Gastritis is inflammation of the gastric mucosa. A distinction is made between acute and chronic gastritis, and the Kyoto Consensus of 2015 defines it as an infectious (predominantly Helicobacter pylori) or inflammatory disease of the mucosa. Symptoms are often nonspecific, so the diagnosis is established based on a combination of complaints, examination, and tests.
Acute and chronic gastritis
Acute gastritis is caused mainly by alcoholic beverages, Helicobacter pylori, nonsteroidal anti-inflammatory drugs (NSAIDs — pain-relieving and anti-inflammatory agents such as aspirin and ibuprofen), and poisoning by chemicals. It can also occur after severe trauma or surgery that reduce the blood supply to the mucosa.
Chronic gastritis is divided into types. Type "A" is atrophic (autoimmune) gastritis, in which antibodies to parietal cells and intrinsic factor (Castle's factor) are detected, and their absence leads to vitamin B12–folate deficiency anemia. Type "B" is bacterial gastritis, and type "C" is reflux gastritis caused by biliary reflux (backflow of bile into the stomach).
Helicobacter pylori: infection and link to ulcers
Helicobacter pylori is a spiral-shaped bacterium that infects the mucosa of the stomach and duodenum and is able to survive for a long time in an acidic environment. Most cases of gastric and duodenal ulcer disease, gastritis, and duodenitis are etiologically associated with H. pylori infection (that is, caused by this bacterium). At the same time, a significant portion of the population is infected, but most infected people have no signs of disease.
The entry of pathogens, usually H. pylori, is the most common cause of gastritis. Untreated gastritis can progress and lead to a gastric ulcer.
Other causes
Among the causes of gastritis, sources cite the use of NSAIDs, excessive alcohol consumption, autoimmune diseases, biliary reflux, steroid medications, certain types of allergy, taking antibiotics and iron supplements, as well as severe stress and prior gastric surgery. Irregular eating, smoking, coffee, and a lack of proteins and vitamins in the diet can contribute to its development.
Symptoms and their nonspecificity
Symptoms of gastritis include:
- abdominal pain;
- indigestion (dyspepsia) and a feeling of fullness and bloating;
- nausea and vomiting;
- decreased appetite.
These manifestations are not specific to gastritis itself, so to clarify the cause the doctor may order tests.
How it is diagnosed
Clinical diagnosis relies on complaints, history, and examination findings, after which a testing plan is drawn up. Methods include a breath test for H. pylori (the patient drinks a special solution, after which the exhaled air is checked), a stool test, and a blood test. Endoscopic diagnosis with biopsy (gastroscopy — examination of the mucosa from the inside) clarifies the nature and location of the changes. Ultrasound examination of the liver, pancreas, and gallbladder helps identify concomitant diseases of the digestive system.
When to see a gastroenterologist
You should see a family doctor on a routine basis if abdominal pain or indigestion lasts more than a week, or if the pain worsens or recurs. A referral to a gastroenterologist is possible if gastritis does not resolve or causes severe symptoms. Warning signs that require prompt evaluation include loss of appetite, a feeling of fullness after a very small portion of food, unintentional weight loss, a feeling of a lump in the abdomen, pain or difficulty swallowing, and persistent vomiting.
Call emergency services (103 or 112) immediately if the vomit looks like bright red blood or coffee grounds, the stool is black, sticky, and extremely foul-smelling, or severe pain in the abdomen or chest has arisen suddenly.
This material is for reference and does not replace a doctor's consultation.
Sources
Update history
This content is for reference and does not replace a doctor's consultation. Medical disclaimer