Gastritis: causes, symptoms and therapies

What is it

The term gastritis is used in medicine to indicate a condition, acute or chronic, generated by a variety of different causes that induce irritation or inflammation of the stomach mucosa, with the appearance of pain or discomfort in the upper abdomen.

It was coined in 1728 by the German physician Georg Ernst Stahl, who used it to describe inflammation of the inner wall of the stomach.

Today it is known that this inflammation is triggered by damage to the cells of the gastric lining and the regenerative process that follows this damage.

Weakening, the defensive barrier of the stomach is no longer sufficient to protect against the action of gastric juices involved in the digestive process, and the mucous membrane suffers.

Often the acute form is due to bad eating habits such as the abuse of alcoholic beverages, spices or some condiments and irritating foods for the gastric mucosa; two different forms are known: erosive, characterized by the presence of superficial erosions, deep or associated with bleeding, and acute non-erosive gastritis, generally associated with the bacterium Helicobacter pylori.

There is also a form of nervous gastritis, linked to states of anxiety or stress.

The inflammation can involve the entire stomach (as in the case of pangastritis) or only part of it (as in the case of antral gastritis).

Common symptoms

Some people with gastritis have no symptoms, although inflammation of the mucous membrane can be detected during tests or during a gastroscopy.

In many cases, acute gastritis is diagnosed during an endoscopy conducted for other reasons, even before it has triggered problems that may suggest inflammation of the stomach wall.

However, the most common symptoms of gastritis are:

• burning, cramping, bloating or pain in the stomach
• nausea or vomiting
• poor digestion (dyspepsia)
• loss of appetite
• presence of blood or dark material in the vomit
• feces of dark color.

The symptomatology usually worsens when the stomach is empty and improves after the meal. However, problems such as bloating, abdominal pain, stomach acid and discomfort can also appear after eating, instead of fasting.

Chronic gastritis associated with Helicobacter pylori infection can also be asymptomatic, but there are cases in which it is associated with pain in the upper abdomen (the epigastrium), lack of appetite, early satiety, weight loss, nausea and vomiting.

Sometimes these symptoms appear along with possible complications of Helicobacter gastritis, such as peptic ulcer, gastric adenocarcinoma and MALT lymphoma (mucosa-associated lymphoid tissue).

The symptoms of autoimmune gastritis depend instead on vitamin B12 deficiency, which due to strong alterations of the stomach wall is not adequately absorbed. As a result, megaloblastic anemia (which can trigger weakness, dizziness, tinnitus, palpitations, angina and other cardiac symptoms), purpura, gastrointestinal problems (glossitis, lack of appetite and diarrhea) and neurological disorders (such as weakness, feeling of sleeping limbs, difficulty coordinating muscle movements, irritability) may develop.

Causes

Lifestyle heavily affects the genesis of this condition. Other possible causes of gastritis:

Complications

Chronic forms of gastritis are accompanied by a decrease in acidity in the gastric environment, and this favors the survival of Helicobacter pylori. This microorganism has been linked to the development of ulcer or stomach tumors (MALT lymphoma or gastric adenocarcinoma).

The appearance of these complications is associated with the presence of additional risk factors in addition to Helicobacter pylori infection.

Peptic ulcer, for example, is favored by the establishment of a vicious circle that prevents gastric acidity from being neutralized.

As far as ALT lymphoma is concerned, however, it is thought that the continuous stimulation of the immune system in the presence of chronic Helicobacter infection comes into play.

Finally, gastric adenocarcinoma is more frequent in cases where gastritis leads to extensive modifications of the cells of the gastric mucosa; Fortunately, only a small percentage of patients with Helicobacter pylori infection develop cancer.

Finally, chronic gastritis associated with H. pylori can also increase the risk of malfunction of the endothelium (the lining tissue of blood vessels) and therefore vascular disorders.

Care and diet

Except for the forms caused by Helicobacter pylori, there are no specific therapies for chronic gastritis.

In acute forms, however, some dietary rules are often sufficient to solve the problem. Among these, chew well, eat slowly and without stress, avoiding large meals and high in fat, alcoholic or carbonated drinks, liquids that are too hot, tea and coffee.

These measures can also represent a real strategy for preventing symptoms such as abdominal cramps, stomach pain and dyspepsia.

In general, then, you can use antacid compounds to eliminate pain and burning, which you can buy in pharmacies without prescription. In particular, antacids can help reduce the symptoms of gastritis by neutralizing the acids produced by the stomach, which are normally necessary for the digestive process, but which in case of gastritis become harmful.

If these drugs do not improve the symptoms, the doctor may prescribe, depending on the case, a therapy with drugs that reduce the secretion of acid by the stomach, such as H2 blockers or proton pump inhibitors, which also seem to inhibit the activity of Helicobacter pylori.

H2 drugs inhibit the action of histamine, a substance involved in the production of gastric juices. Proton pump inhibitors act instead on an enzyme located on the membrane of cells in the stomach wall that produce acid; These are substances that can inhibit acid secretion and guarantee a long duration of action.

To eradicate the bacterium, however, antibiotic therapy is necessary. It is generally not recommended to treat this infection only with an antibiotic; This approach could in fact lead to the development of resistance to treatment. For this, a proton pump inhibitor therapy may be prescribed in combination with an antibiotic (usually amoxicillin or clarithromycin) and a second antimicrobial agent.

Among the molecules that can be combined with antibiotics and proton pump inhibitors (or anti-H2 drugs) to eradicate Helicobacter pylori are also antidiarrheal drugs.

You can also use agents (such as sucralfate, misoprostol and bismuth subsalicylate) that protect the gastric mucosa.

Among the possible natural remedies, mallow stands out, which has been associated with anti-ulcer effects.

Finally, if gastritis is due to taking drugs (such as NSAIDs or cortisone) it is good to consult your doctor to modify the treatment in progress and avoid, thus, problems such as annoying stomach cramps.

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When to consult your doctor

Only the doctor can diagnose gastritis and give indications on how to better manage the disease depending on the severity of the symptoms. In addition, the doctor should always consult if symptoms persist or worsen.