Gastritis is inflammation, irritation, or erosion of the stomach lining. Erosive gastritis specifically refers to damage that causes shallow breaks or wounds in this protective inner layer. This condition can appear suddenly or develop gradually over time.
Understanding Erosive Gastritis
Erosive gastritis involves visible breaks or wounds, called erosions, in the stomach’s protective lining. These can be superficial or deepen into ulcers. This differs from non-erosive gastritis, where inflammation is present but the lining remains intact.
The condition presents in two forms: acute or chronic. Acute erosive gastritis has a sudden onset, often linked to an immediate irritant, and may resolve quickly. Chronic erosive gastritis develops gradually, potentially persisting for months or years as inflammation continues to injure the stomach lining.
Common Causes and Risk Factors
A common cause of erosive gastritis is the regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. These medications can directly irritate and compromise the stomach’s protective barrier, making it vulnerable to acid damage. Excessive alcohol consumption also contributes, as it directly irritates the stomach lining and increases acid production.
Stress, particularly severe physical stress from critical illness, major surgery, or extensive burns, can induce acute erosive gastritis. This “stress gastritis” can reduce blood flow to the stomach lining, impairing its natural defenses. Less common factors include certain viral infections, radiation exposure, or underlying conditions like Crohn’s disease, which can lead to chronic erosive gastritis.
Recognizing the Signs and Symptoms
Erosive gastritis symptoms vary, with some individuals experiencing no noticeable signs, especially in mild cases. When symptoms appear, they often include discomfort or pain in the upper abdomen, frequently described as a burning or gnawing sensation. Nausea and vomiting are common, along with a loss of appetite or feeling unusually full after eating only a small amount.
In more severe instances, erosions or ulcers can lead to gastrointestinal bleeding. Signs of bleeding may include black, tarry stools, or vomiting blood that resembles coffee grounds. Persistent bleeding can result in symptoms of anemia, such as fatigue, weakness, or shortness of breath, highlighting the importance of seeking medical attention.
Diagnosis and Management
Diagnosis of erosive gastritis typically involves an upper endoscopy, also known as gastroscopy. During this procedure, a thin, flexible tube with a camera is inserted down the throat to visualize the esophagus, stomach, and small intestine. This allows healthcare providers to directly observe any erosions, ulcers, or inflammation in the stomach lining. If suspicious areas are identified, a small tissue sample, or biopsy, may be taken for microscopic examination to confirm diagnosis or rule out other conditions.
Management focus on removing the cause and reducing stomach acid to allow healing. This often means discontinuing NSAID use or reducing alcohol intake. Medications that suppress stomach acid production are commonly prescribed. Proton pump inhibitors (PPIs), such as omeprazole or pantoprazole, are often a first-line treatment due to their strong acid-reducing capabilities.
Another class of medications, H2 blockers like famotidine, also reduce stomach acid by blocking histamine receptors. These medications help alleviate symptoms and promote healing. Additionally, lifestyle adjustments are important, including dietary changes to avoid irritants, managing stress, and refraining from smoking, which support healing and help prevent recurrence.
Potential Complications
If left untreated or severe, erosive gastritis can lead to serious complications. Gastrointestinal bleeding is a concern, occurring when erosions or ulcers penetrate blood vessels in the stomach wall. This bleeding can range from mild, leading to gradual blood loss and anemia, to severe, requiring urgent medical intervention.
Another complication is the development of peptic ulcers, which are deeper sores that can cause more intense pain and are at higher risk of bleeding. In rare but severe cases, an ulcer can erode completely through the stomach wall, leading to a perforation. This is a medical emergency where stomach contents can leak into the abdominal cavity, causing infection and potentially life-threatening complications like peritonitis.