What Is Gastritis?

Gastritis is when your stomach lining becomes inflamed. Many people with gastritis don’t have symptoms. Among those who do, symptoms can include nausea, vomiting, bloating, indigestion, or heartburn.

This common condition can be acute (meaning it has a sudden onset) or chronic (meaning it develops gradually). In either case, there are many treatment options for gastritis, such as medication and lifestyle changes, that may alleviate symptoms.

Gastritis is classified according to how long you’ve had symptoms and what the underlying cause is.

Acute vs. Chronic Gastritis

• Acute gastritis is a sudden and temporary condition characterized by inflammation and irritation, which may include shallow breaks in the stomach lining.

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  It often leads to a noticeable upset stomach or bowel problems, but these symptoms often get better on their own in a few days.

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• Chronic gastritis is a persistent, long-term inflammatory condition that deteriorates the stomach lining over time. Left untreated, certain types of inflammation may result in gastric adenocarcinoma, a type of stomach cancer.

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   It can be caused by a number of factors, including frequent and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), Helicobacter pylori (H. pylori) infection, extreme stress, smoking, and autoimmune diseases.

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Erosive vs. Nonerosive Gastritis

• Erosive gastritis: When the illness wears away at your stomach lining, leaving ulcers
• Nonerosive gastritis: When the illness doesn’t eat away at your stomach lining, but instead causes irritation, such as reddening. It may also lead to atrophy (thinning) of the stomach lining, which can cause digestive problems.

Other Ways to Classify Gastritis

Sometimes you may hear gastritis categorized based on cause.

• Infectious gastritis: A type of gastritis induced by bacteria, viruses, parasites, or fungi

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• Reactive or chemical gastritis: A form of gastritis triggered by drugs (typically NSAIDs), alcohol, or bile reflux (when bile from the small intestine flows backward into the stomach or esophagus rather than flowing as usual into the small intestine)

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• Autoimmune gastritis: A type of gastritis caused by an autoimmune disorder and the resulting dysfunction of gastric acid secretion

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• Eosinophilic gastritis: A rare, chronic disease caused by an overproduction of white blood cells called eosinophils, which can lead to inflammation and damage in the stomach. Eosinophilic gastritis is often associated with allergies.

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• A loss of appetite or feeling full quickly when eating
• Nausea and vomiting
• Indigestion, which can feel like a burning sensation in the belly that heightens after eating
• Bloating and abdominal pain
• Hiccups and belching
• Dark blood in your vomit or black, tarry stools, which can indicate the stomach lining is bleeding
• Unexplained weight loss
• Anemia

Gastritis can be caused by several factors, including:

• Bacterial and Viral Infections Infection caused by the bacteria H. pylori is overwhelmingly the most common cause of chronic gastritis.

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  Other bacteria, viruses, parasites and fungus can cause gastritis, too.

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• Long-Term Use of NSAIDs NSAID pain relievers like ibuprofen and naproxen sodium can damage the stomach lining and lead to gastritis if taken often for an extended period of time.

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• Extreme Stress Stress due to bodily trauma, severe illness, major surgery, or untreated chronic depression can lead to gastritis.

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• Alcohol and Cigarettes Drinking too much alcohol and smoking both can irritate the stomach lining.

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• Drug Use Recreational drugs, such as cocaine, can also cause gastritis.

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• Chemotherapy and Radiation Gastritis is a potential side effect of cancer treatments like chemotherapy or radiation therapy.

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• Acidic Beverages Drinking too much coffee or other acidic beverages can irritate the stomach lining.

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• Autoimmune Disease Certain autoimmune conditions, such as celiac disease and Crohn’s disease, cause inflammation in the digestive tract.

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• Food Allergies An abnormal immune response to certain foods can cause a rare type of gastritis known as eosinophilic gastritis. As mentioned, people with this condition experience a buildup of eosinophils, which can lead to inflammation and damage in the stomach.

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• Older Age Older adults are at an increased risk of gastritis because the stomach lining often gets thinner with age. In addition, common causes of gastritis, such as H. pylori infection and autoimmune disorders, are usually more severe in older adults than in younger adults.

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• Bile Reflux This occurs when bile, a bodily fluid that helps break down food in the small intestine, comes back up into the esophagus and stomach, damaging the stomach lining.

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  Bile reflux is a common side effect in people who have just had weight loss surgery or other types of surgery that remove part of the stomach.

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• Upper endoscopy exam: An endoscopy is a procedure in which a long, thin tube with a tiny camera is passed down the GI tract from the throat and into the esophagus to examine the stomach and small intestine. Using the endoscope, your doctor will look for signs of inflammation and conduct a biopsy (removing a small tissue sample from your stomach) to test it for specific bacteria and viruses.

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• Breath or stool tests: Breath or stool tests can detect H. pylori. During a breath test, individuals drink a glass of clear, tasteless liquid that contains radioactive carbon, which is broken down by H. pylori bacteria. They then blow into a bag, which is sealed afterward. Those with an H. pylori infection will have radioactive carbon present in the bag.

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   Your medical team may also collect a stool sample to test for bacteria that can cause gastritis. These tests can also check for blood in your stool, another potential indicator of gastritis.

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• Blood tests: Although blood tests can’t actually diagnose gastritis, they can identify potential indicators of gastritis, such as a vitamin B12 deficiency.

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The best treatment options will depend on the root cause of your gastritis and may include one or a combination of the options below:

Medication for Gastritis

Medication options for gastritis include:

• Antibiotics If you have H. pylori infection in your digestive tract, your doctor will likely prescribe antibiotics, usually taken for 7 to 14 days.

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• Proton Pump Inhibitors These medications reduce stomach acid production. They can be bought over-the-counter or with a prescription.

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  They include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (AcipHex).

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• H2 Blockers H2 blockers decrease how much stomach acid is secreted by glands in your stomach lining. They include famotidine (Pepcid AC, Zantac 360), cimetidine (Tagamet), or nizatidine (Acid AR).

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• Antacids These over-the-counter medications neutralize stomach acid, decreasing symptoms like heartburn and indigestion quickly, but they don’t treat ulcers. They include aluminum hydroxide (Amphojel), magnesium hydroxide (Phillips' Milk of Magnesia), calcium carbonate (Rolaids, Titralac, Tums), sodium bicarbonate (Alka-Seltzer), and aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta). Antacids can lead to more side effects like constipation or diarrhea compared to PPIs and acid blockers.

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• Practice good hygiene. As mentioned, H. pylori infection is the most common cause of chronic gastritis. It can be prevented with good hygiene habits, including handwashing.
• Limit or avoid foods and beverages that irritate the stomach lining. Too much alcohol, caffeine, or spicy and acidic foods can cause stomach discomfort, and wear down your stomach lining when consumed in excess.
• Decrease use of NSAIDs. Be mindful of how often you use pain medications including aspirin, ibuprofen, and naproxen. Try not to use them long-term.

Certain lifestyle changes can make a big difference if you have gastritis. They include:

• Make dietary changes. If you don’t have symptoms, you may not have to change your diet. But if you do, pay attention to what you eat and how you feel afterward, as certain foods can be a trigger for gastritis symptoms. In general, try to avoid alcohol, coffee, carbonated drinks, acidic or spicy foods, ultra-processed or deep-fried foods and foods that are high in fat. If the root cause of your gastritis is celiac disease or food allergies, your doctor may refer you to a dietitian to create a nutrition plan for you.

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• Reduce NSAID use. If long-term use of NSAIDs triggered your gastritis, your doctor may suggest you stop taking NSAIDs, take a lower dose, find a replacement medication for pain, or try taking it alongside a PPI.

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• Quit smoking. Smoking cigarettes can irritate the stomach lining. Quitting can relieve symptoms of gastritis.

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• Consider vitamin supplementation. If you have gastritis caused by an autoimmune condition, your doctor may recommend certain vitamin supplements to prevent anemia. Talk to your doctor about what kinds and how much you should take.

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• Consider acupuncture. Some research suggests that acupuncture may lessen inflammation, protect the stomach lining, and improve quality of life among people with chronic gastritis. Research in this area has been limited, though, and more studies are needed to confirm these findings.

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Untreated gastritis can worsen digestive health and may lead to issues such as:

• Peptic ulcer disease: Painful sores (ulcers) can form along the stomach lining and small intestine, exacerbating gastritis symptoms. These ulcers can be caused by H. pylori infection or overuse of NSAID medications.

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• Gastric polyps: These small masses of cells can form along the stomach lining. Most times they’re harmless, but in rare cases they can develop into cancer. In rare instances, polyps can block the opening between the stomach and small intestine.

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• Stomach bleeding: Ulcers can bleed, causing low red blood cell counts or anemia. When ulcers break through the stomach lining, stomach contents leak into the abdominal cavity, causing an infection called peritonitis, which is a surgical emergency.

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• Anemia: Autoimmune gastritis can also cause malabsorption of vitamin B12, which can lead to pernicious anemia.

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• Stomach cancer: Certain types of gastritis can increase the risk of developing tumors — benign or cancerous — in the stomach lining. Gastritis caused by H. pylori infection, for example, increases the risk of gastric mucosa-associated lymphoid tissue (MALT) lymphoma, a type of cancer.

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  Researchers suggest that the bacteria converts substances in some foods into chemicals that cause DNA mutations in the stomach lining.

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• Gastritis is an inflammation of the stomach lining that can be temporary (acute) or chronic.
• H. pylori infection and frequent, long-term NSAID use are the most common causes of gastritis.
• There are many treatment options for gastritis, including medication and lifestyle changes.