Gastritis Overview – Symptoms, Causes, Treatments

Gastritis may be just as common as the cold and flu. In fact, as many as 10% of visits to a hospital emergency room are attributed to gastritis when there’s abdominal pain.

But, what exactly is gastritis?

What is Gastritis?

The word “gastritis” comes from two Greek words: “gaster”, meaning stomach, and “itis,” which means inflammation. So when you hear someone say they have gastritis, they mean that their stomach has become inflamed.

Gastritis is not one disease, but rather a group of conditions where stomach lining inflammation occurs.

Gastritis may be sudden (acute) or long-lasting (chronic); or it may occur alongside a more serious medical condition.

What Causes Gastritis?

The most common cause of gastritis is an infection with Helicobacter pylori bacteria (H. pylori). About half of the population is infected with H. pylori, but not everyone will develop gastritis or symptoms by 6t0 years old. 

Gastritis may be caused by a number of factors:

  • Alcohol consumption
  • Allergens
  • Aspirin 
  • Autoimmune disorders
  • Bacterial infections (the type that normally cause pneumonia or bladder infections)
  • Burns
  • Cancer chemotherapy medications
  • Chronic bile reflux
  • Chronic vomiting
  • Cigarette smoke
  • Corrosives (acid or lye)
  • Eating disorders (i.e. bulimia)
  • Emotional distress
  • Excessive caffeine consumption
  • Iron tablets
  • Major surgery
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) (i.e. ibuprofen, Goody’s or BC powders)
  • Overeating
  • Parasitic infection / worms (most often from poorly cooked seafood)
  • Pernicious anemia
  • Physical stress (i.e. following a critical illness or injury)
  • Potassium supplements
  • Radiation
  • Steroid treatments
  • Stomach surgery
  • Swallowing poisons or foreign objects (i.e. paper clips or pins)
  • Syphilis
  • Traumatic injury
  • Tuberculosis
  • Viral infections

The list of causes is rather long, so keep an eye out for symptoms. 

Symptoms of Gastritis

Some people have gastritis but don’t experience any symptoms. Conversely, minor stomach changes may lead to severe symptoms. It can be common for older people to have stomach damage without any symptoms initially, but then experience internal bleeding. 

Gastritis is usually accompanied by pain or discomfort in the upper part of the abdomen, sometimes referred to as “dyspepsia.” The pain can later radiate to the back.

Gastritis can often be accompanied by other symptoms, including:

  • A feeling of fullness in the upper abdomen
  • Abdominal bloating
  • Aching, burning, sharp, stabbing or gnawing pain
  • Appetite loss
  • Belching
  • Bloody bowel movements
  • Chest pain
  • Dark, sticky, black, extremely foul-smelling bowel movements
  • Feeling faint
  • Fever
  • Lethargy
  • Nausea and vomiting
  • Poor pallor
  • Rapid or racing heart beat
  • Shortness of breath
  • Sweating
  • Vomiting blood

Note: Black stools or blood in the vomit could be caused by stomach bleeding. If this happens, it could be an indication of a serious health condition that requires immediate medical attention.

Diagnosing Gastritis

Seeing a health care provider is important to diagnose gastritis. Your doctor will ask about your current symptoms, medical history, and if you’re taking any medications currently.

It is important for your physician to know about any habits that may be associated with gastritis, such as alcohol intake, cigarette smoking, and other lifestyle issues.

Your doctor may recommend a variety of different tests in order to rule-out certain medical conditions that can be mistaken for gastritis.

Diagnosis tests may include:

  • An electrocardiogram (ECG) to explore for chest pains or rapid heart beat
  • Blood cell counts (to test for anemia / low blood count)
  • Kidney, liver, and pancreas related blood tests
  • Pregnancy test
  • Stool tests (to check for blood or certain infections)
  • Tests for H. pylori – urea breath test, stool antigen, and/or blood antibody
  • Urinalysis

A gastroenterologist may order additional diagnostic tests:

  • Upper gastrointestinal endoscopy to examine the stomach lining, and extracts a tissue sample (a biopsy) to help diagnose if gastritis is present.
  • X-ray of the esophagus, stomach, and duodenum after ingesting liquid barium to coat the stomach lining. The barium coating gives a clear X-ray of the affected area.
  • Ultrasound to evaluate the gallbladder, liver and various parts of the pancreas.

Gastritis Treatment

H. Pylori Infection Prevention and Treatment

Treatment for gastritis involves removing the irritant causing the inflammation. For example, if you have an H. pylori infection, your doctor will first prescribe medication to clear the bacteria.

A combination of several antibiotics and an acid suppressor (or proton pump inhibitor, also known as PPI) taken over a two-week period has a 70-90% efficacy rate for resolving H. pylori.

The antibiotics kill the H. pylori bacteria. Acid-suppressing drugs such as histamine-2 blockers (H2 blockers) reduce the amount of hydrochloric acid that is released into the digestive tract.

Proton pump inhibitors (PPIs) shut down the pumping process in cells that produce acid. A stomach protector or stomach coating agent protects the lining of the stomach from acid related damage.

Probiotic supplements can be effective in reducing H. pylori-associated gastritis.

Gastritis symptoms will usually disappear when the underlying H. pylori infection or other gastritis-associated problem is treated. 

Identify Avoidable Gastritis Triggers

If the underlying cause is not clear, such as H. pylori, it’s important to identify the gastritis triggers causing the symptoms. The most common trigger is NSAID medications.

Avoidance of NSAIDs can reduce irritation to the stomach lining to help reduce symptoms and reduce the risk of intestinal bleeding from ulcers.  

Avoidance of the following may also help:

  • Alcohol consumption
  • Aspirin
  • Certain foods (especially hot and/or highly spiced, such as chili)
  • Cigarette smoke
  • Coffee and other caffeine-containing beverages such as soda and tea

Avoiding triggers is especially important for people with severe gastritis who are at high risk for developing complications.

Medications for Gastritis

Antacids, although often recommended for gastric ulcer relief, should be taken with caution as they may cause various side effects. 

These are side effect examples for different types of antacids: 

  • Aluminum-containing antacids – may lead to constipation and affect your body’s ability to absorb other medications.
  • Calcium-containing antacids – may also result in constipation and disrupt medication absorption capabilities. In high doses, they can cause high blood calcium levels and decreased kidney function. However, they are good at controlling stomach acid, while also supplementing body calcium.
  • Magnesium-containing antacids – may cause diarrhea and also disrupt absorption capabilities. Not recommended for patients with kidney problems.

Two types of acid-suppressors are currently available:

H2 blockers work by reducing the amount of hydrochloric acid released and some are available without a prescription. Examples are cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid).

PPIs stop stomach acids from being produced by stopping the pumping process in acid-producing cells. Examples include lansoprazole (Prevacid), omeprazole (Prilosec), and esomeprazole (Nexium).  There are several others also available on the market, some only with a prescription.

Stomach protectors or coating agents protect the stomach’s lining by coating it. Examples include sucralfate (Carafate) and misoprostol (Cytotec).

Antiemetics help to control nausea and vomiting. There are numerous examples including promethazine (Phenergan), ondansetron hydrochloride (Zofran), prochlorperazine (Compazine), and trimethobenzamide (Tigan).

Alternative Gastritis Treatments and Other Tips

Eating properly is essential to treating and preventing digestive problems, including gastritis. Try changing the way you eat your food.

  • Eat only fruit in the morning. Fruit is mainly water, so they are easier to digest than other foods.
  • Eat several small meals per day. Eating more frequent, smaller meals keeps your stomach from getting too full. That reduces gastric pressure and the feeling of fullness or reflux. Aim for six small meals per day instead of three large meals.
  • Keep a diary of foods and drinks that trigger gastritis symptoms. Do your best not to eat them, you may be able to prevent gastritis from occurring.

Changing your diet is crucial to managing gastritis. Stress reduction is also important. We’re all aware of the fact that stress can be better managed by eating well, getting enough rest, and making sure to include some form of exercise into your daily routine.

Gastritis Final Thoughts

Gastritis can sometimes lead to more serious health issues, including ulcers and an increased chance of developing stomach cancer. Gastritis is usually not too painful and tends to improve quickly with proper dietary self care.

Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.