Gastritis is inflammation of the stomach lining. It can develop quickly and be short-lived (acute gastritis) or last for months and years (chronic gastritis). Typical complaints are stomach pain and heaviness in the upper abdomen and nausea, especially after eating, but in some people gastritis causes almost no symptoms.
Gastritis symptoms
- pain, burning, or discomfort in the upper abdomen, just below the breastbone;
- a feeling of heaviness and of getting full quickly;
- nausea, sometimes vomiting;
- bloating, belching, and reduced appetite;
- heartburn and a sour taste in the mouth.
These complaints are not specific. Similar feelings occur with ulcers, gallbladder and pancreatic disease, and food poisoning. That is why you cannot diagnose gastritis yourself from symptoms alone.
Causes of gastritis
The most common causes are:
- Helicobacter pylori bacteria. They live in the stomach and, over a long course, keep the lining inflamed. Infection usually spreads through household contact and contaminated food or water.
- NSAID painkillers (for example ibuprofen and aspirin): taken often, they irritate the lining.
- Alcohol in large amounts, and smoking.
- Severe stress or serious illness, and stomach surgery.
- Immune system disorders in which the lining is damaged by the body's own antibodies.
Gastritis is sometimes divided by stomach acid level, into high-acid and low-acid forms. For the patient something else matters more: finding the cause, because treatment depends on it.
Why gastritis matters
Gastritis is usually not life-threatening, but without treatment the inflammation can persist and lead to an ulcer of the stomach or duodenum. A warning sign is bleeding from the damaged lining. It shows up as vomiting blood, vomit that looks like coffee grounds, or black, tarry stools. This is an emergency.
How gastritis is diagnosed
A gastroenterologist makes the diagnosis. The doctor asks about your complaints, diet, medicines, alcohol, and smoking, and examines your abdomen. To confirm the diagnosis, the doctor usually orders:
- a test for Helicobacter pylori (a blood test, breath test, or stool test);
- an endoscopic examination of the stomach, with a look at the lining and a biopsy if needed. It shows the state of the lining most accurately;
- a complete blood count and other tests as indicated.
How gastritis is treated
Treatment depends on the cause, so the doctor chooses the plan. If Helicobacter pylori is found, a specific course of treatment is prescribed. If painkillers are the cause, the doctor decides whether they can be replaced or stopped. When needed, medicines that reduce stomach acid or protect the lining are used. Do not take them constantly "just in case" or pick the doses yourself.
Lifestyle changes also help: give up alcohol and smoking, cut back on caffeine, avoid eating before bed (finish your last meal 3–4 hours before sleep), eat smaller portions, and avoid the foods that make you feel worse. For different people these are spicy, fatty, or acidic foods. You do not need a strict diet for years, and a doctor or dietitian can help you plan the eating that suits you.
Prevention
There is no vaccine against gastritis, but you can lower the risk:
- wash your hands, drink water from safe sources, and keep to food hygiene, which lowers the risk of Helicobacter pylori infection;
- do not take painkillers without need or longer than the doctor prescribed, and take them after meals;
- limit alcohol and quit smoking;
- eat regularly and do not skip meals for long;
- do not ignore upper abdominal pain that keeps coming back.
When to see a doctor
Book a gastroenterologist if pain, heaviness, or nausea in the upper abdomen lasts longer than a week, keeps returning, or does not go away after changing your diet. Do not delay if you notice marked weight loss, trouble swallowing, or constant vomiting. Call an ambulance at 112 if you vomit blood, pass black tarry stools, or have sudden severe abdominal pain. You can find suitable specialists in the Doctors block further down this page.
