What Is It?

Gastritis is an inflammation of the stomach lining. In someone who suffers from gastritis, the lining of the stomach often looks red, irritated and swollen, and it also may have raw, abraded areas that can bleed.

Many different illnesses and irritants — acting either alone or in combination — can trigger the inflammation of gastritis. Some of the most common triggers include:

• Infection with Helicobacter pylori (H. pylori) bacteria — In addition to causing gastritis, H. pylori infections also have been linked to the development of stomach cancer and peptic ulcer disease (open sores inside the stomach or part of the small intestine). Although doctors are not sure how people become infected with H. pylori, they suspect that the bacteria may be spread through contaminated food, water, saliva or digestive fluids. In the United States, the number of people infected with H. pylori increases with age. About 20 percent of Americans under age 40 are affected, whereas H. pylori affects about 50 percent of people over age 60. Many people who are infected with H. pylori never complain of digestive symptoms, but the reason for this variation in how people respond to H. pylori infections is not understood and is being investigated.
  
  
• Viral infections — Brief bouts of gastritis are common during short-term viral infections.
  
  
• Irritants — Chemical and environmental irritants can damage the stomach lining and cause gastritis. Some of the most common culprits include alcohol, cigarette smoke, aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin and others) and naproxen (Aleve, Naprosyn and others).

Currently in the United States, gastritis accounts for approximately 2 million visits to doctors’ offices each year. Although gastritis can occur in people of all ages and backgrounds, it is especially common in:

• People over age 60
• People who drink alcohol excessively
• Smokers
• People who routinely use NSAIDs, especially at high doses

Symptoms of gastritis can include:

• Abdominal discomfort that may become worse after eating
• Persistent pain between the navel and the lower ribs
• Nausea, sometimes with vomiting
• Poor appetite
• Belching, bloating or a feeling of fullness in the abdomen
• With severe gastritis, sometimes bloody vomiting and black stools

After reviewing your symptoms, the doctor will ask you about your lifestyle.

Specifically, the doctor will want to know:

• The amount of alcohol you drink
• About your use of NSAIDs
• Whether you have tried over-the-counter antacids or other medicines to treat your symptoms and whether these helped

Your doctor will perform a physical examination with special attention to your abdomen. He or she may perform a digital rectal examination, obtaining a small smear of feces or rectal fluids to be checked for the presence of blood. If no blood is present, and if your history and physical examination are normal, your doctor probably will suggest some treatment before ordering any further tests. If that treatment fails, your doctor may perform either blood tests or a breath test to determine whether you have an H. pylori infection. In some cases, your doctor may want to inspect your stomach lining directly with a procedure called gastroscopy, in which a flexible, lighted instrument is passed into your stomach. During the procedure, your doctor also can take a biopsy, a small tissue sample to be examined in the laboratory.

Gastroscopy also is performed if:

• The results of your initial physical examination or rectal examination are not normal.
• You have seen blood in your vomit or stool.
• Your rectal smear tests positive for blood.
• You have unusual symptoms, such as weight loss or extreme fatigue.

If you have mild, uncomplicated gastritis, your symptoms probably will improve after only a few days of treatment.

To help prevent gastritis:

• Don’t smoke.
• If you drink alcohol, do so in moderation.
• If you take an NSAID to treat a medical problem, and the medicine upsets your stomach, stop taking the medicine and speak with your doctor.
• Always wash your hands before you eat and after you use the restroom. Doctors still are investigating the ways that people spread and catch H. pylori infections. You can clean your hands using soap and water or an alcohol-based hand-sanitizing gel.

If you have mild, uncomplicated gastritis, the treatment approach includes:

• Stopping smoking
• Stopping alcohol use temporarily. After gastritis heals, your doctor will advise no more than one to two drinks a day, or none at all
• Avoiding foods that you think may make your symptoms worse. Foods that are fatty, spicy or very acidic (coffee, orange juice, tomato juice) cause problems most often.
• Using medications to decrease stomach acids. You may try over-the-counter antacids (such as Maalox, Mylanta, Tums or generic forms) or an H2 blocker (Tagamet, Zantac, Pepcid and generic equivalents). H2 blockers also are available in prescription strength. Proton pump inhibitors such as omeprazole (Prilosec) and lansoprazole (Prevacid) are the strongest acid blockers, but are usually more expensive.

This approach should help you begin to feel better within a few days, with maximum results after a week or two.

If you are still having symptoms, and further testing confirms that you have an H. pylori infection, your doctor will treat you with medications to kill H. pylori bacteria. If symptoms still persist, the doctor will recommend gastroscopy or X-rays to outline the upper portion of your digestive tract, including the stomach (a process called an upper-GI series).

Make an appointment to see your doctor if you have symptoms of gastritis that awaken you from sleep, prevent you from eating, or interfere with your work or school performance. Also, call your doctor if you find that you must use nonprescription antacids or H2 blockers to treat your symptoms more than twice each week.

Call your doctor immediately if you have severe abdominal pain, blood in your vomit, or stools that look black and tarry.

Once your doctor identifies the cause of your gastritis and begins treatment, the prognosis for a full recovery is very good. However, if your gastritis is related to smoking or alcohol use, you must be willing to change your lifestyle to eliminate these irritants.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.