Gastritis

Causes

The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers and drinking too much alcohol can also contribute to gastritis.

Causes of acute gastritis include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin
• Steroid medications
• Alcohol use disorder
• Smoking
• Severe stress from sepsis, burns, or injury

Causes of chronic gastritis can include:

• Bacterial infection, such as Helicobacter pylori (H. pylori)
• Viral infection
• Fungal infection
• NSAID use
• Alcohol use disorder
• Reflux of bile into the stomach
• Autoimmune diseases such as Crohn disease or sarcoidosis
• Pernicious anemia—a cause of autoimmune gastritis
• Radiation therapy
• Swallowing caustic substances

Risk Factors

Things that may raise the chance of acute gastritis include:

• NSAID use
• Excess alcohol use
• Head injury
• Surgery
• Respiratory failure
• Kidney failure
• Liver failure
• Stress

Things that raise the chance of chronic gastritis include:

• H. pylori infection
• NSAID use
• Excess alcohol use

Symptoms

Gastritis may not cause any symptoms. Those who do have symptoms may have:

• Burning and pain in the belly
• Indigestion
• Acid reflux
• Burping
• Bloating
• Loss of appetite
• Feeling full in the upper belly after eating
• Nausea and vomiting

If the gastritis is causing bleeding, a person may have:

• Bloody or black vomit
• Bloody or dark black, tarry stools

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Tests may include:

• Upper GI series—x-rays with a special dye to highlight abnormal areas (also called a barium swallow)
• Upper GI endoscopy—a thin, lighted tube inserted down the throat and into the stomach to check the inside of the stomach
• Biopsy—a sample of tissue is removed and checked in a lab
• Blood, breath, or stool tests—to check for infection with the bacteria H. pylori

Upper GI Endoscopy

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Treatment

The goals of treatment are to heal the stomach lining and ease any symptoms. This may be done with:

Medicine

Medicines may help ease symptoms. Some can also help heal the stomach lining. Medicine is available over the counter or by prescription. The doctor may advise:

• Antacids
• H2 blockers
• Proton pump inhibitors
• Antibiotics if an infection is present or possible

Treatment may also include stopping or changing medicine that is causing problems.

Prevention

To help reduce the chances of gastritis from NSAIDs:

• Use other drugs when possible for managing pain.
• Take the lowest possible dose.
• Do not take drugs longer than needed.
• Do not drink alcohol while taking the drugs.

To help reduce the chances of H. pylori infection:

• Wash hands often with soap and water and before eating or preparing food.
• Drink water from a safe source.

People who smoke or vape should look for ways to quit. The doctor may have some tools to help with quitting.

Avoid alcohol. People who do drink should do so in moderation. This means one drink or less a day for women and two drinks a day or less for men.