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6836 0080Gastritis is the inflammation of the stomach lining (gastric mucosa). The stomach lining is protected by a layer of mucus that prevents the corrosive effects of stomach acid. However, when this protective barrier weakens, digestive fluids can damage or inflame the lining of the stomach, leading to gastritis. This condition can interfere with digestion and lead to various symptoms.
Gastritis can be categorised into various types based on the duration and underlying cause. These include:
Acute Gastritis
This refers to sudden onset inflammation or swelling of the stomach lining with recurrent episodes of attacks that usually only last a few days.
Chronic Gastritis
This refers to persistent, low-grade inflammation of the stomach lining, whose symptoms may develop gradually over time.
An individual may develop gastritis due to several causes, including:
Helicobacter pylori (H. pylori)
This bacterium can reside in the stomach lining and weaken the protective layer of mucus, resulting in inflammation. It can be transmitted from person to person or through contaminated water and food. If left untreated, the infection may lead to peptic ulcers or an increased risk of stomach cancer.
Autoimmune Diseases
In some cases, the immune system can mistakenly attack the cells that form the lining of the stomach, causing chronic inflammation and gastritis. Some autoimmune disorders linked to gastritis include Hashimoto's disease and type 1 diabetes.
Inflammatory Bowel Disease
Individuals with inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, are susceptible to developing gastritis.
Reactive or Chemical Causes
Alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) can increase the risk of gastritis, depending on the dose and frequency of use. They can also cause chemical erosion of the stomach lining, known as erosive gastritis.
Regular Use of Pain Relievers
Prolonged use of aspirin, ibuprofen, and other anti-inflammatory drugs may hinder the production of an essential substance called prostaglandin. This substance protects the stomach lining from stomach acid, insufficient production can result in the development of gastritis.
Advanced Age
As individuals age, the stomach lining becomes thinner and more vulnerable to inflammation and damage.
Excessive Alcohol Consumption
Heavy alcohol use can irritate and erode the stomach lining, causing the stomach to secrete more digestive juices and leading to acute gastritis.
Stress
Severe physical stress from major surgery, injury, burns, or infections may increase the risk of developing acute gastritis.
Cancer Treatment
Radiation therapy or chemotherapy can affect the healthy cells in the stomach lining and lead to inflammation and damage.
In some cases, gastritis may not cause noticeable symptoms (asymptomatic). However, some individuals may experience symptoms such as:
Nausea
This sensation can occur before or after meals and may be accompanied by a feeling of queasiness or vomiting.
Abdominal Pain
Individuals with gastritis often experience a burning, gnawing, or dull ache in the upper abdomen, which may worsen after eating.
Abdominal Bloating
Gastritis can cause the stomach to feel distended or bloated, typically after meals or throughout the day.
Indigestion
Also known as dyspepsia, this condition is characterised by upper abdominal discomfort, often accompanied by belching and heartburn. Symptoms tend to worsen when eating or lying down.
Loss of Appetite
Individuals with gastritis may notice decreased appetite and a sense of early fullness even after eating small portions.
Without proper treatment, gastritis can result in a range of complications, which include:
Anaemia
Chronic gastritis can result in bleeding in the gastrointestinal tract, leading to anaemia, a condition characterised by a decrease in the overall amount of red blood cells.
Atrophic Gastritis
This condition refers to the long-term inflammation and thinning of the stomach lining, often caused by the H. pylori bacterium.
Peptic Ulcers
These painful open sores develop on the inner lining of the stomach and duodenum. Left untreated, they can cause abdominal pain, bleeding, and perforation of the stomach wall.
Peritonitis
Gastritis may exacerbate stomach ulcers, causing stomach contents to leak into the abdominal cavity. This can lead to the spread of bacteria and peritonitis, which is an inflammation of the inner abdominal wall.
Stomach Cancer
In certain instances, chronic gastritis can trigger the formation of abnormal growths in the stomach lining, such as polyps, which could increase the risk of stomach cancer.
To diagnose gastritis, the doctor will carefully review the patient’s medical history, conduct a thorough physical evaluation, and may recommend any of the following tests:
Gastroscopy
A flexible video endoscope is inserted through the mouth into the stomach to check for inflammation in the digestive tract. A gastroenterologist can obtain biopsy samples from the oesophagus, stomach and duodenum via the endoscope.
H.Pylori Breath Test
This test involves the patient ingesting a capsule or liquid containing a radioactive substance (urea), specifically labelled with a carbon atom. If H. pylori is present, it will break down the urea and release the labelled carbon, which can be detected in the patient's breath.
Upper GI Series
During this procedure, the patient consumes a contrast material containing barium. This substance coats the oesophagus, stomach, and small intestine, making them visible on X-rays. By doing so, any abnormalities can be identified by the doctor.
Depending on the cause of gastritis, medicine may be prescribed, such as:
Antibiotics (Amoxicillin and Clarithromycin)
These drugs for gastritis are specifically designed to target and eliminate the bacterium H. pylori and help the stomach lining to heal.
H2 Blockers
H2 blockers, such as ranitidine or famotidine, help reduce the production of stomach acid. These gastritis medications can also alleviate symptoms such as abdominal pain and heartburn.
Proton-Pump Inhibitors (PPI)
PPIs such as omeprazole and lansoprazole help block the enzymes (pepsin) responsible for gastric acid secretion in the digestive tract.
Antacids
These gastritis treatments help neutralise stomach acids to relieve symptoms such as heartburn and indigestion.
Frequently Asked Questions (FAQs)
Dr Kieron Lim
MBBS, University of LondonMember, Royal College of Physicians (UK)Fellow, Academy of Medicine (Gastroenterology) SingaporeFellow, Royal College of Physicians (Edinburgh)
Dr Kieron Lim is a senior consultant specialising in Gastroenterology and Hepatology. He is dedicated to providing comprehensive medical care for individuals with gastrointestinal, intestinal, and liver disorders. With decades of specialist experience, Dr Lim focuses on assessing and treating conditions such as liver fibrosis, liver cirrhosis, viral hepatitis B and C, fatty liver disease, liver cancer, and much more. He strives to deliver efficient and evidence-based services in a private and comfortable setting.