Inflammation of the stomach lining, which may be caused by irritation or infection
- More common over the age of 50; rare in children
- Sometimes runs in families
- Alcohol abuse and smoking are risk factors
- Gender is not a significant factor
Gastritis, which is inflammation of the stomach lining, is a common disorder. More than half of the population over the age of 50 have gastritis, although in some cases there are no symptoms. The disorder may be acute and have a sudden onset, but it is more frequently chronic, developing gradually over months or years. The symptoms commonly include discomfort in the upper abdomen. The inflammation may be complicated by bleeding from the stomach.
Some types of gastritis run in families. However, in the 1980s, Helicobacter pylori infection was found to be a major cause of chronic gastritis. This discovery has led to effective treatment for many people with the disorder.
What are the causes?
Acute gastritis may occur when the stomach lining is damaged by drinking an excessive amount of alcohol or by taking aspirin or another nonsteroidal anti-inflammatory drug, such as ibuprofen. Acute gastritis can also develop after serious illness, such as blood poisoning (see Septicaemia).
Chronic gastritis is often caused by infection with H. pylori bacteria, which are found in the stomach lining of about half of the population. The bacterium damages the mucous layer that protects the stomach lining from digestive juices, allowing acid to attack the lining. Chronic gastritis may also occur in Crohn’s disease, a disorder which may cause digestive tract inflammation. Long-term use of alcohol, tobacco, and nonsteroidal anti-inflammatory drugs, such as aspirin, may also lead to chronic gastritis.
One type of chronic gastritis, known as atrophic or autoimmune gastritis, is caused by an abnormal reaction of the immune system in which the body produces antibodies that attack the tissues of the stomach lining.
What are the symptoms?
Chronic gastritis often does not cause any symptoms, but it may gradually result in damage to the stomach lining that will eventually produce symptoms similar to those of acute gastritis. The onset of symptoms in acute gastritis is much faster and the symptoms are more severe. The symptoms of both types of gastritis may include:
Discomfort or pain in the stomach area, often after eating.
Nausea and vomiting.
Loss of appetite.
Bleeding from the stomach lining may go unnoticed until it gives rise to iron-deficiency anaemia, which causes tiredness and pale skin. If the bleeding is severe, you may vomit blood or pass black, tarry stools (see Bleeding from the digestive tract).
Atrophic gastritis is usually painless, and the only symptoms may be those of pernicious anaemia due to a deficiency of vitamin B12. Atrophic gastritis damages the stomach so that it cannot make intrinsic factor, a substance essential for the absorption of this vitamin. People with chronic gastritis, especially atrophic gastritis, also have an increased risk of developing stomach cancer.
What can I do?
The symptoms of mild gastritis can be treated with over-the-counter antacids, which neutralize the acid in the stomach. You may also find that your symptoms are relieved by eating small, regular meals, reducing alcohol intake, and giving up smoking. If symptoms persist or are severe or you are losing weight, consult your doctor.
What might be done?
Your doctor will ask you about your smoking, drinking, and dietary habits, and your use of medications. You may be given a faecal, blood, or breath test to look for H. pylori infection. You may also have a blood test for anaemia to see if there has been bleeding from the stomach lining. Your doctor may arrange for you to have endoscopy (see Upper digestive tract endoscopy) to examine the stomach lining.
If H. pylori infection is confirmed, a combination of antibiotics and ulcer-healing drugs may be prescribed. If you have gastritis and need to take aspirin or another nonsteroidal anti-inflammatory drug for a period of time, you may also be advised to take a proton pump inhibitor drug, such as omeprazole. Proton pump inhibitors reduce the production of stomach acid and help to protect the stomach lining.
Gastritis usually improves if lifestyle changes, such as reducing intake of alcohol, are made. If chronic gastritis is caused by H. pylori infection, complete recovery usually follows treatment with antibiotics and ulcer-healing drugs. However, infection sometimes recurs, requiring further treatment.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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