What causes Gastritis?

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Gastritis is an inflammation of the stomach lining. Weaknesses or injury to the mucus-lined barrier that protects your stomach wall allows your digestive juices to damage and inflame your stomach lining. A number of diseases and conditions can increase your risk of gastritis, including Crohn's disease and sarcoidosis, a condition in which collections of inflammatory cells grow in the body.

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Gastritis may be caused by many things.

It can be caused by diet and lifestyle habits such as:

• Drinking too much alcohol

• Eating spicy foods

• Smoking

• Extreme stress

• Long-term use of aspirin and over-the-counter pain and fever medicines (nonsteroidal anti-inflammatory drugs or NSAIDs)

 

Health issues that can lead to gastritis include:

• Infections caused by bacteria and viruses

• Major surgery

• Traumatic injury or burns

 

Some diseases can also cause gastritis. These include:

• Autoimmune disorders.  When your immune system attacks your body’s healthy cells by mistake.

• Chronic bile reflux.  When bile, a fluid that helps with digestion, backs up into your stomach and food pipe (esophagus).

• Pernicious anemia.  A form of anemia that happens when your stomach is not able to digest vitamin B12.

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Source: Mayo Clinic

Source: John Hopkins Medicine

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Risk Factors for Gastritis

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Factors that increase your risk of gastritis include:

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• Bacterial infection.  Although infection with Helicobacter pylori is among the most common worldwide human infections, only some people with the infection develop gastritis or other upper gastrointestinal disorders. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and diet.

• Regular use of pain relievers.  Common pain relievers — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox) — can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach.

• Older age.  Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are.

• Excessive alcohol use.  Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis.

• Stress.  Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis.

• Your own body attacking cells in your stomach.  Called autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This reaction can wear away at your stomach's protective barrier.

  Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto's disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.

• Other diseases and conditions.  Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease and parasitic infections.

 

Source: Mayo Clinic

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Symptoms of Gastritis

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Each person’s symptoms may vary.  Gastritis doesn't always cause signs and symptoms. The most common symptoms of gastritis include:

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• Stomach upset or pain

• Belching and hiccups

• Belly or abdominal bleeding

• Nausea and vomiting

• Feeling of fullness or burning in your stomach

• Loss of appetite

• Blood in your vomit or stool (a sign that your stomach lining may be bleeding)

 

The symptoms of gastritis may look like other health problems. Always see your healthcare provider to be sure.

 

Source: Mayo Clinic

Source: John Hopkins Medicine

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Complications

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Left untreated, gastritis may lead to stomach ulcers and stomach bleeding. Rarely, some forms of chronic gastritis may increase your risk of stomach cancer, especially if you have extensive thinning of the stomach lining and changes in the lining's cells.

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Tell your doctor if your signs and symptoms aren't improving despite treatment for gastritis.

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Chronic gastritis hurts your stomach lining. It can raise your risk for other health problems such as:

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• Peptic ulcer disease, painful sores in your upper digestive tract

• Gastric polyps, small masses of cells that form on the inside lining of your stomach

• Stomach tumors, both cancerous and non-cancerous

 

You may also get atrophic gastritis. This can happen if your gastritis is caused by the H. pylori bacteria or by an autoimmune disorder. Atrophic gastritis destroys the stomach lining cells that make your digestive juices. This raises your risk for getting stomach cancer.

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Source: Mayo Clinic

Source: John Hopkins Medicine

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Diagnosis  & Testing

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Your healthcare provider will give you a physical exam and ask about your past health. You may also have tests including:

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• Upper GI (gastrointestinal) series or barium swallow.  This X-ray checks the organs of the top part of your digestive system. It checks the esophagus, stomach, and the first part of your small intestine (duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on the X-ray. 

• Upper endoscopy, also called EGD (esophagogastroduodenoscopy).  This test looks at  the inside of your esophagus, stomach, and duodenum. It uses a thin, lighted tube, called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your healthcare provider can see the inside of these organs. He or she can also take a small tissue sample (biopsy) if needed.

• Blood tests.  You will have a test for H. pylori, a type of bacteria that may be in your stomach. Another test will check for anemia. You can get anemia when you don’t have enough red blood cells.

• Stool spectrum.  This test checks to see if you have stomach bacteria that can cause gastritis. A small sample of your stool is collected and sent to a lab. Another stool specimen can check for blood in your stool which may be a sign of gastritis if there has been bleeding.

• Breath test.  You may have a test where your breath is collected and analyzed for a stomach bacteria.

• Tests for H. pylori.  Your doctor may recommend tests to determine whether you have the bacterium H. pylori. Which type of test you undergo depends on your situation. H. pylori may be detected in a blood test, in a stool test or by a breath test.

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Source: John Hopkins Medicine

Source: Mayo Clinic

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Treatments

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Your healthcare provider will make a care plan for you based on:

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• Your age, overall health, and past health

• How serious your case is

• How well you handle certain medicines, treatments, or therapies

• If your condition is expected to get worse

• What you would like to do

 

Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances.

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Medications used to treat gastritis include:

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• Antibiotic medications to kill H. pylori.  For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days.

• Medications that block acid production and promote healing.  Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix).

  Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk.

• Medications to reduce acid production.  Acid blockers — also called histamine (H-2) blockers — reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR).

• Antacids that neutralize stomach acid.  Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients.

 

Source: John Hopkins Medicine

Source: Mayo Clinic

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Gastritis Prevention

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Experts don’t know it is possible to stop gastritis from happening. But you may lower your risk of getting the disease by:

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• Having good hygiene habits, especially washing your hands.  This can keep you from getting the H. pylori bacteria.

• Not eating or drinking things that can irritate your stomach lining.  This includes alcohol, caffeine, and spicy foods.

• Not taking medicines such as aspirin and over-the-counter pain and fever medicines (nonsteroidal anti-inflammatory drugs or NSAIDS).

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Source: John Hopkins Medicine

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Living with Gastritis

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You may find some relief from signs and symptoms if you:

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• Eat smaller, more-frequent meals.  If you experience frequent indigestion, eat smaller meals more often to help ease the effects of stomach acid.

• Avoid irritating foods.  Avoid foods that irritate your stomach, especially those that are spicy, acidic, fried or fatty.

• Avoid alcohol.  Alcohol can irritate the mucous lining of your stomach.

• Consider switching pain relievers.  If you use pain relievers that increase your risk of gastritis, ask your doctor whether acetaminophen (Tylenol, others) may be an option for you. This medication is less likely to aggravate your stomach problem.

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Source: Mayo Clinic

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What to Eat  and Avoid when Suffering from Gastritis

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If you have celiac disease and need to avoid gluten and wheat, you may need to be careful about the gluten-free alternatives you choose.

 

Some popular options, such as pasta made from corn, are not suitable for a gastritis diet. 

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Below is a list of safe (compliant) and non-safe (non-compliant) foods for those with gastritis:

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Compliant 

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• Beans and legumes (as tolerated)

• Eggs, egg whites, or egg substitutes (not fried)

• Seafood, shellfish (not fried)

• Honey

• Low-acid vegetables (cucumber, white potato, carrots)

• Low-sugar, low-acid fruit (pumpkin, blueberries, strawberries, apples)

• Mild, low-salt cheese

• Oats, barley (avoid if you have celiac disease or Gluten allergy, sensitivity, or intolerance)

• Peppermint, ginger, turmeric

• Plain, low-fat yogurt

• Probiotic-rich foods (sauerkraut, kimchi, kombucha)

• Rice

• Skinless lean poultry (chicken, turkey)

• Whole grain bread and pasta (avoid if you have celiac disease or Gluten allergy, sensitivity, or intolerance)

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Non-Compliant

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• Acidic fruits (citrus) and vegetables (onion)

• Alcohol

• Chocolate

• Coffee and Tea

• Corn and products made with corn (pasta, bread)

• Dairy products

• Energy drinks

• Fatty/greasy food, fast food, spicy food

• Fried or hard-boiled eggs

• Garlic (small amounts as tolerated)

• Ice cream, cakes, and pastries, baked goods

• Marinades, salsa, mayonnaise, creamy sauces

• Nuts and nut butter (small amounts may be tolerated)

• Potato chips, packaged snacks

• Processed meat (sausage, hot dogs), lunch meat

• Red meat, duck, goose

• Refined grains, fresh bread, pasta made with refined flour

• Smoked meats

• Soda, carbonated beverages

• Spices, herbs, seasonings (especially black pepper)

• Tomato and tomato products (juice, paste, sauce)

 

Source: VeryWellHealth

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Fruits and Vegetables

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Produce that is very acidic, especially citrus fruit and tomatoes, are best avoided if you have gastritis. Vegetables used to add spice or a lot of flavors, such as onions, can also be hard to tolerate if you have stomach irritation.

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Instead, choose low-acid or more neutral (alkaline) fruits and veggies—preferably those that are good sources of fiber—such as apples, berries, pumpkin, and carrots. 

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Source: VeryWellHealth

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Grains

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For the most part you’ll want to choose whole grain bread, brown rice, pasta, and other grains. However, if you are having gastritis symptoms that are making it harder for you to eat, plain white rice or white potato can be easier to digest. 

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Oats, barley, and quinoa are other nutritious options. If you do not eat wheat, avoid pasta alternatives or bread made from corn, which is not approved for a gastritis diet. 

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Source: VeryWellHealth

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Dairy

 

You’ll want to avoid full-fat dairy products, but low-fat yogurt that’s also low in sugar and packed with probiotics can be a healthy addition to a gastritis diet. Some hard cheeses that are low in salt may be tolerated in small portions. You’ll want to avoid any sauces, fillings, or puddings made with rich, heavy cream. 

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Source: VeryWellHealth

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Protein

 

Eggs, egg whites, and egg substitutes can be an excellent source of protein. However, you will want to prepare them soft-boiled, poached, or scrambled rather than fried.

 

Avoid pairing them with salty, processed, breakfast meat like sausage or ham, refrain from adding butter or milk, and avoid seasoning (even black pepper). 

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Red meat is not approved, but you may choose from lean cuts of turkey or chicken and some seafood (as long as it isn’t fried). 

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Nuts and nut butter, as well as beans and legumes, can be high in fat but they are versatile sources of protein to include in your diet. Start with smaller portions (without added sugar) and see what you are able to tolerate. 

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Source: VeryWellHealth

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Desserts

 

Any food that is high in fat and sugar should be avoided on the gastritis diet. Baked goods, pastries, and ice cream or puddings tend to be rich and can irritate an inflamed stomach (especially if they are made with dairy).

 

Chocolate is also not approved. 

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Source: VeryWellHealth

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Beverages

 

Some people with mild gastritis can tolerate weak tea or coffee with a splash of low-fat milk or non-dairy creamer. Honey can also be added to tea. In general, though, these beverages are very acidic and not approved for a gastritis diet.

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Cold drinks with a lot of sugar, such as soda and energy drinks, are also not approved.

Acidic juices (such as orange juice or other citrus fruit, as well as tomato juice) are not approved. Some fruit juice may be OK, but choose varieties that are low in sugar. 

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Avoid alcoholic beverages, including wine, beer, and cocktails. If you drink alcohol, your doctor will likely advise you to stop if you have gastritis. 

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Source: VeryWellHealth