Gastritis: Symptoms, Causes, Diagnosis, and Treatment

Gastritis occurs when the mucosa, the stomach’s protective layer, becomes inflamed. This soft tissue acts as a shield, preventing damage from digestive acids, enzymes, and bacteria. If the immune system detects a threat, it triggers inflammation to fight infection or support healing.

Various factors can cause this inflammation, including bacterial infections responsible for most stomach ulcers, excessive alcohol consumption, and smoking. Although gastritis is rarely severe, proper treatment is essential for recovery. Without treatment, gastritis can lead to health complications, like ulcers, and increase the risk of stomach cancer.

Types of Gastritis

• Acute gastritis develops suddenly and is temporary, often caused by short-term conditions.
• Chronic gastritis is a long-term condition that may develop gradually due to an underlying chronic issue. Some people may not notice symptoms consistently or at all.

Additionally, gastritis can be either erosive or nonerosive:

• Erosive gastritis damages the stomach lining, leading to ulcers. Substances like acid, bile, alcohol, or certain medications often trigger it.
• Non-erosive gastritis does not cause ulcers but leads to irritation, such as redness in the stomach lining. A specific type, atrophic gastritis, can cause the stomach lining to thin or waste away, affecting digestion.

Gastritis may also be categorized based on its cause, including:

• Infectious gastritis (caused by bacteria, viruses, or fungi)
• Drug-induced gastritis (triggered by medications like NSAIDs)
• Alcohol-induced gastritis (resulting from excessive alcohol consumption)
• Stress-induced gastritis (linked to physical or emotional stress)
• Autoimmune gastritis (when the immune system attacks the stomach lining)
• Eosinophilic gastritis (caused by an abnormal immune response leading to inflammation)

Symptoms of Gastritis

Although gastritis symptoms are not always visible, when they are, they usually indicate a more serious or prolonged illness. When the stomach lining deteriorates and loses its ability to defend against stomach acids and enzymes, symptoms arise. This might cause bleeding, stomach ulcers, and indigestion.

Common symptoms include:

• Loss of appetite or feeling full instantly after eating.
• Upper abdominal pain or bloating, particularly in the epigastric region.
• Nausea or vomiting.
• A gnawing or burning ache in the upper abdomen that may improve or worsen after eating.
• A feeling of fullness or discomfort in the stomach after meals.

Causes of Gastritis

Gastritis occurs when the immune system responds to a threat in the stomach, triggering inflammation. Several factors can cause this condition, including:

• Infections – Bacterial, viral, parasitic, and fungal infections, especially H. pylori, can lead to acute or chronic gastritis.
• Chemicals – Excessive alcohol, NSAIDs (like aspirin and ibuprofen), and certain drugs, including recreational substances, can damage the stomach lining.
• Autoimmune Disorders – The immune system may mistakenly attack stomach cells, causing chronic inflammation.
• Reduced Blood Supply – Severe stress from surgery, trauma, or critical illness can limit blood flow to the stomach, weakening its defenses.
• Other Factors – Radiation therapy, chemotherapy, and bile reflux can also contribute to gastritis.

Risk Factors of Gastritis

Many factors can increase the odds of developing gastritis, including:

• Bacterial Infection – Helicobacter pylori (H. pylori) is one of the most widespread bacterial infections worldwide. However, not everyone infected develops gastritis or other gastrointestinal issues. Experts believe genetic susceptibility or lifestyle choices, such as smoking and diet, may influence the risk.
• Frequent Use of Pain Relievers – Nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen sodium (Aleve, Anaprox DS) and ibuprofen (Advil, Motrin IB) can contribute to both acute and chronic gastritis. Regular use or high doses of these medications may harm the stomach lining.
• Aging – The stomach lining naturally thins with age, increasing the risk of gastritis.
• Excessive Alcohol Consumption – Alcohol can irritate and weaken the stomach lining, increasing its susceptibility to digestive acids. Heavy alcohol use is a common cause of acute gastritis.
• High Levels of Stress – Severe stress caused by major surgery, injuries, burns, or infections can lead to acute gastritis.
• Cancer Treatments – Chemotherapy and radiation therapy can increase the risk of gastritis by affecting the stomach lining.
• Autoimmune Gastritis – In this condition, the immune system mistakenly attacks the stomach lining, weakening its protective barrier. Autoimmune gastritis is more common in individuals with other autoimmune diseases, such as Hashimoto’s disease and type 1 diabetes, including vitamin B12 deficiency.
• Other Medical Conditions – Gastritis can be associated with diseases such as HIV/AIDS, Crohn’s disease, celiac disease, sarcoidosis, and parasitic infections.

When to See a Doctor

If your symptoms last more than a week, you should see a doctor. You should also get medical attention right away if you have terrible pain, vomiting that prevents you from eating or drinking, or dehydration symptoms such as lightheadedness or dizziness. Get medical attention right away if you notice blood in your vomit or feces or black, tarry stools.

Diagnosis for Gastritis

Healthcare providers diagnose gastritis by evaluating symptoms and medical history. While they may suspect gastritis based on this information, tests are needed for confirmation.

• Imaging Tests – An upper GI series (X-rays of the upper digestive tract) can detect ulcers or stomach lining erosion, though it may not always confirm gastritis.
• Endoscopy with Biopsy – A gastroscopy (upper endoscopy) uses a small camera on a flexible tube to examine the stomach lining. During this procedure, a provider can collect a tissue sample (biopsy) for microscopic analysis. Gastritis is often visually identifiable before the biopsy confirms it.
• Additional Tests – To determine the cause or check for complications, providers may order:
  • Blood tests
  • Stool tests
  • H. pylori breath test

Treatment for Gastritis

Acute gastritis heals once the underlying cause is resolved. The stomach lining repairs itself after damage from drugs, alcohol, or reduced blood flow, while most infections clear up on their own.

Chronic gastritis requires medical care, as it is often linked to long-term conditions. Some causes are treatable, while others need ongoing management to reduce inflammation and prevent further damage.

Over-the-counter medications may provide temporary relief, but consulting a healthcare provider is compulsory to find the root cause effectively.

Frequently Asked Questions