What is gastritis?

Gastritis is when the stomach lining becomes inflamed (swollen and red). The stomach lining may also erode (wear down) because of the inflammation.

Gastritis can happen suddenly and be short-lived (acute gastritis), or develop gradually and last over a few months or years (chronic gastritis). While gastritis can be mild and heal on its own, sometimes treatment may be needed, depending on the cause and symptoms.

What are the symptoms of gastritis?

Not everyone with gastritis will experience symptoms. If you have symptoms, they may include:

• a burning pain in the upper stomach area (such as in heartburn) — which may improve or worsen with eating
• nausea
• vomiting
• loss of appetite
• bloating and burping
• hiccups
• diarrhoea
• feeling uncomfortably full after eating
• weight loss
• bad breath
• blood in the vomit or stools (poo)

What causes gastritis?

There are many things that can increase the risk of gastritis. The most common causes are infection with a type of bacteria, taking some medications, and drinking too much alcohol.

Infection with bacteria

The bacteria that may cause gastritis are called Helicobacter pylori (H. pylori). These bacteria are found in 4 in every 10 Australian adults over 60. Even so, many of those infected with H. pylori don’t develop any gastritis symptoms or ulcers. The reason for this is not clear.

Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, are commonly used for pain relief, but they can also increase acidic gastric juices produced in the stomach. The increased stomach acid can inflame and wear down the stomach lining.

Drinking alcohol excessively

Excessive drinking can erode the lining of the stomach, making it weaker and more likely to be damaged by the stomach’s acidic digestive juices.

Other causes of gastritis include:

• having too much acid in the stomach
• intense stress
• backflow of bile into the stomach (known as ‘bile reflux’)
• diabetes
• an infection
• diseases of the intestines or stomach, such as Crohn’s disease
• an allergic reaction
• some cancer treatments

When should I see my doctor?

Gastritis often clears up by itself. You should see your doctor if you have:

• gastritis symptoms that last more than a week
• vomit that contains blood or a black, tarry substance (dried blood)
• blood in your stool (poo), or stool that is black
• your pain gets worse
• you have a fever

How is gastritis diagnosed?

To confirm the cause of the symptoms, your doctor is likely to talk to you and examine you. They may also ask you to have some tests, such as blood tests, breath tests or stool tests.

Your doctor may also refer you to a specialist who is an expert in the digestive tract (gastroenterologist).

You may also be asked to have an endoscopy. An endoscopy involves inserting a flexible tube with a tiny camera down the throat into the upper digestive tract to have a look for signs of inflammation and ulcers. This is usually done with some sedation. A small tissue sample may be taken to examined in the laboratory.

How is gastritis treated?

Treatment of gastritis depends on its cause. Your doctor may prescribe a mix of prescription and non-prescription (over the counter) medicines, and recommend lifestyle changes.

Common gastritis treatments are:

• antibiotic medicines to kill the H. pylori bacteria. If prescribed, it’s important you complete the full course
• prescription medicines that reduce the amount of acid made in the stomach, called H2 blockers or proton pump inhibitors
• over the counter antacids, which neutralise stomach acid (these should be taken separately from some other medicines — ask your pharmacist)

You can also make some lifestyle changes to help improve your healing process, and reduce any further chances of irritation. You could try to:

• eat smaller meals more often
• avoid foods that can irritate your stomach, such as foods that are spicy, acidic (e.g. citrus and tomatoes), fried or fatty
• avoid alcohol and coffee
• avoid non-steroidal anti-inflammatory drugs (NSAIDs) — ask your doctor or pharmacist for alternative pain relievers
• reduce stress
• stop smoking

It’s also important take your medicines as directed and to learn what triggers your symptoms.

Complications of gastritis

If left untreated, gastritis can lead to stomach ulcers and bleeding. While rare, it can also increase the risk of stomach cancer.