US Pharm. 2017;42(12):11.

Inflamed Stomach Lining

Gastritis is a term used to describe an inflammation of the stomach lining. Inflammation occurs when cells in the lining of the stomach are irritated or damaged. Some cells in the stomach lining produce protective mucus, and when they are damaged, less mucus is produced, leaving the stomach inadequately protected against digestive acids. Exposure to digestive acids causes more inflammation and irritation, potentially resulting in erosion of the stomach lining and, ultimately, ulcers. In addition to treating or removing the underlying cause of the inflammation, medication is used to neutralize the stomach acid and reduce the amount of acid produced to help the stomach heal.

Prevalence and Cause

A common cause of gastritis is infection with Helicobacter pylori, the bacterium that causes ulcers. Other risk factors include excessive alcohol intake, frequent vomiting, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), stress, radiation for cancer treatment, autoimmune diseases, and some medical procedures. Acute, or sudden, gastritis is the most common type, occurring in 8 out of 1,000 people, while the slower-developing chronic gastritis is much less common, occurring in only 1 out of 10,000 people.

Gastritis is not always symptomatic, and even when symptoms occur, they are not the same in all people. The most frequently experienced symptoms include nausea, vomiting, indigestion, lack of appetite, and upper abdominal pain or discomfort. There are no definitive tests for gastritis; physicians rely on the medical history and a physical examination of the patient to make an accurate diagnosis. Sometimes, an upper endoscopy is used to aid in diagnosis. During an endoscopy, a thin, flexible tube with a light and camera on the end is passed through the mouth and into the stomach, allowing for direct viewing of the stomach lining.

The Best Treatment Is Prevention

When the specific underlying reason for gastritis is known, physicians focus first on resolving the cause. For example, when the bacterium H pylori is the source of gastritis, antibiotics are prescribed; if aspirin or another medication is the cause, then that medication is discontinued. With the underlying problem resolved, gastritis can improve quickly. Medications like antacids may be used to improve gastritis symptoms. They work by neutralizing the stomach acid and reducing the amount of acid produced by the stomach.

H pylori is passed from person to person through fecal-oral transmission. Infection can occur when fecal matter from a bowel movement is ingested by a person who doesn’t wash his or her hands. The bacteria may also be passed from soiled hands to surfaces like countertops and doorknobs, where they are then passed along to someone else. In both cases, H pylori is ingested along with the food. The habit of regularly washing one’s hands can go a long way toward preventing H pylori infection and resulting gastritis. 

Although NSAIDs (aspirin, ibuprofen, naproxen) decrease pain and inflammation, they also interfere with a hormone needed to produce the mucus that protects the stomach lining. Using the lowest effective NSAID dose for the shortest duration is another best practice for reducing the risk of gastritis.

Don’t Let Gastritis Become Chronic

Chronic or untreated gastritis may lead to bleeding in the stomach, ulcers that can perforate and cause infection in the abdomen, and nausea and vomiting caused by obstructions. Also, chronic infection with H pylori increases the risk of developing stomach cancer. Some measures may be taken to heal the stomach lining once gastritis occurs. Eating smaller meals throughout the day, rather than three big meals, can minimize the production of stomach acid. A reduction in alcohol consumption will lessen irritation and inflammation of the stomach lining. Quitting smoking and reducing stress may also help reduce the damage to the stomach lining that causes gastritis. Eating vegetables in the cabbage family may help with H pylori because they contain sulforaphane, a substance known to have antibacterial effects. If you have questions about gastritis treatment or prevention, your local pharmacist can help.