Inflammation of the stomach lining (gastritis): symptoms, causes
Typical for an inflammation of the gastric mucosa are abdominal complaints such as a feeling of fullness or pain in the upper abdomen. The patients have no appetite, often they feel nauseous. Gastritis can be acute or chronic. In many cases, even sparing the stomach improves the symptoms, and in more severe or chronic cases, medication helps. Read here how to recognize an inflammation of the stomach lining and what you can do.
- Symptoms: Feeling of fullness, pain in the upper abdomen, loss of appetite, nausea, heartburn, belching, less often digestive problems
- Causes: irritating substances (e.g. alcohol, drugs), stress, stomach germ Helicobacter pylori, autoimmune reactions
- Treatment: light diet, acid binders, proton pump inhibitors, relaxation exercises
- Diet: Light food, avoid alcohol and hot spices, steam instead of frying
- Dangers: Danger to life with bleeding ulcers, long-term increased risk of stomach cancer
Gastritis can cause various unspecific complaints. The main symptoms are typical for both acute and chronic gastritis. However, in the acute form they occur suddenly, while a chronic gastritis develops insidiously.
Common symptoms of gastritis are:
- Feeling of fullness
- Upper abdomen pain
- reduced appetite
- Bad breath
- bland taste in the mouth
- early satiety
- Back pain
What kind of people may suffer from gastritis? , these are people who drink a lot of alcohol. However, there are also drugs that make people susceptible. These include blood thinners, acetylsalicylic acid or painkillers such as ibuprofen and diclofenac. As a side effect they attack the stomach lining. Last but not least, the bacterium Helicobacter pylori can also cause gastritis.
In case of a clear gastritis, one takes an acid blocker for at least three weeks. The gastric mucosa can thus regenerate itself again. In mild cases, base preparations also help. Either way, they support recovery by avoiding smoking, alcohol and stress. Those who are then free of complaints should continue to take care to keep their stress levels within limits.
Under no circumstances take acid blockers as a preventive measure! Among other things, this inhibits digestive performance: the stomach needs acid to digest. Basically you keep your stomach fit with a harmonious life. This means: a regular daily routine, sport, moderate alcohol, preferably no smoking and sufficient sleep. And: “Chewed well, is half digested” – eat three times a day in peace, and without.
Symptoms of Chronic Gastritis
In chronic gastritis, a distinction is made between types A, B and C, depending on the cause, as well as various special forms.
Symptoms of type A gastritis
In type A gastritis, less gastric acid is produced. This can cause digestive problems. In addition, this form of gastritis results in a vitamin B12 deficiency, which triggers a so-called pernicious anaemia, a special form of anaemia. Symptoms are then, among others, sensations of discomfort, tiredness and exhaustion.
Symptoms of type B gastritis
Type B gastritis usually shows only unspecific symptoms. Some patients develop bad breath and as the disease progresses, additional conditions such as:
- Duodenal ulcer
- Stomach cancer (carcinoma of the stomach)
- MALT lymphoma (mucosa-associated cancer of the lymphatic tissue)
Symptoms of type C gastritis
Even a chronic type C gastritis usually causes only unspecific symptoms. Many patients report discomfort in the upper abdomen. Often the symptoms correspond to those of a irritable stomach.
Gastritis: causes and risk factors
Gastritis occurs when the protective mucous membrane of the stomach is damaged. These can be substances that irritate the stomach or factors that stimulate an overproduction of corrosive stomach acid.
Triggers for acute gastritis are, for example:
- excessive consumption of alcohol
- excessive consumption of nicotine
- frequent consumption of foods that irritate the stomach, such as coffee or hot spices
- frequent or high-dose intake of certain drugs, for example painkillers or anti-inflammatory drugs such as cortisone
- psychological stress
- Food poisoning by bacteria such as staphylococci or salmonella
- mechanical irritation, for example by a stomach tube or other foreign bodies
- Burns caused by acids or alkalis
- physical stress such as during long-term respiration, craniocerebral trauma, burns, brain diseases, major surgery, shock (circulatory collapse)
- Competitive sports (“runners stomach”)
If bacteria such as staphylococci or salmonella are the cause, gastritis can be contagious. The pathogens are then excreted with the stool, and other people can become infected, for example by sharing a toilet.
The stomach is a hollow muscle and lined inside with a mucous membrane. It protects the body from gastric acid, so to say for a non medical audience. For digestion, food and gastric acid are mixed together in the stomach and transported further towards the intestines by muscle work.
Causes of chronic gastritis
Type A gastritis
Type A gastritis is also known as autoimmune chronic gastritis. Autoimmune means that the body’s own defence system is directed against the body itself: It forms antibodies that attack the body’s own structures. Type A gastritis is the rarest form of chronic gastritis with about 5 percent of cases.
They attack the document cells that produce stomach acid. Therefore less gastric acid is released. Other antibodies are directed against the intrinsic factor. This protein is produced in the stomach and is necessary for the absorption of vitamin B12. The consequence is a lack of Vittamin B-12.
Type A gastritis accounts for about five percent of chronic gastritis. It can be inherited and mainly affects northern Europeans. The inflammation is often located in the main section of the stomach. Many patients also suffer from other autoimmune diseases, for example
Type B gastritis
About 80 percent of cases of chronic gastritis are of type B. They are usually caused by the bacterium Helicobacter pylori (H. pylori). The stomach germ can be transmitted via saliva or stool. More rarely, related pathogens are also the cause of type B gastritis such as Helicobacter heilmannii, which is transmitted from dogs or cats to humans.
In the case of gastritis caused by bacteria, the protective mucous layer is destroyed by the germs. The stomach acid now attacks the mucous membrane directly.
Chronic type B gastritis mainly affects the stomach section between the stomach body and the stomach outlet (gastric antrum).
Type C gastritis
Type C chronic gastritis accounts for about 15 percent of chronic gastritis. It is caused by a chemical irritation of the stomach. These include above all painkillers such as acetylsalicylic acid (ASS), ibuprofen or diclofenac. They belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs).
The backwashing of bile into the stomach (bile reflux) can also lead to chronic gastritis type C.
Rare forms of chronic gastritis
Chronic gastritis can also have other causes in rare cases. Among others, the following special forms are available:
- Eosinophilic (allergic) gastritis: for example in case of allergies to cow’s milk or soya
- Lymphocytic gastritis: possibly triggered by H. pylori or celiac disease, leading to, among other things, Ménétrier’s disease (giant wrinkle gastritis) or anaemia (anemia)
- Granulomatous gastritis: in inflammatory diseases such as Crohn’s disease, sarcoidosis or tuberculosis
An inflamed or irritated stomach mucosa can often be treated on its own with simple measures. If this is not enough, various drugs help.
The first measure to take in case of gastritis is to leave out everything that irritates the stomach lining. Coffee, alcohol and nicotine are therefore taboo during a gastritis.
If the symptoms are severe, it may be advisable to avoid food completely for one or two days. As a rule, you have no appetite anyway.
Otherwise, it is often enough to eat light food, with easily digestible small meals.
If stress is the trigger of gastritis, relaxation methods such as autogenic training, meditation or the progressive muscle relaxation according to Jacobson can help.
Useful gastritis home remedies are also:
- Hot water bottle or grain pillow (cherry pit pillow)
- Chamomile tea (anti-inflammatory effect)
- Tea mixture of chamomile, peppermint and liquorice (mix half a teaspoon of liquorice root and chamomile flowers with a teaspoon of peppermint leaves)
- Gruel (protects the stomach lining)
- Melissa or hop blossom tea (calming effect)
- Potato juice
- Healing earth
Rolling cure with chamomile tea: A rolling cure for inflammation of the stomach lining can also be helpful. Drink two cups of chamomile tea. Then lie on your back for ten minutes. Then turn to the left side, the right side and the stomach for another ten minutes at a time. Stay in bed for about half an hour after this rolling cure. Use this household remedy daily for one week.
Treatment with medication
Antacids: If behavioural measures alone are not enough, antacids help. These active ingredients neutralize the aggressive stomach acid.
H2-receptor blockers: Another possibility are so-called H2-receptor blockers (such as cimetidine or ranitidine). They reduce the production of gastric acid. This allows the inflamed stomach lining to recover and is protected from further damage.
Proton pump inhibitors: Even more effective are so-called proton pump inhibitors (proton pump inhibitors, PPI). They also reduce the production of gastric acid. Often used PPIs are for example omeprazole and pantoprazole. However, they should only be taken on a long-term basis in exceptional cases and in consultation with the doctor.
Antibiotics: In case of own chronic gastritis type B, it is important to get rid of the disease-causing bacteria. For example, a combination of two or three antibiotics together with a proton pump inhibitor for seven days can, in over 90 per cent of cases, expel Helicobacter pylori.
Anti-spasmodic and anti-nausea drugs: For further symptoms of gastritis, anti-nausea drugs (antiemetics) or antispasmodic, pain-relieving drugs (spasmolytics) help.
Vitamin B 12: Chronic type A gastritis carries the risk of pernicious anaemia. This is caused by a vitamin B12 deficiency. Patients therefore usually receive vitamin B12 injections.
Treatment with alternative medicine
Homeopathy: Homeopathic remedies for inflammation of the gastric mucosa are for example Carbo vegetabilis and Lycopodium. They should ease the discomfort.
Schuessler salts: Schuessler salts against nausea or belching are for example No. 9 Sodium phosphoricum, which should regulate the acid balance in the body and No. 7 Magnesium phosphoricum, which is said to have a relaxing, cramp-relieving effect on the digestive organs.
Traditional Chinese Medicine: Treatment according to Traditional Chinese Medicine (TCM) – for example in the form of acupuncture – can also relieve gastritis symptoms, as patients report
Emergency stomach bleeding!
Sometimes the damage to the mucous membrane in gastritis is so severe that bleeding occurs. In lighter cases, these can be stopped during a gastroscopy (gastroscopy). Heavy bleeding – recognizable by bloody vomiting or dark-colored stool (tarry stools) – can be life-threatening. They require emergency treatment. Sometimes only surgery can stop the bleeding.
In the case of gastritis, the main concern is not to irritate the stomach lining any further. Many patients with acute gastritis lack appetite anyway, so they go without food for one or two days. It is then important to take in sufficient liquid, such as chamomile tea or clear broth.
The following tips for stomach protection can also help you:
- Avoid stomach-irritating substances such as citrus fruits, coffee, alcohol, hot spices
- Gruel, rusk, soups, rice and mashed potatoes are particularly good for the stomach
- Better five small meals spread over the day than a few large meals
- Raw food is a strain on sensitive stomachs. Steamed dishes are the most digestible.
- Unfavourable are high-fat foods
Further information on nutrition in gastritis can be found in the article Gastritis: Nutrition.
Examinations and diagnosis
If you have stomach problems, first consult your family doctor. If necessary, he will refer you to a stomach specialist, a gastroenterologist, later on. First, your doctor will ask you in detail about your medical history (anamnesis). He asks, for example:
- How long have you had the symptoms?
- Do you suffer from stomach ache, vomiting or diarrhoea?
- Are you taking any medication, such as painkillers?
- Do you feel full?
Your doctor will then examine you. To do this, it listens to your abdomen, registering both the bowel sounds and the pulse rate of the large blood vessels in your abdomen. Then he’ll tap your stomach. This enables him to detect air or fluid accumulations. When palpating the abdomen, the doctor pays attention to possible hardening. It also palpates your liver under the right costal arch and your spleen under the left costal arch.
Gastritis can only be clearly diagnosed by the doctor taking a look inside the stomach. In a so-called endoscopy, a thin tube with a small camera at the tip is carefully advanced through the esophagus to the stomach. This enables the doctor to detect possible changes in the mucous membrane such as redness, swelling or bleeding.
With the help of fine instruments, the doctor can also take a tissue sample from the mucous membrane during the endoscopic examination. A pathologist examines these tissue samples more closely under his microscope to determine the type of inflammation. In doing so he can recognize whether the inflammation is limited to the upper layers of the mucous membrane (surface gastritis) or has already damaged the stomach glands (atrophic gastritis).
Test for Helicobacter pylori
In addition, the biopsy can be used to perform a rapid urease test for the stomach germ Helicobacter pylori. It is the most common trigger for chronic gastritis. For this purpose urea is added to the tissue sample. If the bacterium is present, its enzyme (the urease) will convert the urea into ammonia. This reaction can be measured.
Other tests to identify H. pylori as a cause of chronic gastritis are:
- Breath test: The patient receives radioactively marked urea. H. pylori splits this up, which allows radioactively labelled carbon dioxide to be detected in exhaled air.
- Antigens in stool: Proteins of H. pylori are excreted via the intestine. These can be detected in the stool.
- Antibodies in serum: In case of an infection with H. pylori, the immune system produces antibodies against the bacteria. These can also be detected in the patient’s blood after infection.
Detection of autoantibodies
If type A gastritis is suspected, the patient is examined for autoantibodies. If chronic bleeding occurs, microcytic anaemia may be detected in the blood count – a form of anaemia with reduced red blood cells.
Course of disease and prognosis
An acute gastritis usually has a good prognosis. It often heals on its own after a few days or weeks without further treatment. However, there are also severe courses, for example when patients have “erosive gastritis”. If haemorrhagic gastritis is accompanied by bleeding, this can be life-threatening. In addition, an inflammation of the stomach lining can develop into a stomach ulcer.
A chronic inflammation of the stomach lining usually lasts for several weeks, months or even years. Due to the constant irritation of the stomach lining, chronic gastritis increases the risk of cells degenerating and causing stomach cancer. First, the cells of the stomach mucosa transform into intestinal cells. This is called intestinal metaplasia (transformation).
Anyone who has chronic gastritis should therefore have a gastroscopy regularly every three years. In this way, cancer and precancerous stages can be detected and treated in time.