Gastritis is a relatively common stomach condition among adults and can also affect children. The stomach wall becomes inflamed in gastritis and there may even be open sores (ulcers) that form in the wall. Gastritis can be acute or chronic, with the latter often associated with H.pylori infection.
What happens in gastritis?
The stomach has the ability to produce highly corrosive gastric acid. It also has mechanisms to ensure that this acid, along with the powerful digestive enzymes it secretes, do not irritate or digest the stomach wall. This is largely facilitated by a mucus barrier that separates the acid and enzymes within the stomach from the stomach wall tissue.
However, this mucus barrier may at times fail or is compromised by various factors. The stomach acid and enzymes can then make contact with the stomach wall. Due to its corrosive nature, the acid and enzymes cause inflammation of the stomach wall. This further compromises the mucus-producing cells in the stomach wall from replenishing the affected areas of the mucus barrier.
Read more on what is gastritis?
Gastritis can be classified as non-erosive or erosive. In non-erosive gastritis the stomach wall is inflamed but there are no open sores (ulcers) in the tissue. With erosive gastritis, the stomach wall is damaged to the point that there are ulcers.
The two main causes of gastritis are the overuse of medication and bacterial infection. There are various other causes of gastritis like excessive consumption of alcohol (alcoholic gastritis) and where the immune system attacks the stomach wall (autoimmune gastritis). However, these causes are less common compared to medication use and bacterial infection of the stomach.
Drugs like NSAIDs (over-the-counter and prescription) compromise the mucus barrier by affecting the secretion of mucus. Helicobacter pylori (H.pylori) is a species of bacteria that can withstand the stomach acid. It tend burrows into the stomach wall, damaging it and preventing the formation of mucus at the site of the bacteria.
How To Spot Gastritis
Many people do not know that they have gastritis until it is identified during diagnostic investigations like an upper GI endoscopy. The symptoms may be mistaken for other conditions like indigestion and sometimes the symptoms are vague or mild that it is ignored altogether. Gastritis, like any medical diagnosis, should be confirmed by a medical professional.
The presence of the signs or symptoms below may be indicative of gastritis but can also occur with peptic ulcer disease, in which gastritis is often present as well. These conditions are marked by upper abdominal discomfort, change in appetite, nausea and other digestive symptoms that tend to ease or worsen with eating.
Whereas gastritis involves the stomach, peptic ulcers are more likely to occur in the duodenum (first part of the small intestine) which leads from the stomach. However, there may also be ulcers in the stomach which also falls under the category of peptic ulcer disease. Often peptic ulcers are preceded by gastritis and duodenitis . Sometimes it is only when ulcers arise that a person takes note of these symptoms as they tend to be worse.
Gnawing or Burning Pain
A gnawing or burning pain in the stomach region is a common symptom in gastritis. The stomach is located in the left upper quadrant (LUQ) of the abdomen, tucked under the left ribcage. Therefore pain is usually felt in this region although it may extend towards the upper middle region of the abdomen. The pain tends to be worse when hungry, after eating and in the early hours of the morning when stomach acid secretion increases due to the natural cycle of the body.
Nausea and Vomiting
Nausea is another common symptom. It occurs due to irritation and sometimes even erosion of the stomach wall. Sometimes it may be persistent but usually it fluctuates, worsening at certain times of the day, when hungry or even after eating. Vomiting does not always occur but can arise in severe cases of nausea. When the vomitus has red streaks or black coffee ground particles then this may be a sign of a bleeding stomach ulcer.
A sensation of bloating is another common symptom of gastritis. A person may feel fullness in the stomach area, especially after eating a few bites of food. However, this is not due to actual distension of the stomach but rather due to the irritation of the stomach wall. The bloating may occur on its own or arise at periods when the other symptoms worsen.
Changes in Appetite
A change in appetite may also occur with gastritis. Some people will report having to eat more frequently to prevent the gnawing or burning pain as well as the nausea. It is not uncommon for people to eat more frequently or larger amounts of food simply to prevent the onset of symptoms or ease it. It may also lead to weight gain in these instances. At other times there is a loss of appetite with gastritis. Many people with gastritis will report a continuous sensation of hunger. However, this is often the gnawing or burning pain mistaken for hunger pangs.
The signs and symptoms of gastritis can affect sleeping patterns. As part of the circadian rhythm, the body’s 24 hour biological clock, stomach acid secretion increases in the early parts of the morning. This can further irritate the already inflamed stomach and is worsened if there are open sores (ulcers). A person may find that their sleep breaks at this time in the morning or there may be uneasy sleep due to the pain.
Aggravation by Stress and Stimulants
Many people with gastritis report a worsening of symptoms during psychological stress. This is most likely due to an increase in stomach acid production during these times. A number of different foods and beverages can also aggravate the symptoms. Alcohol, coffee and other caffeinated beverages as well spicy foods tend to worsen gastritis. Apart from alcohol in alcoholic gastritis, these foods and beverages are not the cause of gastritis but are triggers and exacerbating factors. Similarly people who use tobacco may also find symptoms worsen with excessive tobacco use.
Read more on foods to avoid for gastritis.