Acute gastritis is defined as inflammation and sometimes erosion of the internal lining of the stomach. It is curable in most instances but you can have chronic gastritis and other serious complications if left untreated.
The most common cause of gastritis is Helicobacter Pylori infection and alcohol, but it can be caused by other factors. Before we mention causes and types of gastritis, let’s first mention how stomach functions under normal circumstances.
How Stomach Functions
Under normal circumstances the stomach produces Hydrochloric acid (HCl) with plays a crucial role in digestion and protecting the body from ingested toxins. HCl is a strong acid, it can easily dissolve meat and bone tissue.
This means the stomach also needs protection from the acid it produces to prevent autodigestion. Your stomach produces a mucus layer which serves as protective mechanism from the acid.
When too much acid is produced, it sometimes erodes the stomach causing gastritis and ulceration.
Causes of Acute Gastritis
There are many causes of gastritis which can be grouped as follows:
- Infective causes
- Chemical causes
The most common cause of gastritis is infection with H.Pylori bacteria. This bacteria is capable of living inside the acidic environment of the stomach.
It causes inflammation of the stomach lining which later becomes Stomach ulcers. Sometimes stomach can be irritated by other viruses such as Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV).
You can also get gastritis from certain chemicals. They cause it by direct erosion of the inner lining of the stomach.
Strong agents that can cause gastritis are:
- Alcohol: binge drinking is the leading cause of hospitalisation due to chemical gastritis
- Ingestion of strong acids like sulfuric acid (battery acid) whether accidentally or in attempt of self-harm erodes the stomach.
- Strong bases found in household cleaning agents are also not good when ingested.
- Most chemicals are ingested accidentally or intentionally during suicide attempt. You should always seek medical help if you have ingested a Pesticide, Battery acid, Detergent or Herbicide.
There are some medically prescribed drugs that are known to cause gastritis and Peptic Ulcer Disease as their side effect.
The most common are aspirin and NSAIDs such as Naproxen, Ibuprofen and Indomethacin.
Some other causes general causes of gastritis are:
- Severe stress
- Food poisoning
Signs and Symptoms of gastritis
The two common symptoms you will have regardless of the cause in nausea and vomiting. Vomitus may have streaks of blood (Hematemesis).
These symptoms may be accompanied by:
- Abdominal cramps
- Abdominal bloating and indigestion
- Melena stools: dark coloured stools indicating bleeding in the stomach or first part of intestines (duodenum)
Gastritis is diagnosed by endoscopy but is usually treated empirically (based on signs and symptoms).
Endoscopy is done if you have ALARM SIGNS or have ingested a strong corrosive chemical.
Alarm signs are signs that indicate you need to be done endoscopy to exclude serious pathologies like cancer in the stomach and intestines . The term Alarm Signs is actually a mnemonic:
- Loss of weight
- Anorexia (loss of appetite) and age more than 55 years
- Recent onset of symptoms
- Melena stools (black stools)
- Swallowing difficulty
H.Pylori infection is confirmed by specific blood antibody test and C-urase breath test. Sometimes a stool is collected for analysis as well.
It is very important that you get screened for H.Pylori as it puts you at great risk of cancer when not treated.
Treatment of Acute Gastritis
There are 2 main steps involved in treatment in treatment of gastritis
Removal of the offending agent
After finding the cause of gastritis, it should be removed if possible for example:
- Treat H.Pylori infection with antibiotics
- Stop all drugs that causes gastric irritation such as NSAIDs
- Stop Alcohol intake
Suppress Acid Production
The next step in suppression of HCL production with drugs called Proton Pump Inhibitors (PPIs) such as:
- Lansoprazole 30mg oral daily for 7 days or
- Omeprazole 20mg oral daily for 7 days
Antacids like Aluminum Hydroxide or Magnesium hydroxide are helpful in alleviating symptoms.
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