What is Gastritis
Gastritis is a generic term that describes a discomfort or disorder of the stomach, generally characterized by pain or burning, which manifests or disappears based on the state of gastric filling.
Types of Gastritis
Outline of classification of gastritis
Gastritis is classified in two ways: the first is called the Sydney-Huston system and is based on the histological and endoscopic entity, on the etiological mechanisms and on the type of lesion. The discriminatory variables in the classification of gastritis according to Sydney-Huston are:
- Presence of Helicobacter Pylori
- Extent of infiltration of immune cells (white blood cells)
- Importance of glandular atrophy and presence of intestinal metaplasia
Scale of severity of gastritis variables
The second method, instead, focuses above all on the etiological agents that determine it:
- Chronic gastritis from Helicobacter Pylori
- Chronic NSAID gastropathy (non-steroidal anti-inflammatory drugs)
- Chronic autoimmune atrophic gastritis
- Chronic infectious gastritis
- Acute gastritis
The most serious complications of gastritis are related to possible bleeding and impaired digestive capacity. Gastritis can induce one or more erosions of the gastric mucosa which, if left untreated, risk evolving into real gastric ulcers; the differentiation between one or the other condition is based on the depth of the lesion.
Gastritis hemorrhage can be treated directly and / or indirectly with:
- Removal / annulment of the causative agent (for example, suspension of gastrolesive drugs)
- Food therapy
- Drug therapy (administration of anti-acids - administration of proton pump inhibitors - administration of antibiotics etc.)
- Endoscopic sclerosis (if easily accessible and if the lesions are up to three)
Complications
Bleeding gastritis causes a constant loss of blood in the stomach; this complication, especially in fertile women who already suffer monthly losses with menstruation, can determine a significant reduction of the hematocrit, inducing or aggravating the anemic condition.
At the gastric level, the mucous membranes secrete the so-called intrinsic factor, an essential molecule for intestinal absorption (in the terminal ileum) of vitamin B12 (cobalamin). The possible atrophy of the mucous membranes induced by gastritis, or worse the evolution in intestinal metaplasia, determine the reduction of the ability to secrete intrinsic factor and to absorb cobalamin. The consequent chronic lack of vitamin B12 - besides being particularly serious for the pregnant woman, as it increases the risk of complications in the neural development of the fetus - could significantly originate or aggravate the anemic form defined pernicious .
Untreated gastritis can develop into an ulcer; this can be defined as such if the erosion, in addition to compromising the mucosa (gastritis) also reaches the basement membrane and / or passes it, until it becomes a perforating ulcer. The piercing ulcer can be very serious and sometimes deadly; however, the correlation between gastritis and the onset of a perforating ulcer is rather modest.
Food and Gastritis
Among the foods that trigger the onset of gastritis or worsen the course we remember:
- Alcoholic beverages (see details: alcohol and gastritis)
- Caffeine and other sympathetic-mimetic amines (such as tea tea, see in-depth information: Coffee and gastritis)
- Nicotine (ingested with saliva)
- Carbonated acid drinks
- Overly salty foods
It should be specified that the foods potentially responsible for gastritis are among those to be abolished in nutritional therapy for the treatment of the disease itself; however, many foods to be avoided during treatment (for example milk, stewed meat, raw meat, large portions of cheese, etc.), do NOT have any pathogenetic effect in healthy subjects, in which, provided they are taken in portions and with adequate frequency, they do not cause any type of gastritis.
Caffeine and other sympathetic-mimetic amines: in particularly sensitive subjects, even the sole consumption of one or two cups of coffee a day (80-160mg of caffeine) can cause an important irritation of the gastric mucosa, especially if the drink is taken in fasting. In fact, caffeine, just like theine, is a stimulant of acid secretion; these drinks, which in themselves are potentially potentially harmful (even if subjectively) to the stomach, must be COMPLETELY abolished both in case of hypersensitivity and in the proper therapy of gastritis.
The same applies to alcoholic beverages; ethyl alcohol is a powerful acid stimulator which, when taken without food, stimulates the secretion of hydrochloric acid by irritating or eroding the mucous membrane; if taken on a full stomach, on the other hand, alcohol causes a slowing of gastric digestion due to excessive lowering of the pH of the chyme (slurry of food digested between the stomach and the intestine). Also the susceptibility to alcohol is absolutely subjective and in most cases only one alcoholic unit at the main meals DOES NOT cause a strong irritative symptomatology of the gastric mucosa.
Not the nicotine either; this is ingested in very high quantities in tobacco chewers (which fortunately today have almost disappeared) and in the most ardent smokers. Smoking causes a continuous ingestion of nicotine, which, like alcohol and caffeine, causes a lowering of the gastric pH due to hyper acid secretion.
A group of foods which, contrary to the aforementioned, represents a DIRECTLY irritating element for the stomach, is that of acidic and carbonated drinks; the most striking example is that of cola-type drinks. These, in addition to containing caffeine, are also characterized by a sufficiently low pH to create an instantaneous irritation of the mucosa and, in the long term, originate gastritis. As if this were not enough, these drinks provide an excessive intake of carbon dioxide, which greatly affects gastric hyper-distension, worsening the painful symptoms of gastritis.
Salty foods contain excessive amounts of sodium chloride (NaCl); this salt has a powerful osmotic effect towards the mucous membranes of the stomach, dehydrating it; at the same time, table salt is a further stimulator of gastric secretion; moreover, considering that generally the most salty foods (except for some baked goods such as crackers and breadsticks or similar) contain good amounts of protein (salted meats, sausages, seasoned cheeses etc.) which in turn determine an increase in hydrochloric acid and of pepsin, it is possible to state that (if taken frequently) salted foods can determine an additional factor of onset for gastritis.
The foods that cause gastritis are few but must be taken with very limited frequency and portions; their aetiological importance depends very much on the individual susceptibility, however, even in a normal subject, the association of more potentially harmful eating habits could determine the pathological onset of this disorder.
Bibliography:
- Inflammation in gastroenterology - A. Martin - Piccin - pag. 71: 109
- Internal and systemic medicine. Sixth edition - C. Rugarli - Elsevier Masson - pag. 648: 656
