Gastritis isn't one disease but a group of conditions, all of which are characterised by inflammation of the lining of your stomach. Commonly, the inflammation results from infection with the same bacterium that causes most stomach ulcers. Yet other factors including traumatic injury and regular use of certain pain relievers also can contribute to gastritis.
In spite of the many conditions associated with gastritis, the signs and symptoms of the disease are very similar: A burning pain in your upper abdomen and occasionally, bloating, belching, nausea or vomiting.
In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn't serious and improves quickly with treatment.
Signs and symptoms
The signs and symptoms of gastritis, which are often relatively mild and short-lived, include:
· A gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better when you eat
· Loss of appetite
· Belching or bloating
· A feeling of fullness in your upper abdomen after eating
· Weight loss
Gastritis that occurs suddenly (acute gastritis) usually results in the classic combination of nausea and burning pain or discomfort in your upper abdomen, whereas chronic gastritis, which develops gradually, is more likely to cause a dull pain and a feeling of fullness or loss of appetite after a few bites of food. For many people, though, chronic gastritis causes no problems at all.
Occasionally, gastritis may cause stomach bleeding, but it's rarely severe unless there's also ulceration of your stomach lining. Bleeding in your stomach can cause you to vomit blood or pass black, tarry stools and may require immediate medical care.
Your stomach. A hollow, muscular sac sits in the upper left corner of your abdomen, just under your rib cage. The typical adult stomach is around 10 inches long and can expand to hold about 1 gallon of food and liquid. When your stomach is empty, its tissues fold in on themselves, a bit like a closed accordion. As your stomach fills and expands, the folds gradually disappear.
Your stomach processes and stores food, which it gradually releases into your small intestine. When food arrives from your esophagus, a muscular ring at the joining of your esophagus and stomach (lower esophageal sphincter) relaxes to let it in. Your stomach walls, lined with layers of powerful muscles, then begin churning the food, mixing it into smaller and smaller pieces. At the same time, glands in the wall of your stomach pump out gastric juices including enzymes and stomach acids that help break food down further.
One of these, hydrochloric acid, is so caustic that it can dissolve iron nails. Your stomach's tissues are protected from this corrosive acid by the mucous-bicarbonate barrier a layered buffering system in which bicarbonate regulates the stomach's acid-alkaline balance, and mucous provides a thick, sticky coating for the stomach walls.
Possible causes numerous
Gastritis usually develops when these and other protective mechanisms are overwhelmed, damaging and inflaming your stomach lining. Some of the many factors that can contribute to or trigger gastritis include:
. Bacterial infection. A majority of the world's population is infected with corkscrew-shaped bacteria called Helicobacter pylori (H. pylori) that live deep in the mucous layer that coats the lining of your stomach. Although it's not entirely clear how the bacteria are transmitted, it's likely they spread from person to person through the oral-fecal route or are ingested in contaminated food or water. H. pylori infection frequently occurs in childhood and can last throughout life if not treated. It's now known to be the primary cause of stomach ulcers and is a leading cause of gastritis. Long-term infection with the bacteria causes a widespread inflammatory response that leads to changes in the stomach lining.
. Regular use of pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin, others), and naproxen (Aleve) can cause stomach inflammation by reducing a substance that preserves the protective stomach lining (prostaglandin). Stomach problems are less likely to develop if you take NSAIDs only occasionally, but regular use or overuse is a common cause of both gastritis and stomach ulcers.
. Excessive alcohol use. Alcohol can irritate and erode the mucous lining of your stomach, making the tissue more vulnerable to the caustic effects of normal stomach secretions.
· Cocaine use. Cocaine can damage your stomach, leading to bleeding and gastritis.
· Stress. Severe stress due to major surgery, traumatic injury, burns or severe infections can cause gastritis as well as ulcers and stomach bleeding.
· Autoimmune disorder. Autoimmune atrophic gastritis develops when your immune system attacks healthy cells in your stomach lining. This triggers an inflammatory response that gradually thins the lining, destroys acid-producing glands and interferes with the production of intrinsic factor, a substance that helps your body absorb vitamin B-12. Lack of B-12, in turn, can lead to pernicious anaemia, a serious condition that if not treated can affect nearly every body system. Autoimmune atrophic gastritis is particularly common in older adults.
· Crohn's disease. Although this bowel disease usually causes chronic inflammation of the lining of the digestive tract, it can sometimes inflame the stomach lining as well. Even when your stomach is affected, however, the signs and symptoms of Crohn's disease abdominal pain and watery diarrhoea are more prominent than symptoms of gastritis are.
· Radiation and chemotherapy. Cancer treatments such as chemotherapy and radiation can inflame your stomach lining, leading to both gastritis and stomach ulcers. When you're exposed to small amounts of radiation, the damage is often temporary, but large doses usually cause irreversible erosion of the stomach lining and destruction of acid-producing glands.
· Bile reflux disease. Bile a fluid that helps you digest fats is produced in your liver and stored in your gallbladder. When it's released from the gallbladder, bile travels to your small intestine through a series of thin tubes. Normally, a ring-like sphincter muscle (pyloric valve) prevents bile from flowing back into your stomach from your small intestine. But if this valve doesn't work properly, bile can back up into your stomach, leading to inflammation and gastritis.
· Other factors. Gastritis may be associated with other medical conditions, including HIV/AIDS, parasitic infections, some connective tissue disorders, and liver or kidney failure.
Although you can't always prevent H. pylori infection, these suggestions can help reduce your risk of gastritis:
· Eat smart. If you experience frequent indigestion, eat smaller, more frequent meals to buffer stomach acid secretion. In addition, avoid any foods you find irritating, especially those that are spicy, acidic, fried or fatty.
· Limit or avoid alcohol. Excessive use of alcohol can irritate and erode the mucous lining of your stomach, causing inflammation and bleeding.
· Don't smoke. Smoking interferes with the protective lining of the stomach, making your stomach more susceptible to gastritis as well as ulcers. Smoking also increases stomach acid, delays stomach healing and is a leading risk factor for stomach cancer. Still, quitting isn't easy, especially if you've smoked for years. Talk to your doctor about methods that may help you stop smoking.
· Switch pain relievers. If possible, avoid taking NSAIDs aspirin, ibuprofen and naproxen. These over-the-counter medications can cause stomach inflammation or make existing irritation worse. Instead, switch to pain relievers containing acetaminophen.
· Follow your doctor's recommendations. Your doctor may recommend that you take an over-the-counter antacid or acid blocker to help prevent recurring gastritis.
Digestive problems ranging from simple stomach upset to stomach cancer can occur for many reasons, including lifestyle choices you can control. In general, to keep your digestive system healthy, doctors recommend that you:
· Practice good eating habits. Just as important as what you eat is the manner in which you eat. Eat moderate proportions, eat at regular times and relax while you eat.
· Maintain a healthy weight. Digestive problems can occur no matter what your weight. But heartburn, bloating and constipation tend to be more common in people who are overweight. Maintaining a healthy weight can often help prevent or reduce these symptoms.
· Get plenty of exercise. Aerobic exercise that increases your breathing and heart rate also stimulates the activity of intestinal muscles, helping to move food waste through your intestines more quickly. It's best to aim for at least 30 minutes of aerobic activity every day.
· Manage stress. Stress increases your risk of heart attack and stroke, dampens your immune system and can trigger or aggravate skin problems. It also increases stomach acid production and slows digestion. Because stress is unavoidable for most people, the key is to learn to handle it effectively a task that's made easier by a nutritious diet, adequate rest, regular exercise and healthy ways to relax. If you have trouble relaxing, consider taking up meditation or studying yoga or tai chi. These disciplines can help focus your mind, calm your anxieties and reduce physical tension. Therapeutic massage may also loosen taut muscles and calm frazzled nerves.
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