Gastritis is an inflammation of the stomach lining. Many things can cause gastritis. Most often the cause is infection with the same bacteria -- Helicobacter pylori -- that causes stomach ulcers. An autoimmune disorder, a backup of bile into the stomach, or long term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also cause gastritis. In some cases, the stomach lining may be "eaten away," leading to sores (peptic ulcers) in the stomach or first part of the small intestine. Gastritis can occur suddenly (acute gastritis) or gradually (chronic gastritis). In most cases, gastritis does not permanently damage the stomach lining.
Signs and Symptoms
The most common symptoms of gastritis are stomach upset and pain. Other possible symptoms include:
can be caused by infection, irritation, autoimmune disorders (where the body’s immune system mistakenly attacks the stomach), or backflow of bile into the stomach (bile reflux). Gastritis can also be caused by a blood disorder called pernicious anemia.
Infections can be caused by:
A number of things can cause irritation, including:
Other causes for gastritis are very rare. These include:
Several tests can be used to make a diagnosis. These include endoscopy of the stomach, where a thin tube with a light and a camera on the end is inserted down your throat into your stomach. This allows the doctor to see into your stomach and take samples (called a biopsy) from the lining if needed. The laboratory tests you may need will depend on the cause of your gastritis. A stool test may be used to check for the presence of blood, or a biopsy may be taken of the tissues of your esophagus or stomach. A breath test may detect H. pylori, or samples from your esophagus or stomach may be taken to look for this bacteria.
Making lifestyle changes, such as avoiding the long term use of alcohol, NSAIDs, coffee, and drugs, may help prevent gastritis and its complications (such as a peptic ulcer). Reducing stress through relaxation techniques -- including yoga, tai chi, and meditation -- can also be helpful.
Treatment of gastritis depends on the cause of the problem. Some cases of gastritis may resolve by themselves over time, or be relieved when you stop drinking alcohol, smoking cigarettes, or taking NSAIDs. You may need to change your diet, although doctors now know that a bland diet isn’t required. If your gastritis is due to H. pylori infection, you will be given antibiotics.
The treatment for gastritis that is caused by irritants is to stop using them. These include:
These steps may also help:
If you have H. pylori, you will probably be prescribed 3 medications. "Triple therapy," including a proton pump inhibitor to reduce acid production and 2 antibiotics, is commonly used to treat H. pylori related gastritis and ulcers. Bismuth salicylate (Pepto Bismol) may be used instead of the second antibiotic. This drug, available over the counter, coats and soothes the stomach, protecting it from the damaging effects of acid. 2 drug regimens are currently being developed.
Some of the same drugs are used for non-H. pylori gastritis as well as for symptoms (like indigestion) due to ulcers:
Antacids -- Available over the counter, they may relieve heartburn or indigestion but will not treat an ulcer. Antacids may block medications from being absorbed and thereby decrease the medicine's effectiveness. Doctors recommend taking antacids at least 1 hour before or 2 hours after taking medications. Ask your pharmacist or doctor for more information. Antacids include:
H2 blockers -- reduce gastric acid secretion. They include:
Proton pump inhibitors -- decrease gastric acid production. They include:
Nutrition and Dietary Supplements
Doctors used to recommend eating bland foods with milk and only small amounts of food with each meal. Researchers now know that such a diet isn’t required to treat gastritis or ulcers.
Following these nutritional tips may help reduce symptoms:
The following supplements may help with digestive health:
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitution -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you individually.
Acupuncture may help reduce stress and improve overall digestive function.
Go back to your doctor if your symptoms do not get better or get worse. Do not ignore potentially life threatening symptoms, such as vomiting blood or blood in your stool. Blood in the stool can be hard to see. The stools may simply look very dark, even black. Be sure to see your health care provider regularly, and call your doctor if there is any change in your symptoms.
If you are on both antibiotics and vitamin B12, take them at different times of day. Vitamin B12 interferes with antibiotic absorption.
If you are pregnant or breastfeeding, you should ask your doctor before taking any medication, including herbs.
Prognosis and Complications
Symptoms of H. pylori infection usually get better with treatment. Your doctor will likely want to see you again 4 weeks or more after stopping your drug regimen. Follow up is very important because the H. pylori bacteria may increase risk of stomach cancer.
Peptic ulcers may develop when stomach acid damages the lining of the stomach or the first part of the small intestine (called the duodenum). These ulcers can usually be treated with lifestyle changes and medication.
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Review Date: 9/10/2011
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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