Gastritis

Gastritis is inflammation of the lining of the stomach, which can be acute, developing suddenly, or chronic, persisting for months or longer. Acute gastritis often causes sudden upper abdominal discomfort, nausea, or vomiting, while chronic gastritis may be asymptomatic or lead to longstanding changes in the stomach lining and digestion.

Common causes include Helicobacter pylori infection, use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other irritants, excessive alcohol consumption, autoimmune gastritis (driven by antibodies against stomach cells and intrinsic factor), bile reflux, and stress-related mucosal damage in seriously ill people. Risk factors include older age, ongoing NSAID use, and a high prevalence of H. pylori in the population.

Symptoms vary; many people have no noticeable signs. When present, they may include epigastric pain or burning, nausea, vomiting, early satiety, bloating, or loss of appetite. Complications can include gastrointestinal bleeding, anemia, peptic ulcers, or in chronic cases, progression to atrophic gastritis or metaplastic changes. Diagnosis relies on clinical history and tests such as blood counts, iron studies, and tests for H. pylori (urea breath test or stool antigen test). Endoscopy with biopsy may be needed to assess the extent of inflammation, confirm H. pylori infection, and detect atrophy or other mucosal changes.

Treatment targets the underlying cause. H. pylori infection is treated with a course of antibiotics plus acid-suppressing therapy. NSAID-related gastritis is managed by stopping or replacing the NSAID and using acid suppression. Autoimmune gastritis is managed with monitoring and treatment of deficiencies such as vitamin B12. Lifestyle measures, including avoiding alcohol and tobacco, may help. Prognosis is generally favorable with treatment, though chronic gastritis with atrophic changes requires ongoing follow-up due to risks of complications and nutritional deficiencies.