The term gastritis means inflammation of stomach (gastric) mucosa. Gastritis is a common problem of the gastrointestinal system. In this condition, gastric mucous membrane undergoes inflammatory changes resulting in superficial mucosal erosion associates with mucosal edema and congestion. Inflammatory stomach secretes large volume of gastric juice, which contains mostly gastric acid and mucosal secretions. This may lead to superficial ulceration and hemorrhage. Gastritis may be acute, which lasts for several hours to a few days, or may be chronic, which results from recurrent episodes of acute gastritis or repeated exposure to stomach to irritating agents.
Classification and Types of Gastritis
Gastritis May Be Broadly Classified As Follows:
- Acute Gastritis: Acute gastritis is a condition that arises suddenly followed by painful inflammatory swelling (edema) of stomach lining. Gastric inflammation or gastritis may sometimes follow mucosal bleeding. This condition is a result of damage cause to the tissues by the gastric acid secreted by stomach mucosa. Helicobacter pylori bacteria initiate the inflammation of stomach mucosa resulting in acute or chronic gastritis. This problem usually subsides within 24 hours.
- Chronic Gastritis: As the name suggests, chronic gastritis involves chronic long-term swelling of the mucosal lining. This condition usually persists for many years. Again Helicobacter pylori is responsible for most of the cases. Chronic gastritis can be further classified into Type A, Type B and Type C.
- Erosive Gastritis: As the name suggests, in this condition the inner lining of stomach begins to erode or wear away. This condition can be acute or chronic and is usually a result of excessive stress though there can be other factors like injury, infection, autoimmune disorders, high alcohol intake and increased use of non-steroidal anti-inflammatory drugs.
- Atrophic Gastritis: Atrophic gastritis results from infection and inflammation of the mucosal lining. The severe type of mucosal swelling that is caused starts to waste away the gastric tissue present within the stomach.
Epidemiology of Gastritis
It is estimated that about 50% of the population is infected with H pylori, which is the main cause for gastritis. Chronic presence of H. Pylori in stomach causes repeated frequent gastritis resulting in chronic gastritis. H pylori infection is rampant in the developing countries including Asia. The mortality statistics of gastritis indicates that most number of cases are reported in United States and Mexico.
Pathophysiology of Gastritis
There are several causes that may lead to reduced mucosal blood flow and disruption of the protective layer of gastric mucosa.
Helicobacter pylori infection increases gastric mucosal permeability by inducing a severe inflammatory response by gastric mucosa. The cytotoxic inflammatory changes caused by H. Pylori results in mucosal degradation of gastric epithelium.
Alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) decrease gastric mucosal blood flow. Relative mucosal ischemia follows loss of the mucosal protective barrier.
The acidic property of gastric fluid usually does not allow bacterial growth over the mucosal epithelial surface. Fallowing gastritis epithelial mucosal cell are damaged. The damage barrier allows bacterial growth within layer of smooth muscles and sub-mucosa. Damage mucosal epithelial cells allows ingested bacterias to established colonies underneath damage epithelial cells.
Causes and Risk Factors for Gastritis
Gastritis tends to be caused due to various factors like social habits, alcohol use, physical stresses, medications, infections, medical and surgical conditions, and chemicals. Few of the common causes of gastritis are discussed below.
- H. Pylori: These bacteria live in mucous lining of stomach.
- Pernicious Anemia: Pernicious anemia occurs when stomach lacks ability to appropriately absorb and digest vitamin B12 due to absence of a naturally occurring substance.
- Bile Reflux: Back flow of the bile from bile tract into stomach.
- Infections: Infections such as tuberculosis, syphilis or other fungal or viral infections.
- Chemicals: Gastritis can be caused due to swallowing chemicals or objects such as corrosives or foreign bodies such as paper clips or pins.
- Surgical Conditions: Gastritis can result from procedures like endoscopy, surgical removal of a part of stomach, or radiation treatment for cancer.
If left untreated, gastritis can cause severe blood loss or in some cases stomach cancer.
Signs and Symptoms of Gastritis
Gastritis symptoms may vary from person to person and there may be cases where symptoms are not experienced at all. Given below are some common symptoms.
- Frequent stomach upset.
- Abdominal pain.
- Abdominal bloating.
- Loss of appetite.
- Burning feeling in stomach between meals or at night.
- Vomiting blood or coffee ground-like vomitus.
- Black or tarry stools.
In severe forms of gastritis, bleeding can also occur inside stomach, leading to following symptoms.
- Feeling of passing out or shortness of breath.
- Chest pain or acute stomach pain.
- Sweating, pallor, and rapid heartbeat.
- Vomiting huge amounts of blood.
- Blood during bowel movements or dark foul-smelling bowel movement.
Treatment for Gastritis
Common Treatments For Gastritis Condition Are:
- Antacids and other medications to reduce acid inside stomach, which is the reason for aggravating irritation in the inflamed areas.
- Avoiding spicy foods.
- Antibiotics in case of infection along with antacids.
- B12 vitamin shots in case of pernicious anemia.
- Proton Pump Inhibitors like omeprazole, esomeprazole, iansoprazole, pantoprazole and rabeprazole.
Investigations for Gastritis
A review of personal and family history and a thorough physical evaluation is the first step before any of following tests are recommended.
- Blood cell counts.
- Liver and kidney function test.
- H. Pylori test.
- Gallbladder and pancreas functions.
- Pregnancy test.
- Upper endoscopy.