What Is Gastritis?

Everyone’s stomach has a coated, protective lining. Stomach acid and bile do not typically damage this thick lining, but if the stomach lining does become inflamed or irritated, it is a condition known as gastritis. Many different risk factors can lead to gastritis; some risk factors are related to lifestyle choices, while others are related to issues such as surgery or autoimmune disorders. 

What Are the Two Types of Gastritis?

There are two types of gastritis: erosive and non-erosive. Erosive gastritis is the most common and also the most damaging. With erosive gastritis, the stomach lining is inflamed, and over time, the stomach’s protective lining will begin to erode. Erosive gastritis is significantly related to habits and lifestyle choices. Non-erosive gastritis, which is much less common, does not erode the stomach, however, the stomach is still inflamed. Gastritis is often chronic, but can also be acute, with symptoms appearing suddenly. 

What Causes Gastritis?

Many risk factors can lead to both types of gastritis. Helicobacter pylori (H. pylori) is the culprit behind most cases of chronic gastritis worldwide, but less so in the United States. Risk factors for gastritis include:

• H. pylori. H. pylori is a bacterial infection that also causes peptic ulcer disease. If left untreated, over time, the bacteria will erode the stomach lining. 
• Alcohol abuse. Heavy drinking will erode the stomach lining over time. 
• Physical stress. Sudden trauma or injury can trigger gastritis, even if the injury isn’t localized to the stomach. Often, burn victims and those with traumatic brain injury (TBI) experience gastritis. 
• Smoking. Similar to alcohol, over time, smoking will inflame and erode the stomach lining.
• Autoimmune disease. Those with autoimmune disorders may also experience an immune response that destroys healthy cells in the stomach, leading to gastritis. 
• Medications. Overuse of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen) can break down the stomach lining with age. 

What Is the Difference Between Gastritis and Indigestion?

Indigestion and gastritis often get confused with one another, but they are not the same condition. Gastritis is an inflammation (and often erosion) of the stomach’s protective lining, while indigestion is a condition that typically manifested as abdominal discomfort, a feeling of stomach upset, or abdominal cramping when someone eats or digests their food. Symptoms of indigestion (also known as dyspepsia) should dissipate once the food is finally digested, however, gastritis symptoms linger because the stomach is inflamed for an extended period of time. 

What Are the Symptoms of Gastritis?

Gastritis symptoms can mimic other GI disorders, and minor signs often get mistaken by patients as indigestion. Generally, if you have gastrointestinal disturbances that last longer than a day or two, you should consult your physician. It could just be a mild case of indigestion, or you may have a condition you need treatment for. Some of the symptoms of gastritis include bloating, nausea and vomiting, upper abdominal pain, no appetite, unexplained weight loss, and feeling “full” after a meal when you haven’t eaten much. More severe gastritis symptoms can include black, tarry stools, stomach ulcers, and the vomiting of blood. 

How Is Gastritis Diagnosed?

Your healthcare provider will provide a consultation and physical exam, and, based upon your symptoms, may order diagnostic testing. Because H. pylori are one of the primary causes of gastritis, many of these tests look for this bacteria. Testing for gastritis includes:

• H. pylori breath test. During a breath test, you will swallow a urea capsule (a harmless, radioactive pill) and then breathe into a balloon. If H. pylori are present in your system, the carbon dioxide in the balloon will increase. 
• Stool test. After you provide a stool sample, the sample is tested for H. pylori. 
• Blood test. Unlike a CBC, this test specifically looks for antibody titers (these fight H. pylori infection).
• Upper endoscopy. This is an outpatient surgical procedure where your physician will insert a long, thin tube into your mouth and down your throat into your esophagus. The tube has a tiny camera on it and gives the doctor a birds-eye view of your stomach.
• Upper GI series. For an upper GI test, you will swallow barium (also known as contrast) and have an X-ray. If there are abnormalities in your stomach lining, your physician should be able to detect them via this test. 

What Is the Treatment for Gastritis?

The treatment for gastritis depends upon each individual case and what is causing the condition. Your gastroenterologist may suggest lifestyle changes, such as avoiding alcohol and quitting smoking. They may also suggest you no longer take over-the-counter NSAIDs. Medication is also used to relieve symptoms and reduce inflammation. If you have an H. pylori infection, your doctor will prescribe antibiotics. Other medications used to treat gastritis include proton pump inhibitors, H2 (histamine) blockers, and antacids.

What Happens If Gastritis Goes Untreated?

If gastritis isn’t treated, it can lead to more serious problems. Untreated gastritis caused by H. pylori can lead to anemia, while autoimmune gastritis may cause pernicious anemia. The ulcers produced by gastritis can worsen, allowing bacteria to escape into the stomach and cause a condition known as peritonitis, a condition that can cause sepsis if not treated. Gastritis related to H. pylori is also a precursor to gastric cancer.