stomach health

Gastritis: Diagnosis and Care

What is gastritis?

The term "gastritis" identifies a disorder characterized by a complex and heterogeneous set of symptoms triggered by inflammation of the gastric mucosa. Depending on the cause of origin, gastritis can take an acute or chronic course.

Acute variants are often due to alcoholism, smoking, excessive NSAID intake, recurrent infections and unbalanced nutrition. In contrast, chronic forms are generally caused by autoimmune diseases, recurrent Helicobacter pylori infections, long-term therapy with gastrolesive drugs and psychosomatic disorders.

The diagnosis of gastritis is essential for tracing back to the cause of the inflammatory process and remedying it through appropriate therapy. Acute gastritis - especially if dependent on an unhealthy diet - is easily resolved through appropriate dietary measures (see: diet and gastritis) and possibly pharmacological ones. Chronic forms, on the other hand, require more in-depth diagnostic investigations and therapy is generally more complex and articulated.

Diagnosis

Any suspicion of gastritis must be investigated by appropriate diagnostic-investigative tests; among these, the diagnosis makes use of:

  • Patient history: often enough for the doctor to hypothesize ongoing gastritis and formulate hypotheses about its origin
  • Test for Helicobacter pylori:
    • Blood test (complete blood count)
    • Stool analysis (research on faecal antigens of Helicobacter pylori )
    • Breath test (urea Breath test)
  • Gastric endoscopy, a diagnostic test useful for viewing the internal walls of the stomach by looking for signs of inflammation that can confirm the diagnosis of gastritis
  • Biopsy: involves taking a sample of tissue from the stomach for a subsequent cytological laboratory test
  • X-ray of the upper digestive system, useful for obtaining an image of the esophagus, stomach and small intestine. It is sometimes performed to search for any abnormalities of the gastro-intestinal tract.

Remedies, care and prevention

To learn more: Drugs for Gastritis Care

Before embarking on any therapy for the treatment of gastritis, it is essential to go back to the triggering cause and understand if we are faced with an acute or chronic form. The therapeutic approach for the treatment of acute gastritis is in fact different from the one undertaken for its chronic variant.

CARE FOR ACUTE GASTRITIS

  • When acute gastritis depends on alcohol abuse, it must be stopped as soon as possible. Alcohol in fact irritates the gastric mucosa, making it more sensitive to the action damaging to gastric juices. Also remember that alcohol - taken at high doses - favors the appearance of gastritis because it reduces the amount of bicarbonate in the mucus. (For further information: read the article on alcohol and gastritis)
  • Gastritis dependent on NSAID abuse requires the suspension of use of these drugs, naturally supervised by the doctor who will indicate appropriate replacement therapy. If it is not possible to suspend a pharmacological therapy that has proved to be gastrolesiva, it is suggested to associate it with gastroprotective drugs, able to buffer the gastric acidity. For more information, read the article gastrolesivi drugs that cause gastritis
  • Acute gastritis can be caused by an unbalanced diet characterized by spicy, fatty and irritating foods of the gastric mucosa. The phenomenon is accentuated if, in addition to taking food contraindicated in case of gastritis, meals are eaten quickly and without chewing properly. Even incorrect food associations can feed the heartburn that accompanies gastritis. For further information: read diet and gastritis
  • Nerve substances can accentuate heartburn. Coffee, for example, being an eupeptic substance (it stimulates the secretion of gastric juices to promote digestion) is part of the list of prohibited foods in case of gastritis. (For further information: read coffee and gastritis). Patients affected or predisposed to gastritis should also limit the intake of cola, cocoa, guarana, tea and mate.
  • Even heavy smokers are at risk of gastritis. Smoking, by dilating the time of gastric emptying, favors gastro-duodenal reflux while reducing the secretion of bicarbonates. For this reason, abstention from smoking is an effective remedy for gastritis, both to prevent it and to cure it.
  • Although discounted, the removal of stress can help to alleviate the symptoms of acute gastritis. For this purpose, it is advisable to engage in sports regularly, and take yoga or pilates courses.

In all the circumstances just described, the administration of antacids (eg aluminum hydroxide + magnesium hydroxide), protectors of the gastric mucosa or proton pump inhibitors can relieve gastric burning, abdominal cramps and dyspepsia, speeding up recovery from gastritis.

Examples of the most used drugs in therapy for the treatment of gastritis

  • Proton pump inhibitors (IPP):
    • Pantoprazole
    • Lansoprazole
  • Antacids:
    • Aluminum hydroxide + magnesium hydroxide
    • calcium carbonate
    • sodium bicarbonate
  • Protectors of the gastric mucosa:
    • sucralfate
    • Bismuth compounds

Even nature can help to ease the symptoms of gastritis. In this case, it is advisable to take mucilaginous and gastroprotective drugs (eg mallow, chamomile, aloe GEL, marshmallow etc.), in the form of herbal teas or infusions. For further information: read the article on natural remedies for gastritis.

CARE FOR CHRONIC GASTRITIS

For the treatment of chronic gastritis the therapeutic approach is more complex. This requires, on the one hand, to minimize the symptoms and, on the other, to remove the responsible cause. In most chronic forms of gastritis, the main defendant is Helicobacter pylori . The infection requires a rather aggressive pharmacological approach which consists of a combined therapy (triple or quadruple therapy) which involves the combination of antibiotics and proton pump inhibitors and / or protectors of the gastric mucosa:

  1. Combination of two antibiotics: amoxicillin and metronidazole +
  2. IPP (eg Pantoprazole or Lansoprazole) +
  3. Gastroprotective drugs (eg Sucralfato)

Remember, however, that alcohol can also produce chronic gastritis; therefore, it is recommended to stop drinking alcohol or follow a specific therapy for alcoholism.

Therapy for chronic gastritis always and in any case includes compliance with the food devices described for acute gastritis.

Untreated gastritis can seriously affect the patient's health. We recall, in fact, that chronic gastritis - especially caused by H. pylori - greatly increases the risk of stomach cancer.