body hydrated

 

Fact Check-

• About 8 out of every 1000 people suffer from acute gastritis and 2 out of every 10,000 people suffer chronic gastritis.
• Autoimmune gastritis is more common in younger women and older people.
• In western population, H.pylori infection rarely becomes the cause of gastritis.
• Chronic gastritis is a common disease in developing countries.
• Socioeconomic and environmental hygiene are important factors in transmission of H.pylori infection worldwide.
• Prevalence of this H.pylori infection in children is 50% in developing countries.
• Differential diagnosis of gastritis includes broadly peptic ulcer disease, pancreatitis, gallstone disease etc.
• One study from India suggested that gastritis affects 25-33% or more of the total population and people among the age 15-50 are mainly diseased by it.
• Pathophysiology and microscopic pathology differs for all types of gastritis.

PGC Resolution-

• Spreading information and awareness  about gastritis
• Support and care to eradicate the infection