Acute Gastritis

This article contains self-care information for the selected condition. If you have questions or need more comprehensive treatment advice, please consult a medical professional.

Acute gastritis is an inflammation or irritation of the stomach lining. The condition tends to last for a short period of time only. If the inflammation persists, however, the condition is referred to as chronic gastritis.

Acute gastritis can affect people of all ages, though it’s more common in adulthood and old age. It can have a number of different causes, ranging from bacterial Helicobacter pylori infection to certain medications, and many more.

The typical symptoms may include stomach pain or discomfort, as well as loss of appetite, nausea or even vomiting. Diagnosis is usually suspected based on a person’s medical history and physical examination. Afterwards it’s confirmed by taking a biopsy sample from the stomach lining. This is essential for making the correct diagnosis. Therefore, treatment depends on the underlying cause revealed in the biopsy results.

Both prevention and prognosis of the condition depend on the underlying cause. For example, in people taking pain relievers called NSAIDs, or excessively consuming alcohol causing gastritis, avoiding these substances is necessary. If the condition is not treated accordingly, it can become chronic resulting in several complications. 1, 2, 3, 4, 5, 6, 7, 8, 9

Generally, anything that damages the stomach lining cells can lead to acute gastritis. If the mucosa is damaged but there is no or very little inflammation, the condition is referred to as gastropathy.

There are many different causes for acute gastritis: Bacterial Helicobacter pylori infection, taking certain pain medications, such as aspirin or ibuprofen, as well as alcohol and smoking are among the most common ones. 1, 2, 3, 4, 5, 7, 8, 9

Causes of acute gastritis include:

1. Helicobacter pylori

• This is one of the most common causes of acute and chronic gastritis.
• The bacteria can be found in around two-thirds of the world’s population.

2. Other pathogens

• These are far less common.
• can include other types of bacteria, as well as viruses, parasites, and fungi.

1. Bile reflux

• Bile is naturally discharged into the small intestines to help digestion.
• If bile accidentally makes its way up to the stomach it can damage the mucosa.

2. Alcohol

• Alcohol, particularly liquor and high-proof alcohol, is considered to have a damaging effect on the stomach mucosa.
• Regular, as well as excessive intake may lead to gastropathy.

3. NSAIDs

• The group of non-steroidal anti-inflammatory drugs (NSAIDs) is one of the most common causes.
• Pain medication, such as aspirin and ibuprofen, can result in an increase in acidity because they inhibit protective substances called prostaglandins.
• Regular, as well as high-dose intake can lead to gastropathy.
• This is even more likely if glucocorticoids, a medication decreasing the body’s immune response, are taken simultaneously.

4. Iron supplements

• The potentially damaging effect on the mucosa is bigger if taken on an empty stomach.
• Also, this side effect is dependent on the dose.

5. Smoking

• Smoking is considered to be a risk factor for gastropathy.

6. Some types of chemotherapy medications

This is a malfunction of the immune system that leads to an autoimmune reaction which can affect the stomach lining cells.

Rare malformations of blood vessels, as well as complications of chronic heart failure can affect the blood flow to the stomach wall causing gastropathy.

If the stomach’s oxygen supply is insufficient due to changes in blood circulation, this can result in gastropathy.This can result from:

• cocaine intake.
• having too little blood volume due to severe dehydration or other causes.
• sepsis.
• severe burns.
• severe trauma.

Some food allergies trigger inflammation in the stomach. The reaction causes high level of white blood cells. The cells in this circumstance are called eosinophiles. Poisons on the other hand, can be irritative. The irritation damages the stomach. This produces gastritis as well.

This is a specific group of conditions that affect the body’s immune system. People with Crohn’s disease or sarcoidosis can develop gastritis as a complication.

In some conditions the exact underlying mechanism is still mostly unknown.

The typical symptoms of gastritis may include stomach pain or discomfort, as well as loss of appetite, nausea or even vomiting. In some cases, however, there may only be mild symptoms, or even no symptoms at all. Food intake can sometimes reduce or increase the abdominal discomfort. 2, 3, 5, 7, 8, 9

1. Stomach pain or discomfort

• This can be absent or range from mild to severe.
• Pain can be aching, burning, or gnawing.

2. Heartburn

3. Loss of appetite

4. Nausea and vomiting

5. Vomiting of blood

• This may occur if the gastritis leads to tears or deep sores of the stomach lining.
• If this is the case, the condition is referred to as erosive gastritis.
• Bleeding can occur several days after the onset of acute gastritis.

6. Weight loss

• This usually takes more time and is therefore more common in chronic gastritis.

7. Fever

• This may occur in rare cases indicating serious infection caused by pathogens other than H. pylori.

8. An unusual feeling of fullness in the stomach area

9. Feeling full too quickly after eating

The condition tends to last for a short period of time only. If the inflammation persists, however, the condition is referred to as chronic gastritis. 3, 7, 8, 9

If you think you might have acute gastritis, try using Ada to find out more about your symptoms.

Diagnosis of acute gastritis is usually suspected based on a person’s medical history and physical examination. Afterwards it’s confirmed by taking a biopsy sample from the stomach lining. This is essential for making the correct diagnosis. 1, 2, 3, 5, 7, 8, 9

The approach to diagnosis includes:

This includes questions about:

• medication use, such as aspirin, ibuprofen, glucocorticoids, chemotherapy medications, bisphosphonates, proton pump inhibitors, iron supplements, antibiotics, and antacids.
• smoking and drinking habits.
• underlying conditions, such as Crohn’s disease or celiac disease.

Often, there are no or only mild findings, such as a slight stomach tenderness. However, signs of other conditions, as well as possible complications can be detected this way.

• An endoscope is a long tube with a camera at its end.
• By inserting the endoscope through the affected person’s mouth and oesophagus into the stomach, doctors can examine the gastric mucosa at close range and take tissue samples.
• Endoscopy of the upper gastrointestinal tract (GI) is essential to confirm the diagnosis of gastritis.
• As a rule, several tissue samples are taken at the same time.
• In many cases, an examination of the gastric mucosa with an endoscope can provide the correct information about the underlying cause of gastritis.
• However, an analysis of the tissue samples is necessary.

• By retrieving tissue samples (biopsy), precise statements can be made about the localization of gastritis in the stomach, the severity, and possible degeneration of individual cells.
• Performing a biopsy is also the standard method to determine whether the H. pylori bacterium is the underlying cause of gastritis.

1. Testing for H. pylori can be achieved by:

• analyzing the biopsy sample (see above).
• carrying out a so-called urea breath test. This test identifies H. pylori by analyzing the air affected people exhale after drinking a certain diagnostic fluid.
• so-called stool antigen testing. This test identifies H. pylori in a stool sample.

2. Immunologic markers

• If autoimmune gastritis is suspected, specific markers, such as antibodies, should be analyzed.

Treatment for acute gastritis depends on the underlying cause. Making the correct diagnosis and treating the condition accordingly is essential in order to avoid the gastritis becoming chronic. Different treatment options include: 2, 3, 4, 7, 8, 9, 10, 11

If the disease is caused by the repeated, as well as excessive use of a certain substance, it is crucial for the affected person to stop taking these substances.

This applies to:

1. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
2. Other medications, such as glucocorticoids, chemotherapy medications, bisphosphonates, and iron supplements.

• smoking.
• alcohol.

In all of these it is important to consult a doctor who can:

• help find a good alternative to current medication.
• can advise on taking the right measures for alcohol or smoking withdrawal symptoms.
• provide the necessary support, e.g. through support groups for alcohol or smoking addiction.

1. Antibiotic medication

• H. pylori is a bacterium that can only be eliminated by the use of antibiotics. Once the bacterium has been successfully eliminated as a cause, gastritis usually disappears as well.

2. proton pump inhibitor (PPI)

• a drug that reduces the amount of acid produced by the stomach

3. triple therapy

• A combination of three drugs is initially used to treat H. pylori infection.
• This treatment includes a proton pump inhibitor (PPI) and two different antibiotics.
• This is necessary to prevent bacteria from developing resistance to a single antibiotic.
• The duration of treatment is between 10 and 14 days.
• After completing H. pylori treatment, the success of the treatment must be confirmed.

This takes place at least four weeks after the beginning of the treatment. The eradication of the bacterium can be assessed with non-invasive methods such as the urea breath test or a stool antigen test.

In most cases, triple therapy will successfully eliminate the infection. If additional treatment is required, doctors usually recommend quad therapy. This involves one PPI and three different antibiotics.

Nutrition

• Nutrition does not play a crucial role in the development of gastritis, although it may be advisable to avoid eating hearty, spicy, or acidic foods that irritate the stomach in order to alleviate symptoms.
• Eating smaller, more frequent meals (instead of larger, heavier meals), weight reduction for those overweight, and stress management can complement but cannot replace treatment.

Other measures:

1. Stress management

• can complement but cannot replace treatment.

2. Weight reduction

• for those overweight
• can complement but cannot replace treatment.

3. Medication that is freely available in pharmacies

• such as antacids
• can alleviate stomach and digestive problems but will not solve the underlying problem and should not be taken as a long-term solution.
• If the symptoms persist for more than a week or if symptoms are severe, a doctor should be consulted.

Effective prevention of acute gastritis is only possible in those cases in which substance use is the underlying cause.

This includes substances like: 4, 7, 8, 9

• non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen.
• other medications, such as glucocorticoids, chemotherapy medications, bisphosphonates, and iron supplements.
• smoking.
• alcohol.

In all of these it is important to consult a doctor who can: 4, 7, 8, 9

• help find a good alternative to current medication.
• can advice on taking the right measures for alcohol or smoking withdrawal symptoms.
• provide the necessary support, e.g. through support groups for alcohol or smoking addiction.

The prognosis of acute gastritis is directly dependent on the underlying cause and if the condition is treated accordingly.

Other factors to consider include: 2, 3, 4, 7, 8, 9

• The course of the disease can also vary greatly from person to person.
• Gastritis caused by the H. pylori bacterium can exist in some people without any symptoms, while others suffer from severe and sometimes increasing symptoms.
• In addition, the prognosis also depends on whether complications develop as a result of inflammation, such as chronic gastritis, stomach ulcers or stomach cancer.

Acute gastritis can lead to complications if the condition becomes chronic. This topic is dealt with in the article about chronic gastritis. 3

If you think you might have acute gastritis, try using Ada to find out more about your symptoms.

Q. How long does acute gastritis last?

A: The duration of an attack of acute gastritis depends on:

• identifying the underlying cause of the condition.
• how soon specific treatment for the condition is started.

If both of the above are fulfilled, in most people symptoms get better within days or a few weeks. If adequate treatment is not implemented, the condition can become chronic. 7, 8

Q: Is acute gastritis contagious?

A: Acute gastritis can have a number of different causes (see above) which range from infectious to noninfectious. All the noninfectious causes therefore cannot be contagious. The most common infectious cause is gastritis due to a H. pylori infection. Its ways of transmission include:

• drinking contaminated water in developing countries. (This may include swimming in rivers, streams, pools, as well as drinking stream water, or eating uncooked vegetables.)
• having family members who are infected. (Sharing the same living environment with someone infected has been proven to increase the risk of infection.)

Good to know: Receiving the infection by coming in contact with someone’s saliva - through kissing or sharing the same bottle - has not been proven to be a way of transmission yet. 6