Home Diseases Inflammation of the gastric mucosa (gastritis): symptoms, causes

Inflammation of the gastric mucosa (gastritis): symptoms, causes

by Josephine Andrews
Published: Last Updated on 351 views

Typical symptoms of gastritis are abdominal discomfort such as a feeling of fullness or pain in the upper abdomen. The patients have no appetite and often feel nauseous. Gastritis can be acute or chronic. Resting the stomach often improves the symptoms; in more severe or chronic cases, medication can help. Read here how to recognize gastric mucosal inflammation and what you can do.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

K29 K52

quick overview

  • Symptoms: feeling of fullness, pain in the upper abdomen, loss of appetite, nausea, heartburn, belching, more rarely digestive problems
  • Causes: irritating substances (eg alcohol, medication), stress, stomach germ Helicobacter pylori, autoimmune reactions
  • Treatment: bland diet, acid binders, proton pump inhibitors, relaxation exercises
  • Diet: Light food, avoiding alcohol and hot spices, steaming instead of frying
  • Dangers: Danger to life with bleeding ulcers, long-term increased risk of stomach cancer

Inflammation of the gastric mucosa: symptoms

Gastritis can cause various non-specific symptoms. The main symptoms are typical for both acute and chronic gastritis. However, they occur suddenly in the acute form, while chronic gastritis develops insidiously.

Common symptoms of gastritis are:

  • bloating
  • pain in the upper abdomen
  • decreased appetite
  • nausea
  • Vomit
  • heartburn
  • burping
  • bad breath

Rarer are:

  • gas
  • bland taste in the mouth
  • early feeling of satiety
  • back pain
  • diarrhea

Symptoms of chronic gastritis

Depending on the causes, a distinction is made between types A, B and C and various special forms of chronic gastritis.

Symptoms of type A gastritis

Type A gastritis produces less acid in the stomach. This can cause digestive problems. In addition, this form of gastritis results in a vitamin B12 deficiency , which triggers what is known as pernicious anemia, a special form of anemia. Symptoms include discomfort, tiredness and exhaustion.

Symptoms of type B gastritis

Type B gastritis usually shows only non-specific symptoms. Some patients develop bad breath and, in the further course, additional diseases such as:

  • Duodenal ulcer (Ulcus duodeni)
  • Stomach cancer (stomach carcinoma)
  • MALT lymphoma (mucosal associated cancer of the lymphatic tissue)

Symptoms of Type C gastritis

Type C chronic inflammation of the gastric mucosa usually only causes unspecific symptoms. Many patients report discomfort in the upper abdomen. The symptoms often correspond to those of an irritable stomach.

Inflammation of the gastric mucosa: causes and risk factors

Gastritis occurs when the protective lining of the stomach is damaged. These can be substances that irritate the stomach or factors that stimulate an overproduction of corrosive gastric acid.

Examples of triggers for acute gastritis are:

  • excessive consumption of alcohol
  • excessive consumption of nicotine
  • Frequent consumption of foods that irritate the stomach, such as coffee or hot spices
  • frequent or high doses of certain medications, such as painkillers or anti-inflammatory drugs such as cortisone
  • mental stress
  • Food poisoning caused by bacteria such as staph or salmonella
  • mechanical irritation, such as from a stomach tube or other foreign bodies
  • Chemical burns from acids or alkalis
  • physical stress such as long-term ventilation, craniocerebral trauma, burns, brain diseases, major surgeries, shock (circulatory collapse)
  • Competitive sports (“runners stomach”)

If bacteria such as staph or salmonella are the cause, gastritis can be contagious. The pathogens are then excreted in the stool and other people can become infected, for example by sharing the toilet.

This is how the stomach is built
The stomach is a hollow muscle and is lined with a mucous membrane on the inside. It protects the stomach from gastric acid. For digestion, food and gastric acid are mixed together in the stomach and transported further towards the intestines by muscular work.

Causes of chronic gastritis

Type A gastritis

Type A gastritis is also known as autoimmune chronic inflammation of the gastric mucosa. Autoimmune means that the body’s own defense system turns against the body itself: it forms antibodies that attack the body’s own structures. Type A gastritis is the rarest form of chronic gastritis, accounting for around 5 percent of cases.

They attack the parietal cells that produce stomach acid. As a result, less stomach acid is released. Other antibodies are directed against the intrinsic factor. This protein is formed in the stomach and is necessary for the absorption of vitamin B12. The result is a vitamin B-12 deficiency.

Type A gastritis accounts for about five percent of chronic gastritis. It can be inherited and mainly affects northern Europeans. The inflammation is often localized in the main part of the stomach. Many patients also suffer from other autoimmune diseases, for example

  • Addison’s disease
  • Type I diabetes mellitus
  • Hashimoto’s thyroiditis (autoimmune thyroid inflammation)

Type B gastritis

About 80 percent of chronic gastritis cases are type B. They are mostly caused by the bacterium Helicobacter pylori (H. pylori). The stomach germ can be transmitted via saliva or stool. More rarely, related pathogens are also the cause of type B gastritis, such as Helicobacter heilmannii, which is transmitted from dogs or cats to humans.

Inflammation of the gastric mucosa by bacteria
In the case of an inflammation of the gastric mucosa caused by bacteria, the protective layer of mucus is destroyed by the germs. The stomach acid now attacks the mucous membrane directly.

Type B chronic gastritis mainly affects the part of the stomach between the body of the stomach and the outlet of the stomach (gastric antrum).

Type C gastritis

Type C chronic gastritis accounts for about 15 percent of chronic gastritis. It is caused by chemical irritation of the stomach. These include painkillers such as acetylsalicylic acid (ASA), ibuprofen or diclofenac. They belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

The flushing of bile back into the stomach (bile reflux) can also result in chronic type C gastritis.

Rare forms of chronic gastritis

In rare cases, chronic gastritis can also have other causes. Among other things, there are the following special forms:

  • Eosinophilic (allergic) gastritis: for example, allergies to cow’s milk or soy
  • Lymphocytic gastritis: possibly triggered by H. pylori or celiac disease, leads to Ménétrier’s disease (giant wrinkle gastritis) or anemia (among other things)
  • Granulomatous gastritis: in inflammatory diseases such as Crohn’s disease, sarcoidosis or tuberculosis

Inflammation of the gastric mucosa: therapy

Inflamed or irritated gastric mucosa can often be treated on your own with simple measures. If that is not enough, various medications can help.

The first step in treating gastritis is to omit anything that irritates the gastric mucosa. Coffee, alcohol and nicotine are therefore taboo during gastritis.

If the symptoms are severe, it can make sense to go completely without food for a day or two. Usually you don’t have an appetite anyway.

Otherwise, it is often enough to eat light food, with easily digestible small meals.

If stress is the trigger of gastritis, relaxation methods such as autogenic training , meditation or progressive muscle relaxation according to Jacobson can help.

Useful gastritis home remedies are also:

  • Hot-water bottle or grain pillow (cherry stone pillow)
  • Chamomile tea (anti-inflammatory)
  • Chamomile , peppermint and licorice tea blend (mix half a teaspoon each of licorice root and chamomile flowers with a teaspoon of peppermint leaves)
  • Oatmeal (protects the stomach lining)
  • Lemon balm or hop blossom tea (have a calming effect)
  • potato juice
  • healing clay

Roll cure with chamomile tea: A roll cure for gastric mucosal inflammation can also be helpful. Drink two cups of chamomile tea for this. Then lie on your back for ten minutes. Then turn on your left side, right side and stomach for another ten minutes each. Remain lying for about half an hour after this roll cure. Use this home remedy daily for a week.

Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.

treatment with medication

Antacids: If behavioral measures alone are not enough, antacids can help. These active ingredients neutralize aggressive gastric acid.

H2-receptor blockers: Another possibility are so-called H2-receptor blockers (such as cimetidine or ranitidine). They reduce the production of stomach acid. This allows the inflamed gastric mucosa to recover and is protected from further damage.

Proton pump inhibitors: So-called proton pump inhibitors (PPIs) are even more effective. They also reduce stomach acid production. Examples of PPIs that are often used are omeprazole and pantoprazole . However, they should only be taken long-term in exceptional cases and in consultation with the doctor.

Antibiotics: If you have chronic type B gastritis, you need to get rid of the disease-causing bacteria. A combination of two or three antibiotics together with a proton pump inhibitor over seven days, for example, can drive out Helicobacter pylori in over 90 percent of cases.

Antispasmodic and anti-nausea agents: Anti-nausea agents (antiemetics) or antispasmodic, pain-relieving drugs (spasmolytics) help against further symptoms of gastritis.

Vitamin B 12: Chronic type A gastritis carries the risk of pernicious anemia. This is caused by a vitamin B12 deficiency. Patients therefore usually receive vitamin B12 injections.

Treatment with alternative medicine

Homeopathy: Homeopathic remedies for inflammation of the gastric mucosa are, for example, Carbo vegetabilis and Lycopodium . They should alleviate the symptoms.

Schuessler salts: Schuessler salts against nausea or belching are, for example, no. 9 sodium phosphoricum, which is said to regulate the acid balance in the body, and no. 7 magnesium phosphoricum, which is said to have a relaxing, antispasmodic effect on the digestive organs.

Traditional Chinese medicine: Treatment according to traditional Chinese medicine (TCM) – for example in the form of acupuncture – can also alleviate gastritis symptoms, as patients report

The concept of these alternative treatment methods and their specific effectiveness are controversial in science and have not been unequivocally proven by studies.

Emergency Stomach Bleeding!

Sometimes the mucosal damage in gastritis is so severe that bleeding occurs. In milder cases, these can be stopped as part of a gastroscopy (gastroscopy). Heavy bleeding – recognizable by bloody vomit or dark-colored stool (tarry stool) – can be life-threatening. They require emergency treatment. Sometimes only surgery can stop the bleeding.

nutrition

In the case of gastritis, the main concern is not to further irritate the gastric mucosa. Many patients with acute gastritis have no appetite anyway, so they do not eat at all for a day or two. It is then important to drink enough liquid, for example chamomile tea or clear broth.

The following tips for protecting your stomach can also help you:

  • Avoid stomach-irritating substances such as citrus fruits, coffee, alcohol and hot spices
  • Oatmeal, rusks, soups, rice and mashed potatoes are particularly gentle on the stomach
  • Better five small meals throughout the day than a few large ones
  • Raw food puts a strain on sensitive stomachs. Steamed foods are the most digestible.
  • High-fat foods are unfavorable

For more information on diet for gastritis, read the post Stomach Lining: Diet .

investigations and diagnosis

If you have stomach problems, first consult your family doctor. If necessary, he will then refer you to a stomach specialist, a gastroenterologist. First, your doctor will ask you in detail about your medical history (anamnesis). For example, he asks:

  • Since when are you having those complaints?
  • Do you suffer from abdominal pain, vomiting or diarrhea?
  • Do you take medication such as painkillers?
  • Do you feel full?

Physical examination

After that, your doctor will examine you. To do this, he listens to your stomach, registering both the intestinal noises and the pulse of the large blood vessels in the abdomen. Then he taps your stomach. In this way he can determine air or liquid accumulations. When palpating the abdomen, the doctor pays attention to possible hardening. He will also feel your liver under the right costal arch and your spleen under the left costal arch.

endoscopy

Gastritis can only be diagnosed with certainty by the doctor taking a look inside the stomach. In a so-called endoscopy , a thin tube with a small camera at the tip is carefully advanced through the esophagus into the stomach. In this way, the doctor can identify possible changes in the mucous membrane such as redness, swelling or bleeding.

biopsy

With the help of fine instruments, the doctor can also take a tissue sample from the mucous membrane as part of the endoscopic examination. A pathologist examines these tissue samples more closely under his microscope to determine the type of inflammation. He can see whether the inflammation is limited to the upper layers of the mucous membrane (surface gastritis) or has already damaged the gastric glands (atrophic gastritis).

Testing for Helicobacter pylori

He can also use the biopsy to carry out a quick urease test for the gastric germ Helicobacter pylori. It is the most common trigger for chronic gastritis. To do this, urea is added to the tissue sample . Should the bacterium be present, its enzyme (the urease) will convert the urea into ammonia. This reaction can be measured.

Other tests to identify H. pylori as the cause of chronic gastritis include:

  • Breath test: The patient is given radioactively labeled urea. H. pylori breaks it down, which means that radioactively labeled carbon dioxide can be detected in the exhaled air.
  • Antigens in the stool: H. pylori proteins are excreted through the intestines. These can be detected in the stool.
  • Antibodies in the serum: In the case of an infection with H. pylori, the immune system produces antibodies against the bacteria. These can also be detected in the patient’s blood after the infection has gone through.

Detection of auto-antibodies

If type A gastritis is suspected, the corresponding autoantibodies are examined. If chronic bleeding occurs, the blood count may show microcytic anemia – a form of anemia with reduced red blood cells.

Course of the disease and prognosis

Acute gastritis usually has a good prognosis. It often heals on its own after a few days or weeks without further treatment. But there are also severe courses, for example when patients have “erosive gastritis”. If bleeding occurs in what is known as hemorrhagic gastritis, it can be life-threatening. Inflammation of the gastric mucosa can also develop into a stomach ulcer.

Chronic inflammation of the gastric mucosa usually lasts for several weeks, months or even years. The constant irritation of the gastric mucosa increases the risk of cells degenerating and causing gastric cancer in chronic gastritis. First, the cells of the gastric mucosa convert into intestine-like cells. Then one speaks of intestinal (the bowel associated) metaplasia (transformation).

Anyone who has chronic gastritis should therefore have a gastroscopy performed regularly every three years. In this way, cancer and its precursors can be detected and treated in good time.

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