Gastritis

Gastritis is an inflammation of the lining of the stomach. There are many possible causes. Gastritis is caused by excessive alcohol consumption, prolonged use of nonsteroidal anti-inflammatory drugs, also known as NSAIDs, such as aspirin or ibuprofen, or infection with bacteria, such as Helicobacter pylori. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Certain diseases, such as pernicious anemia and chronic bile reflux, or autoimmune disorders, can cause gastritis as well. Gastritis may also occur in those who have had weightloss surgery resulting in the banding or reconstruction of the digestive track. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting, or a feeling of fullness or burning in the upper abdomen. Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem.

Infection

Irritation

Symptoms

The following symptoms can be a result of gastritis or can be related to the underlying cause:

• Upper abdominal pain or discomfort
• Gastric hemorrhage
• 
  
Hyperchlorhydria
• Appetite loss
• Belching
  
• Nausea
• Vomiting
• Fever
• Lethargy

Diagnosis

In suspected cases, a doctor usually orders a barium meal test and esophagogastroduodenoscopy to determine gastritis and related conditions such as peptic ulcers and gastric cancer. It is always important that the doctor reviews a patient's history regarding medications, alcohol intake, smoking, and other factors that can be associated with gastritis. In some cases, the appearance of the stomach lining seen during gastroscopy and the results of the barium meal test are reliable in determining gastritis and the cause. However, the most reliable method for determining gastritis is doing a biopsy during gastroscopy and checking for histological characteristics of gastritis and infection. For Helicobacter infection (the most common cause), one can test non-invasively with a urea breath test, stool antigen test, or blood antibody test.

If diarrhea is present also, the correct diagnosis may not be gastritis but rather gastroenteritis.

Treatment

Treatment for gastritis usually consists of removing the irritant or the infection. In cases of infection, a doctor will most often prescribe antimicrobial drugs. Helicobacter infection typically responds well to the triple therapy protocol (consisting of two antibiotics, and a proton pump inhibitor). Regimens that work well include PCA or PCM triple therapy (PPI, Clarithromycin, Amoxicillin) or (PPI, Clarithromycin, Metronidazole). Quadruple therapy has a >90% success rate and includes PPIs, Bismuth subsalicylates, Metronidazole, and Tetracycline.