Gastritis refers to inflammation of the stomach lining. While many experience temporary stomach irritation, gastritis can persist for extended periods, even months or years. This persistent inflammation has various underlying causes and health implications.
Acute Versus Chronic Gastritis
Gastritis is broadly categorized into acute and chronic forms, primarily differing in their onset and duration. Acute gastritis appears suddenly and is often short-lived, with symptoms resolving quickly once the underlying irritant or infection is addressed. This form commonly arises from factors like excessive alcohol intake, certain medications such as non-steroidal anti-inflammatory drugs (NSAIDs), or acute infections.
Chronic gastritis develops gradually and can persist for weeks, months, or years if unmanaged. This inflammation damages the gastric mucosa, the stomach’s protective lining. Unlike acute gastritis, chronic forms involve continuous inflammation or long-term infection, leading to enduring changes in the stomach lining.
Why Gastritis Persists and Its Signs
Chronic gastritis persists due to underlying factors that continuously irritate or damage the stomach lining. A primary cause globally is infection with the bacterium Helicobacter pylori (H. pylori), which can lead to long-term inflammation and cell changes in the stomach. Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin also contributes to persistent gastritis by eroding the stomach lining. Autoimmune conditions, where the body’s immune system mistakenly attacks healthy stomach cells, represent another less common but enduring cause. Excessive alcohol consumption and bile reflux, where bile flows back into the stomach from the small intestine, can also lead to chronic irritation and inflammation.
Signs and symptoms of chronic gastritis include a persistent gnawing or burning pain in the upper abdomen, often described as indigestion. Individuals may also experience persistent nausea, vomiting, bloating, and a sensation of feeling full after consuming only small amounts of food. Unexplained weight loss or a reduced appetite can also indicate chronic gastritis.
Getting a Diagnosis and Managing Long-Term Gastritis
Diagnosing chronic gastritis involves a thorough assessment by a healthcare professional. This begins with a physical examination and a review of the patient’s medical history, including medication use and dietary habits. To identify the cause, specific tests for H. pylori infection are common, such as urea breath tests, stool antigen tests, or blood tests.
An upper gastrointestinal (GI) endoscopy with biopsy is often performed, where a flexible tube with a camera is inserted to visualize the stomach lining and collect tissue samples for microscopic examination. Blood tests can also assess for complications like anemia.
Management of chronic gastritis focuses on addressing the underlying cause and alleviating symptoms. Treatment approaches may involve lifestyle adjustments, such as dietary modifications to avoid trigger foods (e.g., spicy, acidic, fatty items) and stress management techniques. Medications are prescribed, including proton pump inhibitors (PPIs) like omeprazole or pantoprazole, which reduce stomach acid. H2 blockers, such as famotidine, also decrease acid. If an H. pylori infection is present, a combination of a PPI and two antibiotics, known as triple therapy, is commonly prescribed for 10 to 14 days to eradicate the bacteria.
What Happens if Chronic Gastritis is Untreated
Untreated chronic gastritis can lead to several complications. Persistent inflammation can cause peptic ulcers, which are painful sores that form in the stomach lining. These ulcers may result in chronic bleeding, potentially leading to anemia due to iron deficiency.
Another concern is gastric atrophy, a condition where prolonged inflammation causes the stomach lining to thin and lose its normal glandular cells. In rare instances, especially with long-standing inflammation or atrophic gastritis, there is an increased risk of developing stomach cancer, such as gastric adenocarcinoma. Proper diagnosis and management are important to mitigate these risks.