An Overview of Erosive and Non-Erosive Gastritis
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Gastritis is a stomach inflammation that may produce bleeding, ulceration, and erosion of the lining. Typical symptoms include upper abdominal pain, nausea, vomiting, bloating, heartburn, and sometimes bleeding. With acute gastritis, the symptoms occur suddenly, caused by an infection, a toxic substance, aspirin and similar drugs, a food allergen, severe stress, surgery, kidney or liver failure, and other serious conditions.
Chronic gastritis often results from alcohol abuse or long-term use of aspirin or another non-steroidal anti-inflammatory drugs used to treat arthritis and other painful conditions. Sometimes it is linked to an underlying disorder, such as Crohn's disease (in which the large and small intestines become inflamed and ulcerated).
In hypertrophic gastritis, a rare disorder, the mucosal folds and the stomach lining become enlarged and thickened.
Diagnostic Studies and Procedures
Most occurrences of gastritis are diagnosed on the basis of the symptoms. In severe cases blood in the vomit may prompt a visit to a doctor. If gastritis is suspected the doctor will probably order gastroscopy, an inspection of the stomach lining. This is done using a gastroscope, a thin, flexible tube with special viewing devices that is passed into the stomach through the mouth. In some cases, a small tissue sample will be removed through the gastroscope and sent for laboratory studies.
Other diagnostic measures may include an upper GI series of X-rays, taken after the patient drinks barium, a chalky substance that coats the Stomach and other digestive organs to make them visible on film. A sample of stomach fluids may also be taken for laboratory analysis of the acid level, since reduced secretion of gastric juice is often associated with gastritis. Generally, this sample is drawn out with a tube that is passed through the nose and esophagus to the stomach.
Treatment will vary according to the symptoms and the underlying cause. Gastritis from a viral infection is self-limiting and does not require any medical intervention. An over-the-counter antacid may alleviate mild symptoms. If an underlying cause has been found, treating it will usually clear up the stomach problem as well.
Severe erosive gastritis calls for prompt treatment to stop any bleeding. When bleeding is profuse, a stomach tube may be inserted and ice water passed through it to constrict any leaking blood vessels, A blood transfusion may be required, though this is rare. If severe bleeding persists, an emergency operation may be performed to remove the eroded part, or, in some cases, the entire stomach.
Alternative approaches are usually not appropriate for acute gastritis that involves bleeding. They may, however, be useful in treating and preventing chronic, non-erosive gastritis.
Herbal Medicine. To alleviate the inflammation, many herbalists recommend marsh mallow root, which may be taken as a tincture or in capsules. Meadowsweet tea or diluted tincture is said to reduce stomach inflammation. Licorice sticks or tea and slippery elm capsules are other remedies. Peppermint tea aids digestion and may help settle an upset stomach. Ginger extract and alfalfa-seed lea may also alleviate a mildly upset stomach.
Some herb books recommend angelica tea for gastritis, but recent studies question its safety. Certain toxic herbs such as European mandrake, arnica, and tansy can cause severe gastritis.
Homeopathy. Practitioners often recommend ipecacuanha to ease the pain and other symptoms of gastritis.
Naturopathy. Sometimes reduced production of hydrochloric acid, one of the stomach's digestive juices, promotes gastritis. Naturopaths advise taking a tablespoon of apple cider vinegar during a flare-up. If you find that it helps, sip a little with meals. If, on the other hand, it makes the symptoms worse, discontinue use and avoid digestive aids that contain hydrochloric acid.
You can usually treat mild attacks of gastritis yourself with non-prescription antacids, but see a doctor if symptoms last more than a day or two or if they recur frequently. Seek immediate medical attention if you vomit blood.
Since smoking and excessive use of alcohol are often linked to gastritis, abstain from both, as well as from beverages that contain caffeine. Try to determine whether a particular food triggers the problem. If something does, avoid it in the future. In any event, stay away from spicy dishes and fatty or fried foods. Eating frequent, small meals may also help.
Stop taking aspirin and other non-steroidal anti-inflammatory drugs. If you need these drugs for a concurrent medical problem, such as arthritis, ask your doctor about taking them in enteric form. These pills have a coating that allows them to pass undissolved into the small intestine, where they are unlikely to cause irritation. In the meantime, take uncoated forms with food or milk, which minimizes their contact with the stomach lining.
Other Causes of Stomach Pain
Heartburn and peptic ulcers produce many of the same symptoms as gastritis. In a few cases, stomach cancer may be responsible for the symptoms.