Massachusetts General Hospital

Gastritis

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What is gastritis?

Gastritis is an inflammation of the stomach lining. While the lining of the stomach is quite strong and can withstand strong acid, drinking too much alcohol, eating spicy foods, or smoking can cause the lining to become inflamed and irritated.

What causes of gastritis?

Gastritis may be caused by the following:

• Drinking too much alcohol

• Eating spicy foods

• Smoking

• Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)

• Infection with bacteria, such as E. coli, Salmonella, or Helicobacter pylori (H. pylori)

• Major surgery

• Traumatic injury or burns

• Severe infection

• Extreme physiological stress

• Certain diseases, such as megaloblastic (pernicious) anemia, autoimmune disorders, and chronic bile reflux

What are the symptoms of gastritis?

The following are the most common symptoms of gastritis. However, each individual may experience symptoms differently. Symptoms may include:

• Stomach upset or pain

• Belching or hiccups

• Abdominal bleeding

• Nausea

• Vomiting

• Feeling of fullness or burning in the stomach

• Loss of appetite

• Blood in vomit or stool (a sign that the stomach lining may be bleeding)

The symptoms of gastritis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

How is gastritis diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for gastritis may include the following:

• Esophagogastroduodenoscopy (also called EGD or upper endoscopy). A procedure that allows the doctor to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the doctor to view this area of the body, as well as removal of a sample of tissue for biopsy (if necessary).

• Upper GI (gastrointestinal) series (also called barium swallow). A diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an X-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.

• Blood tests. A test for H. pylori, a bacteria which may be present in the stomach and detect anemia, a condition in which there are not enough red blood cells present, which can be linked to gastritis.

• Stool culture. This checks for the presence of abnormal bacteria in the digestive tract that may cause diarrhea and other problems. A small sample of stool is collected and sent to a laboratory by your doctor's office. In two or three days, the test will show whether abnormal bacteria are present; presence of blood in the stool may be a sign of gastritis.

Treatment for gastritis

Specific treatment for gastritis will be determined by your doctor based on:

• Your age, overall health, and medical history

• Extent of the condition

• Your tolerance of specific medicines, procedures, or therapies

• Expectations for the course of the condition

• Your opinion or preference

Generally, treatment for gastritis involves antacids and other medications aimed at reducing stomach acid, relieving symptoms, and promoting the healing of the stomach lining. If gastritis is related to an illness or infection, that problem should be treated as well. If gastritis is caused by H. pylori, the most common treatment is a triple therapy that combines two anitibiotics with a proton pump inhibitor (PPI) to kill the bacteria. Sometimes the treatment may also include bismuth subsalicylate (Pepto-Bismol). 

Patients are also advised to avoid foods, beverages, or medications that cause symptoms or irritate the lining of the stomach. If the gastritis is related to smoking, quitting is recommended.