For those who suffer from it, gastritis means heartburn , stomach acid, cramps, difficulty digesting, gastroesophageal reflux , bad breath and nausea. A series of very annoying disorders that, especially in cases of chronic gastritis , can also represent a risk for general health.
Among other things, gastritis is a widespread disease : about one million Italians, of which most are women, fight periodically .
There is not a single factor responsible for the onset of this disease: let’s find out about the different conditions that can cause it, the most common symptoms useful to recognize it and the possible treatments to treat it.
What is gastritis?
Gastritis is an inflammatory process of the gastric mucosa, or epithelium that internally covers the stomach and protects it.
This mucosa acts as a barrier against the acids responsible for digestion, which are corrosive. When it weakens, stomach acids tend to damage and inflame the walls of the stomach.
As with all inflammatory processes, gastritis can be :
acute , when it develops over a short period of time, usually with complete recovery, especially if no complications are required;
chronic, when there is a noxious stimulus that persists over time and causes chronic damage, sometimes even irreversible.
The so-called nervous gastritis deserves a separate discussion , a psychosomatic pathology , with symptoms very similar to those of normal gastritis.
Let’s see in detail the features of each of these forms.
This form is characterized by a sudden and rapid onset of symptoms, with a usually limited duration
Acute gastritis usually manifests itself in intense pain , unlike chronic pain , which occurs more gradually and is usually characterized by more dull pain.
In the chronic form, the inflammatory state of the gastric mucosa does not healspontaneously, but tends to persist over time. The evolution of the disease can lead to a gradual destruction of the stomach glands.
Chronic gastritis is divided into different etiological types, depending on its cause:
type A gastritis (about 5% of cases), caused by an autoimmune reaction. The immune system destroys some cells of the gastric mucosa, which are mistakenly seen as foreign;
type B gastritis (about 60% of cases), caused by infection with Helicobacter Pylori (HP);
type C gastritis (about 30% of cases) is caused by chemical agents harmful to the gastric mucosa, such as alcohol, nicotine, NSAIDs (Non-Steroidal Anti-inflammatory Drugs) or bile reflux.
There may also be rare forms , such as Crohn’s disease, eosinophilic gastritis, lymphocyte gastritis, etc.
The condition commonly and improperly defined as nerve gastritis deserves a separate mention.
Often attributable to disorders of gastrointestinal motility , it sees a strong correlation with stress (a real irritable stomach).
The symptoms, in this case, manifest themselves as a result of various kinds of concerns , or for a too frenetic working life or in conditions of suffering due to painful or traumatic events .
The symptoms are equivalent to those of other forms of gastritis.
Causes and risk factors
The causes of the weakening of the defensive barrier of the stomach can be many and different. Therefore, also for the causes, a distinction must be made between the various forms of this disorder.
As we saw in the previous paragraph, those of chronic gastritis can be autoimmune, due to infection with HP or chemistry harmful to the gastric mucosa, while the nervous one is due to psychosomatic factors.
For the acute form , the causes are mostly due to exogenous damage , such as excess alcohol, drugs (in particular NSAIDs, associated with a significant risk of ulcer and bleeding , especially if taken continuously). More rarely, the cause may be due to infection and trauma.
Obviously, excesses of harmful substances, such as alcohol and smoking, can be avoided , as can the uncontrolled intake or without gastric protection of NSAIDs. Keeping correct behavior in this sense is the first form of prevention of acute forms of gastritis.
Instead, HP infection of chronic forms is strongly related to the family environment and is normally contracted in childhood . There is a hypothesis that HP infection is also the trigger for the autoimmune reaction that leads to type A gastritis.
The symptoms of gastritis
Gastritis often remains completely asymptomatic , especially the chronic one. It happens to be occasionally diagnosed through a gastroscopy performed for other reasons or due to persistent anemia found in laboratory tests.
Why is anemia related to gastritis? Because there could be not only inflammation, but also erosion and bleeding , in some cases a real ulcer .
In chronic type A gastritis , the destruction of acid-producing cells (important for digesting food) and Intrinsic Factor (an important substance for the absorption of vitamin B12 , which in turn is important for the formation of red blood cells) involves dyspepsia ( feeling of heaviness on the stomach) and a particular type of anemia with red blood cells larger than normal (the so-called Pernicious Anemia ).
Other symptoms that may eventually occur are:
lack of appetite
nausea and vomit
epigastric pain (in the upper abdomen)
The main problem of acute gastritis is the risk of erosions , and in some cases of a real gastrointestinal ulcer (with all the risks that can derive from a bleeding). This complication also applies to chronic type C gastritis.
Instead, the most serious complication related to types A and B is the highest risk, compared to the normal population, of developing a carcinoma or a lymphoma of the stomach (respectively 1: 3.000 and 1: 40.000).
In advanced stages of type A, we also have pernicious anemia.
Diagnosis and examinations
If you have symptoms that make you suspect gastritis, contact your doctor , who may prescribe you some tests or refer you to a doctor who specializes in disorders of the digestive system ( gastroenterologist ).
Among the possible tests to be done to diagnose gastritis, there are:
blood tests. Blood tests can be aimed at detecting the presence of antibodies to HP.
Stool examination. Aimed to discover the presence of Helicobacter Pylori .
Radiography . Performed on the stomach and small intestine, usually after taking barium, a fluid that coats the mucous membranes and makes them more visible on the radiographic film.
Gastroscopy . It allows the doctor to check if there are abnormalities in the upper gastrointestinal tract, not detectable with an X-ray.
Attention : the diagnosis of chronic gastritis is always and only histological. This means that the patient must have performed a gastroscopy with biopsies.
Drug treatment and therapy
The therapy to follow depends on the cause of gastritis.
A lifestyle change is particularly useful if gastritis is caused by harmful agents . As already mentioned, especially acute gastritis has a good prognosis.
On the contrary, gastritis caused by bacteria must be treated with intensive antibiotic therapy, due to the increased risk of malignant degeneration; the success of the therapy must be ascertained.
There are various eradication schemes , in case of HP, and the type of therapy is discussed together with the patient. After the alleged eradication, this must be attested by Breath Test(or other methods to assess the presence of HP). In some cases, gastroscopy with biopsies must be repeated.
Autoimmune gastritis is difficult to treat. Vitamin B12 can be replaced with injections, to bypass the missed gastrointestinal absorption, and frequent but not abundant meals are recommended to reduce dyspepsia. If there is a parallel HP infection , it must be treated with antibiotics and in some cases the regression of autoimmune gastritis can be observed .
In case of complications , such as an ulcer or erosion of the gastric mucosa, acid production can be inhibited with PPIs , thus reducing symptoms and increasing the chances of recovery. If this also does not help and serious complications occur , such as stomach perforation, immediate emergency surgery is required .
Because of possible serious complications (ulcer, carcinoma), gastritis must always be controlled and, if possible, treated.
In any case, in the event you think you might suffer from gastritis, we recommend that you always contact your doctor , who can advise you on the best treatment for your situation.
Nutrition and diet for gastritis
In general, a healthy lifestyle and low-fat diet are recommended to combat gastritis .
Furthermore, it is important to follow some guidelines , which can help you counter gastritis, such as:
moderate portions and eat slowly
eat at regular times
maintain a healthy weight
keep stress under control.
A series of foods with irritating power, especially spicy, acid or fried foods, should be avoided.
Not recommended foods
In the case of gastritis, coffee or caffeinated drinks and methylxanthines (tea, chocolate, cola) are not recommended because they cause reflux. It is also better to limit the use of spices , fizzy drinks and liquids that are too hot, as well as wine and spirits.
It might also want to remove the broth or extracts for the meat broth, as they stimulate gastric secretion, as well as meats and cheeses spicy and fermented.
Among the cooking methods , frying increases the content of acreoline , a substance that worsens inflammation of the mucosa, so it should be avoided.
It is always better to opt for simple preparations , with light sauces, therefore more digestible, like raw extra virgin olive oil .
Yes to all vegetables and fresh fruit , as well as well-cooked bread, pasta, rice and cereals. Fresh cheeses and highly digestible milk, eggs, white meat and lean fish are also recommended.
In addition to the suggestions already given previously for an anti-gastritis food style, it is also important to take care of your general well-being .
In this sense, and especially in cases of nervous gastritis, it is good to learn to keep stress under control. An excessively hectic and stressful life can increase the production of gastric acids and slow down digestion, favoring the onset of gastritis.
For this reason it is essential to find your own way to relax: you can try yoga or tai-chi , or with massages, all techniques that help reduce physical tension and reduce anxiety.
Even practicing physical activity regularly is helpful, both to relieve stress and to promote intestinal motility. There are no recommended sports or limitations in sports for those suffering from gastritis, so you can choose the most suitable sport for you.
As for possible vegetable adjuvants, such as herbal teas or herbal infusions , they can be used as an adjunct and not a replacement therapy , and always after appropriate consultation with your doctor.
On the basis of prevention of gastritis there is a healthy lifestyle.
A correct diet , without nutritional deficiencies and without excesses, is your best ally against this disease, just as it is important to avoid smoking and alcohol and take medicines always under medical supervision.
It should be emphasized that if there has already been a case of HP infection (parents or close family members) in the family, and that anemia or vague symptoms such as dyspepsia occur, screening for HP is recommended .