Gastritis is the inflammation of the stomach lining (mucosa), often caused by bacterial infection, frequent use of pain relievers, or excessive alcohol consumption. While usually mild, symptoms can escalate, signaling a serious complication. This guide helps individuals determine the appropriate level of medical care, from home management to an immediate emergency room visit.
Common Symptoms of Gastritis
Gastritis symptoms are typically centered in the upper abdomen (epigastric region). The most frequent complaint is a gnawing or burning ache that may improve or worsen after eating. This discomfort is caused by the inflamed stomach lining losing protection against digestive acids.
Patients often experience nausea, vomiting, and a feeling of fullness shortly after beginning a meal. Other symptoms include bloating, belching, and a reduced appetite. These mild to moderate symptoms, especially when short-lived, usually do not require emergency intervention.
Severe Warning Signs Requiring an Emergency Room Visit
Specific symptoms indicate that gastritis has progressed to a severe complication, such as internal bleeding or perforation, requiring immediate medical attention. Any sign of gastrointestinal bleeding is a medical emergency because it suggests an ulcer or severe erosion has penetrated a blood vessel.
Signs of upper gastrointestinal bleeding include vomiting bright red blood (hematemesis) or material resembling coffee grounds. Passing black, sticky, and tarry stools (melena) also indicates that blood has traveled through the digestive tract.
Severe, sudden, and rapidly worsening abdominal pain is a critical warning sign. This intense pain can signal a gastrointestinal perforation, where an ulcer has worn a hole through the stomach wall. Pain radiating to the back or chest should prompt an immediate ER visit.
Signs of shock demand emergency stabilization, resulting from significant blood loss or severe infection. These signs include a rapid heart rate, a sudden drop in blood pressure, dizziness, fainting, or cold and clammy skin. If the pain is severe enough to cause doubling over, or if you experience chest tightness or difficulty breathing, seek emergency care.
When to See Urgent Care or Primary Care
Many gastritis issues require prompt medical evaluation but are not life-threatening emergencies. If you have persistent stomach pain or indigestion lasting a week or longer, schedule an appointment with a primary care provider. Chronic symptoms need investigation to manage the underlying cause, such as a Helicobacter pylori (H. pylori) infection.
Urgent care is appropriate for symptoms suggesting dehydration or persistent distress without major bleeding. This includes persistent vomiting where you cannot keep down liquids for over 24 hours, leading to lightheadedness or dizziness. Mild to moderate dehydration requires intervention to restore fluid balance.
You should also seek prompt evaluation if you experience unexplained weight loss or feel full after eating only a small amount of food. If manageable pain does not improve with over-the-counter antacids or acid reducers, a medical professional should assess the situation. If symptoms are getting progressively worse over a few days, or if the pain keeps returning, a visit to urgent care is advisable.
Expected Medical Evaluation and Next Steps
Upon arrival at a medical facility, you will first undergo triage, where staff assess symptom severity to prioritize care. The initial evaluation involves a physical exam, medical history review, and blood tests to check for signs of bleeding, infection, or anemia.
For diagnosis, several tests may be used to look for the cause of the inflammation. These can include a stool sample to check for blood or the presence of H. pylori bacteria. A urea breath test is another non-invasive method used to detect an active H. pylori infection.
If a detailed visual inspection is necessary, an upper gastrointestinal endoscopy may be performed. This procedure involves inserting a thin, flexible tube with a camera down the throat to view the lining of the esophagus, stomach, and small intestine. During the endoscopy, the doctor can take tissue samples (biopsies) to test for inflammation or H. pylori.
Initial treatment focuses on stabilizing acute complications, such as stopping active bleeding, and addressing the underlying cause. Medications to reduce stomach acid, such as proton pump inhibitors or H2 blockers, are often prescribed to allow the stomach lining to heal. If an H. pylori infection is found, a course of antibiotics will be given to eradicate the bacteria.