Gastritis: All you need to know

Inflammation, irritation, or erosion of the inner lining of the stomach is the most common condition which is generally called gastritis.

It is generally caused by the bacteria most often associated with stomach ulcers for most people or with the regular use of certain pain killers for a prolonged amount of time.

Gastritis can be acute (occurring suddenly) or may last longer sometimes even life-long (chronic gastritis), but if left unresolved can lead to stomach ulcers and ultimately to cancer.

But for most people and cases it is not considered to be a serious issue as it improves with treatment.

Statistics of Prevalence of Gastritis in Nepal

Gastritis is generally associated with the inflammation of the inner lining of the intestine and the causative agent in most cases of gastritis (41.1%) is found to be Helicobacter Pylori from an endoscopic study.

Hence, it is wise to correlate the incidence of H. Pylori with the prevalence of gastritis in most cases but not always. Moreover, H. Pylori is also associated with 69.5% of gastric ulcers, and, 11.5% of gastric cancers in Nepal.

Similarly, several independent studies performed on patients with complete endoscopy results for infection of bacteria H. Pylori revealed that (27-68) % of them were infected.

Not much significant difference has been observed when classified across the gender. Moreover, when the specimens were sent to the labs for further analysis on the kind of gastritis included it was found that erythematous antral gastritis constituted (40.7%) followed by erosive gastritis at (30.1%), while pangastritis (8.8%), duodenal ulcer (11.5%), gastric ulcer (8%), erosive fundal gastritis (1.8%), reflux esophagitis (37%).

Therefore, H. Pylori is strongly correlated with chronic active gastritis in Nepalese adults.

Similarly, the prevalence of this disease is also strongly correlated with the socio-economic condition of the population. The data points to a huge disparity between a developing country in comparison to in the industrialized nations.

Symptoms of Gastritis

• Pain associated with the burning ache in the upper abdomen
• Nausea and vomiting
• The feeling of fullness in the abdomen
• Loss of appetite
• Abdominal bloating
• Indigestion

While in some cases gastritis may not even cause any signs and symptoms.

Complications

If left untreated for a long period, gastritis often leads to stomach bleeding and stomach ulcers.

And sometimes it may also lead up to stomach cancer especially when the thinning of the stomach lining is extensive along with the genetic changes in the cells of the intestinal epithelium.

Causes and Risk Factors

There are myriad causes that can trigger gastritis in people all of which primarily damage the inner lining of the intestine causing inflammation. A few of them are listed below.

1. Bacterial Infection

Undoubtedly, infection with Helicobacter Pylori is the most common infection that causes gastritis, nevertheless, not all who contract and are infected, develop gastritis.

It actually depends on the immunity and susceptibility to the bacterium along with their lifestyle choices such as smoking, and diet.

2. Long-term use of Pain killers

Chronic (long-term) use of certain pain relievers especially ibuprofen (Advil, Motrin IB, and others) along with naproxen sodium (Aleve, Anaprox DS) can cause chronic or acute gastritis.

The mechanism is such that these drugs remove the vital protective substance that helps protect the inner lining of the stomach, leaving it susceptible to wear and tear, and infection. 

3. Aging

Older people are more prone to the risk of having gastritis in general since the inner lining of the stomach thins automatically with age along with the fact that they are more susceptible to H. Pylori infection than compared to younger people.

4. Alcohol overuse

Alcohol tends to erode and irritate the stomach lining in general, hence leaving the person more prone to gastritis.

But generally speaking, alcohol overuse tends to trigger acute gastritis more than a chronic one.

5. Stress

Surgery, injury, burns, or severe infections are generally the kind of major stressors that can sometimes cause acute gastritis.

6. Cancer treatment

Patients undergoing chemotherapy, or radiation therapy, are likely to experience gastritis.

7. Autoimmune gastritis

This is caused when immune cells of your own body attack the inner lining of your stomach due to various auto-immune diseases such as Hashimoto’s disease, and Type-1 diabetes.

Rarely speaking vitamin B-12 deficiency can also sometimes cause auto-immune gastritis.

8. Pre-existing medical conditions

Gastritis is also often associated with other medical conditions that peoples possess such as HIV/AIDS, Crohn’s disease, celiac disease, sarcoidosis, and parasitic infections.

9. Bile Reflux

The backflow of bile from the bile tract into the intestine may also result in gastritis.

Diagnosis

The doctor might generally review and ask about the family history, your pre-existing medical condition, and symptoms that you are having to diagnose and ascertain if you have gastritis.

Mostly speaking thorough physical evaluation would suffice for your doctor to conclude, but if required, they might also recommend you to take some blood test, upper endoscopy, or fecal occult blood test.

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1. Upper GI Endoscopy

During this procedure, an endoscope, a tube with a tiny camera, is sent to the intestine from your mouth to observe the possible inflammation of the lining.

If needed, doctors might extract a tiny piece of the sample from your intestine and send it to the lab for further analysis.

2. H. Pylori breath test

H. Pylori falls under the group of bacteria that is found in the stomach and is known for causing several types of stomach diseases(gastritis, ulcer cancers, and many others).

Many of the victims of this bacteria show little to no symptoms so, knowing if you have it or not is hard. And if left untreated, it can be fatal.

Therefore, Pylori Breath Test is done to find its presence in the stomach and treat it before it causes any problems.

3. Blood test

Various blood tests could be performed to analyze if you have gastritis. For example, you might be screened for H. Pylori infection or anemia.

4. Fecal occult blood test

This is primarily done to check the presence of blood in stool, which might be a possible sign of gastritis.

Conclusion

To sum up, the prevalence of bacterial infection H. Pylori constitutes gastritis cases in our population with no significant difference observed across gender.

Development of peptic ulcers from gastritis is mostly seen in the case of Nepalese adults which also coincides with higher rates of H. Pylori colonization.

Similarly, chronic active gastritis and chronic follicular gastritis are predominant cases in our population with a significantly higher rate of H. Pylori infections.

Treatment of Gastritis

• It’s best to take care of your eating habits if you have gastritis, such hot and spicy foods must be avoided as much as possible.

• Your doctor can recommend you some antacids (proton pump inhibitors or H-2 blockers) depending on your case study.

• In case of H. Pylori infection, you might be recommended certain antibiotics or other acid-blocking drugs.

• In case of gastritis resulting from a lack of red blood cells, shots of vitamin B-12 shots could be given.

• It is a wise decision to avoid foods that irritate the intestinal lining such as lactose from the dairy product or gluten from wheat products.

• It’s best to take a recommendation from your physician before you start any medication on your own.

References

Amrendra Kumar Mandal, et al (2019) An association of Helicobacter pylori infection with endoscopic and histological findings in the Nepalese population, Journal of Family Medicine and Primary Care

Jennifer Robinson, MD (2020) What is Gastritis, WebMD

Mayo Clinic, Gastritis, Health magazine

Roshana Shrestha, et al (2014) Helicobacter Pylori Infection Among Patients with Upper Gastrointestinal Symptoms: Prevalence and Relation to Endoscopy Diagnosis and Histopathology, Journal of Family Medicine and Primary Care

Sashi Silwal et al (2021) Knowledge Regarding Gastritis among Late Adolescence in Central Nepal, Marsyangdi Journal

Umid Kumar Shrestha et al (2013)Prevalence of Helicobacter pylori infection, its correlation with gastroduodenal diseases and the incidence of gastric cancer in Nepal, Journal of Advances in Internal Medicine