Guarding against Gastritis
Gastritis is a common condition today, affecting those of all ages, and often causing intense pain and discomfort. While there are many factors that cause gastritis, it can usually be treated by a simple combination of drugs and changes in diet, explains Dr. Harsha Baranage, General Practitioner and Resident Medical Officer at Asiri Surgical Hospitals, as he discusses the various aspects of the disease in this interview with MediScene.
What is Gastritis?
Gastritis is the irritation of the stomach lining, which in turn causes the inflammation of the superficial layers of the stomach. If it persists over a long period of time, the deeper layers of the stomach may also get involved.
What causes gastritis?
There are two primary causes of gastritis:
- Bacterial Infection: People who are infected with the bacteria H. pylori are at risk of having gastritis. A high percentage of people are believed to harbour these bacteria. While in some people, H. pylori may break down the protective coating of the stomach, causing changes in the stomach's lining, in others it may not cause any complications at all.
- Use of NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, brufen and ibuprofen are known to cause gastritis. Regular use of these drugs, or taking too many of them, may reduce a key substance that helps preserve the protective lining of your stomach.
Apart from this, there are also several associated factors that are believed to cause gastritis. These include, smoking, high consumption of spicy foods, long periods of hunger, stress and excessive consumption of alcohol.
Some people may also have a condition of hyperacidity in the stomach, where the acid secretions are higher than usual, making them more prone to gastritis.
Signs and symptoms
The main symptom of gastritis is abdominal discomfort and epigastric pain (a sharp, intermittent pain in the upper-mid abdomen). In rare cases, the pain may be centred towards the left or right, and is sometimes mistaken for heart conditions such as angina.
|Helicobacter pylori bacteria on human stomach epithelial cells can cause certain types of stomach ulcers and gastritis
Other symptoms may include nausea, chest pain, headache, bloating and distention of the abdomen. In severe cases vomiting and altered stools may occur.
Left untreated, gastritis can lead to stomach ulcers. Ulcers lead to bleeding and perforation in the stomach lining, as well as penetration (the inflammation spreading to other organs such as the pancreas). In certain cases it may also cause gastric/stomach cancer.
Doctors are usually able to diagnose gastritis from the symptoms, and to initiate treatment. There are also some tests that may be necessary, if the symptoms persist.
- CLO Test - To identify the presence of H. pylori.
- Upper Gastrointestinal Endos-copy - This procedure allows the doctor to see abnormalities in the upper gastrointestinal tract that may not be visible on x-rays. An endoscopy is usually recommended if there is long term severe gastritis or failure to respond to treatment. It is a relatively simple and uncomplicated procedure in which a fibre optic device is inserted through the mouth, into the oesophagus, stomach and duodenum. If ulcers are suspected, a biopsy may be necessary, with tissue samples taken from the margin of the ulcer during the endoscopy, to exclude any underlying disease such as cancer.
- Ultrasound scan of the abdomen - This is usually necessary to diagnose ulcer-related complications such as perforation and penetration.
- X-rays of the chest and abdomen.
Prevention and self-care
- Good eating habits - Eat balanced meals, moderately and regularly. For young children, small, frequent meals are advisable.
In addition avoid foods that are spicy, acidic, fried or fatty - this is particularly important if ulcers are present.
There is a myth that a glass of milk or cup of yoghurt helps reduce gastritis symptoms - whereas milk may actually increase the acidity in the stomach. It is better to drink plenty of water.
The regular consumption of fast food such as pastries, buns, pizzas, etc. may also aggravate gastritis. These contain sodium and calcium propionate, which, over a period of time, can damage the stomach lining.
- Don't smoke
- Avoid or limit alcohol
- Take precautions while taking NSAIDs - If taking NSAIDs, combine with one of the PPIs.
Those who have already been diagnosed with gastritis or gastric or duodenal ulcers should take alternate pain relievers such as paracetamol or tramadol.
Stomach acid irritates the inflamed tissue in the stomach, causing pain and further inflammation. Therefore, treatment usually involves taking drugs to reduce or neutralise stomach acid.
- Antacids - These neutralise stomach acids and provide pain relief. They may be taken as syrups or pills. Common antacids include digene, aludrox, mucaine and gaviscon.
- H2 receptor blockers - such as ranitidine, famotidene and cymetidene, block the receptors in the stomach that are responsible for acid secretion.
- Protone Pump Inhibitors (PPI) - These reduce stomach acid by blocking the action of tiny pumps within the acid-secreting cells in the stomach. These include omeprazole, lansoprazole and rabeprazole. If a patient is on NSAIDs, the medication is usually combined with one of these.
- Eradication therapy for H. Pylori - A combination of PPIs or H2 Blockers with selected antibiotics is recommended if the CLO test is positive.
It is important that patients continue treatment for the stipulated period, even if the symptoms are not present.