Gastritis: what it is, types, and why flare-ups occur

The word "gastritis" is the Greek word for "stomach" plus the Latin "-itis," meaning "inflammation." It sounds simple, but behind a single diagnosis lie different conditions: from a one-time irritation after a questionable dinner to a years-long process with structural remodeling of the mucosa. Let's sort out what becomes inflamed, why flare-ups occur, and when it's time to see a doctor.

What gastritis is and what happens to the gastric mucosa

Gastritis is when the lining of the stomach is inflamed or swollen. The inner layer is irritated, and this manifests as abdominal pain, indigestion, nausea, and a feeling of fullness.

And right away, about the equation "inflammation means it hurts." Many people with gastritis have no symptoms at all, and the inflammation is found incidentally during an examination for another reason. So the absence of complaints does not rule out the diagnosis, and pain by itself does not confirm it.

Sometimes people look for "stomach colitis." There is no such diagnosis: gastritis is about the stomach, colitis is about a different part.

Types of gastritis: acute, chronic, active

Acute — inflammation that does not last long and occurs after a one-time or short-lived exposure to strong irritants: contaminated food, certain medications, or against the background of acute infections.

Chronic — long-term recurrent inflammation that drags on for months and years. The structure of the mucosa changes, and stomach functions are impaired: secretory, motor, and incretory. Frequency increases with age.

Active — not a separate disease but a characteristic. Inflammation activity is one of the criteria for morphological assessment of a biopsy specimen, along with the degree of inflammation, atrophy, metaplasia, and H. pylori colonization. The entry "active gastritis" means that an inflammatory reaction is ongoing in the tissue, not a special type of disease.

By type, they distinguish A — autoimmune, B — bacterial, associated with H. pylori, C — chemical-toxic, for example due to bile reflux or medications. A mixture of A and B is called pangastritis. There is no single classification, so conclusions from different laboratories may look different.

Causes of inflammation of the gastric mucosa

The list of causes in reference books is short, and most items are familiar to almost everyone:

• Helicobacter pylori infection;
• painkillers from the nonsteroidal anti-inflammatory group — aspirin, ibuprofen, naproxen;
• alcohol abuse;
• severe stress, severe illness, stomach surgery;
• less commonly — autoimmune disorders, bile reflux, viral infections, trauma, caustic substances.

In the autoimmune variant, the immune system attacks the gastric mucosa.

The role of bacteria in gastritis

Helicobacter pylori is the bacterium usually looked for first. Bacterial type B gastritis accounts for up to 90% of all cases of chronic gastritis in developing countries and less than 50% in developed ones. The proportion of bacterial gastritis depends on the region.

It is detected by a breath test (drink a special solution and provide a breath sample), a stool test, or a blood test. What to do about what is found is decided by the doctor.

What a gastritis flare-up is and how it is recognized

Chronic gastritis is described as a recurrent condition, that is, one that comes back. A flare-up (in conversation people say "flared-up gastritis") is the return of symptoms after a quiet period: the upper abdomen hurts again, indigestion appears, along with a feeling of fullness and bloating, nausea, and appetite decreases.

It is recognized by the complaints and their dynamics: what has returned and for how long. If symptoms last longer than a week, worsen, or recur, this is a reason to see a doctor and, possibly, to have a gastroscopy. Without treatment, gastritis can worsen and lead to a stomach ulcer; possible complications include blood loss and an increased risk of stomach cancer.

How gastritis is diagnosed and when a doctor is needed

The doctor takes a history of complaints and may order: a complete blood count (to check for anemia), a breath test for H. pylori, a stool test, and, if the picture is unclear, esophagogastroduodenoscopy with mucosal biopsy. A mucosal biopsy allows the condition of the tissue to be assessed under a microscope.

People go to the doctor if pain or indigestion lasts longer than a week, or if the pain worsens or returns. An accelerated check of the condition is needed for loss of appetite, a feeling of fullness after a very small portion, effortless weight loss, a sensation of a lump in the abdomen, pain or difficulty swallowing, or repeated vomiting.

Gastritis by itself is not a reason to call an ambulance. You need to call 103 or 112 if there is vomiting of bright red blood or material resembling coffee grounds, stool that is black, sticky, and very foul-smelling, or sudden severe pain in the abdomen or chest.

And finally: this text is for reference, it does not replace a doctor's consultation — a diagnosis is made based on examination, not on an article.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer