Learn how the new prebiotic soluble fibers benefit bowel health and many GI disorders
Gastritis
The stomach, as everyone knows from watching TV ads, is J-shaped and
collects swallowed food and liquid. It then methodically grinds the food
into small pieces and squirts it out in tiny jets of fluid into the duodenum
which is the first portion of the small intestine.
There are several types of cells lining the stomach. One produces hydrochloric acid and another, pepsin, a digestive hormone. Along with the grinding motion of the stomach, these chemicals break down the food and prepare it for digestion.
What is Gastritis
Gastritis means inflamation of the stomach. It means that white blood
cells move into the wall of the stomach as a response to some type of
injury. Gastritis does not mean that there is an ulcer or cancer. It is
simply inflammation–either acute or chronic. What are the causes
of gastritis?
Helicobacter
Pylori
This is the name of a bacteria that has learned to live in the thick mucous
lining of the stomach. Although it doesn't actually infect the underlying
tissue, it does result in acute and chronic inflammation. It probably
occurs early in childhood and remains throughout life unless antibiotics
cure it. The infection can lead to ulcers and, in later life, even to
stomach cancer in some people. Fortunately, there are now ways to make
the diagnosis and treat this disorder.
Autoimmune Gastritis - Pernicious Anemia
The immune system makes antibodies and other proteins that fight off infection
and keep the body healthy. In some disorders, the body mistakenly targets
one of its own organs as a foreign protein or infection. It makes antibodies
against it and can severely damage or even destroy the organ. Diseases
such as lupus, hypothyroidism, rheumatoid arthritis and the type of diabetes
that requires insulin, are examples. The stomach lining also may be attacked
by the immune system leading to loss of the stomach cells. This causes
acute and chronic inflammation which can result in a condition called
pernicious anemia. The anemia occurs because the body no longer can absorb
vitamin B12 due to a lack of a key stomach factor, destroyed by the chronic
inflammation. Stomach cancer can even occur later in life.
Aspirin & NSAID Gastritis
NSAID stands for non-steroidal anti-inflammatory drug. These are arthritis
and pain relievers and include the over-the-counter drugs Advil, Naprosyn,
Motrin and ibuprofen as well as many prescription arthritis medicines
such as Voltaren, Feldene, Lodine and Relafen. Along with aspirin, they
reduce a protective substance in the stomach called prostaglandin. These
drugs usually cause no problems when taken for the short-term. However,
regular use can lead to a gastritis as well as a more serious ulcer condition.
Alcohol
Alcohol and certain other chemicals can cause inflammation and injury
to the stomach. This is strictly dose related in that a lot of alcohol
is usually needed to cause gastritis. Social or occasional alcohol use
is not damaging to the stomach although alcohol does stimulate the stomach
to make acid.
Hypertrophic Gastritis
At times, the folds in the stomach will become enlarged and swollen along
with the inflammation. There is not a great deal known about why this
occurs. A variation of this type of gastritis is called Ménétrier's
disease where the gastric folds become gigantic. With this condition,
there is often protein loss into the stomach from these weeping folds.
Miscellaneous
There are other but rarer types of gastritis such as eosinophilic, phlegmonous
(a severe bacterial infection) and granulomatous gastritis.
Symptoms
The symptoms of gastritis depend on how acute it is and how long it has
been present. In the acute phase, there may be pain or gnawing in the
upper abdomen, nausea and vomiting. In the chronic phase, the pain may
be dull and there may be loss of appetite with a feeling of fullness after
several bites of food. Very often, there are no symptoms at all. If the
pain is severe, there may be an ulcer as well as gastritis.
Diagnosis
The physician may suspect gastritis by listening to the medical history.
However, the only certain way to make the diagnosis is by endoscopy and
biopsy of the stomach lining. Endoscopy is an exam where, under mild sedation,
a lighted flexible scope is passed into the stomach. Pictures can be taken
but, more importantly, biopsies can be obtained for analysis under the
microscope. An upper GI x-ray exam and certain blood studies may be helpful.
Treatment
The treatment of gastritis will depend on its cause. For most types of
gastritis, reduction of stomach acid by medication is often helpful. Beyond
that, a specific diagnosis needs to be made. Antibiotics are used for
infection. Elimination of aspirin, NSAIDs or alcohol is indicated when
one of these is the problem. For the more unusual types of gastritis,
other treatments may be needed. Gastritis by itself is rarely a serious
problem.
Complications
The cause of most types of gastritis is known and effective treatment
and preventive measures are available so that serious complications are
unusual. One exception is the H. pylori infection which, when present
for a long time, may lead to stomach cancer in some individuals. This
infection can also lead to a malignancy of the lymph system called a lymphoma.
One such low-grade lymphoma is called a MALT lymphoma. Eliminating the
infection from the stomach often cures this type of lymphoma.
Summary
The causes of gastritis are varied. The symptoms can be acute and severe
or chronic, low-grade or even absent. The diagnosis is usually easily
made by endoscopy. In most instances, effective treatment is available
and serious complications are unusual. By working with the physician,
a good outcome usually occurs.
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