Managing painful gastritis

Treatment of gastritis depends on the specific cause. FILE PHOTO | NMG

Gastritis refers to inflammation of the stomach lining. It may occur suddenly (acute gastritis), or slowly over time (chronic gastritis). If left untreated, gastritis may lead to stomach ulcers and stomach bleeding. 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.

Symptoms of Gastritis Some people with gastritis may not have any symptoms; however, both acute and chronic gastritis may have symptoms and signs of burning pain in upper abdomen, nausea, vomiting, and occasionally, belching, bloating, loss of appetite and indigestion. In severe gastritis, bleeding may occur inside the stomach. For these severe cases, any of the following symptoms will be seen as well as those already mentioned above especially in older patients; - Severe stomach pain - Chest pain - Sweating and heartbeat - Feeling faint or short of breath - Vomiting large amounts of blood - Bloody bowel movements or - dark, sticky, very foul-smelling bowel movements

What causes Gastritis? There are a number of risk factors that cause gastritis

Bacterial infection. Although infection with H. 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 bacteria could be inherited or could be caused by lifestyle choices, such as smoking and diet.

Regular use of pain relievers. Common pain relievers can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substances 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.

Excessive alcohol consumption. 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.

When do I see a doctor?

Almost everyone has had episodes of indigestion and stomach irritation. Most cases of indigestion are short-lived and don't require medical care. However, it is advisable to see your doctor if you have signs and symptoms of gastritis lasting for a week or longer. Tell your doctor if your stomach discomfort occurs after taking prescription or over-the-counter drugs, especially aspirin or other pain relievers. If you are vomiting blood, have blood in your stool or have stool that appear black, see your doctor right away to determine the cause.

How do I know I have Gastritis? Gastritis can be diagnosed by symptoms and medical history or by breath, blood, stool, immunological, and biopsy tests to detect H. Pylori. Other tests like endoscopy or radiologic studies demonstrate mucosal changes. Tests for H. Pylori. Your doctor may recommend tests to determine whether you have H. Pylori bacteria, it may be detected in a blood test, in a stool test or by a breath test. For the breath test, the patient drinks a small glass of clear, tasteless liquid that contains radioactive carbon. H. Pylori bacteria to break down the test liquid in your stomach. Later, you blow into a bag, which is then sealed. If you're infected with H. Pylori, your breath sample will contain the radioactive carbon. Using a scope to examine your upper digestive system (endoscopy). During endoscopy, your doctor passes a flexible tube equipped with a lens (endoscope) down your throat and into your oesophagus, stomach and small intestine. Using the endoscope, your doctor looks for signs of inflammation. If a suspicious area is found, your doctor may remove small tissue samples (biopsy) for laboratory examination. A biopsy can also identify the presence of H. Pylori in your stomach lining. X-ray of your upper digestive system. Sometimes called a barium swallow or upper gastrointestinal series, this series of X-rays creates images of your oesophagus, stomach and small intestine to look for abnormalities. To make the ulcer more visible, you may swallow a white, metallic liquid (containing barium) that coats your digestive tract. The severity of symptoms determines the method of evaluation. Normally, for patients with recurrent symptoms of gastritis despite treatment, endoscopic evaluations are recommended.

Treatment. Treatment of gastritis depends on the specific cause. Some immediate remedies like for Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Medications used to treat gastritis include; use of antibiotic medications to kill H. Pylori, use of proton inhibitor medications that block acid production and promote healing and use of antacids to neutralize stomach acid.

Lifestyle modifications at home to avert gastritis 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. Foods that may cause gastritis can differ from person to person, but in general, 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 for an alternative option that is less likely to aggravate your stomach problem Avoid smoking

Dr Mwai is a Consultant Family Physician, Aga Khan University Hospital, Nairobi. Send your health questions to [email protected]

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