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Acute Gastritis

  1. What is acute gastritis?
  2. Symptoms
  3. Causes
  4. Risks
  5. Diagnosis
  6. Treatment
  7. Prevention
  8. FAQ

What is acute gastritis?

Acute gastritis is an inflammation or irritation of the stomach lining, leading to symptoms which may include:[1]

  • Stomach pain or belly pain
  • A general feeling of indigestion
  • Loss of appetite and a feeling of fullness
  • Nausea
  • Bloating and gas
  • Vomiting
  • Weight loss

There are several different types of acute gastritis. This is due to the fact that the physical processes in the body that lead to a person developing it, can vary, as can the part(s) of the stomach affected.

The two main forms of acute gastritis are:[2]

Erosive acute gastritis. In this type of gastritis, the symptoms are caused by damage to the mucosa layer of the stomach. This is also known as the stomach lining; it produces, and is covered by, protective mucus. Erosive gastritis causes erosions in the stomach lining, which can take the form of shallow tears or deep sores, called ulcers.

Non-erosive acute gastritis. In this type of gastritis, the symptoms are caused by damage to the stomach lining, but this damage does not result in tears or ulcers.

A number of management strategies exist to treat acute gastritis, including over-the-counter and prescription medications, and dietary changes. In most cases, acute gastritis has a short recovery time of only a few days. The condition can be very mild and may get better on its own without treatment. Mild gastritis is much more common than severe or acute gastritis.[3]

Acute vs. chronic gastritis

Acute gastritis is similar to chronic gastritis, but occurs more suddenly. The symptoms and pain caused by the stomach irritation and inflammation that are associated with acute gastritis set in quickly. These symptoms are often experienced as a severe stomach pain, which usually lasts for a short time, i.e. hours or days. Acute gastritis has a shorter recovery time, normally improving in a few days to a few weeks after treatment has begun.

In contrast, chronic gastritis often causes duller pain, which, by definition, is always longer-lasting. For example, it may be constantly present over months.[4]

More often than acute gastritis, chronic gastritis can lead to other possible long-term complications affecting the digestive system, such as peptic ulcers, gastric polyps, or, in rare cases, stomach cancer. The increased stomach cancer risk associated with chronic gastritis is still low overall, though, and can be decreased further by getting adequate gastritis treatment and regular check-ups, according to a doctor’s recommendations. Worried you may have acute or chronic gastritis? Download the free Ada app and start symptom assessment.

Acute gastritis vs. gastroenteritis

Both acute and chronic gastritis directly affect the stomach and cause nausea and vomiting. Gastroenteritis affects both the stomach and intestines and may also cause diarrhea.

Good to know: It is fairly common to experience dehydration as a result of gastroenteritis, due to the amount of water lost because of vomiting and/or loose stools or diarrhea. This can be treated with rehydration therapies. Dehydration is much more commonly associated with gastroenteritis than with gastritis. Unsure whether your symptoms relate to gastritis or gastroenteritis? Download the free Ada app and start symptom assessment.

Symptoms of acute gastritis

Symptoms of acute gastritis are primarily digestive, and may include:[1][2][4]

  • Recurring nausea
  • Vomiting
  • Abdominal pain
  • A feeling of burning in the stomach
  • Feeling full too quickly after eating
  • A general feeling of fullness in the upper part of belly, stomach area, or below the ribs

Some people experience additional symptoms, which can be suggestive of severe gastritis, especially if they are associated with a (bleeding) ulcer.

Additional symptoms may include:[1]

  • Passing melena; a stool containing blood related to upper gastrointestinal bleeding, which will appear to be black or tarry
  • Vomiting blood; this may resemble coffee grounds if it has been in the stomach for a while already, or it could appear red if it is from an ulcer which is bleeding freshly
  • Fever and/or sweating
  • Dizziness and vertigo
  • Rapid heartbeat and/or shortness of breath

Seek medical attention immediately if these symptoms are present, as they require prompt treatment and are unlikely to get better on their own. Complications such as ulcers can result from severe or prolonged gastritis. These may also cause bleeding from the lining of the stomach.

While many milder cases of acute gastritis can be managed effectively at home, a doctor should without much delay be consulted if:[4]

  • Indigestion symptoms last for longer than one week at a time
  • Pain that is severe in the daytime or awakens a person from sleep is present
  • Signs of blood in vomit or stool are present

Acute gastritis symptoms in children

Research suggests that one possible cause of acute gastritis, infection with H. Pylori bacteria, is usually already acquired in childhood.[1] Nevertheless, even though children may occasionally experience gastritis, they are less likely than adults to develop acute gastritis. It is possible to carry low levels of these bacteria in the gut for many years without developing acute gastritis as a result.

However, experiencing gastritis as a result of adverse reactions to foods, such as soy milk or cow’s milk, is more common in children than in adults.[2]

As with adults, the symptoms of gastritis in children may also be possible signs of a wide range of other conditions, such as viral gastroenteritis or inflammatory bowel diseases such as Crohn’s disease. It is important to seek medical attention when symptoms first appear and are severe, or if they stay for more than a few days, in order to receive a proper check-up and diagnosis from a doctor.

In children, toddlers and babies, the symptoms of acute gastritis are similar to those experienced by adults. Immediate medical attention should always be sought in severe cases. Signs of severe gastritis requiring immediate medical attention, may include:[5]

  • Confusion, sleepiness or loss of consciousness
  • Severe stomach pain, especially if it doesn’t get any better despite passing stool or gas
  • Vomiting blood, which will usually be dark brown in color - this signifies that it has been in the stomach for a few hours - and may have a grainy texture like coffee grounds, but may occasionally also be reddish and non-grainy, if it is fresh
  • Passing bloody stools, which may appear tarry or maroon in colour, or have streaks of blood
  • Vomiting and/or failing to keep liquids down for longer than 8 hours

Causes of acute gastritis

When the protective layer of mucus in the stomach is damaged, gastric acids can irritate the stomach lining. The mucus layer of the stomach lining can become damaged in many ways ‒ including through repeated use of certain pain-relievers such as aspirin, ibuprofen and naproxen, among others ‒ and through excessive consumption of alcohol.

Helicobacter pylori, or H. pylori, the bacteria that cause peptic ulcers, can also cause acute gastritis, although many people have H. pylori in their stomach without experiencing gastritis symptoms. Other possible causes of acute gastritis may include:[1][4][6]

Allergies, intolerances and food poisoning. Certain foods which trigger an adverse reaction can cause inflammation and irritation in the stomach, resulting in gastritis. See the section on Prevention for more information on eliminating causal foods from one’s diet.

Bile. An alkaline substance, bile can spill backwards from the small intestine into the stomach and irritate the stomach lining, causing gastritis. The backwards spillage of bile from the small intestine into the stomach is called reflux. The likelihood of this causing gastritis is increased if reflux happens repeatedly or for a prolonged time.

Bacterial infections. Other than H. Pylori, certain bacterial infections can cause acute gastritis, although this is much less common. They include: H. heilmannii, streptococci, staphylococci, Proteus species, E coli, tuberculosis, secondary syphilis, Clostridium species.

Additional, less common causes of acute gastritis may include:

  • Viral infections, such as cytomegalovirus (CMV)
  • Fungal infections, such as phycomycosis, Candidiasis and histoplasmosis
  • Parasitic infections, such as anisakidosis
  • Traumatic injury, where the stomach experiences direct trauma, i.e. in a car accident
  • Ischemia, a rare condition in which the blood supply to the stomach decreases, causing severe symptoms of gastritis. Ischemic gastritis can be fatal if left untreated, and a CT scan of the stomach will be performed if it is suspected.
  • Radiation treatment in the area of the stomach

Though it is much less common, acute gastritis can also be caused by other digestive issues such as Crohn’s disease or other conditions, such as kidney failure. However, gastritis caused by autoimmune conditions, such as Crohn’s disease, tends to be chronic (long-lasting), rather than acute. If you are concerned that you or a loved one may have an underlying condition which is causing the symptoms of gastritis, download the free Ada app and start symptom assessment.

Risk factors

A variety of lifestyle and health factors increase a person’s risk of developing acute gastritis. Underlying health issues include:[1][3]

  • A particular vulnerability to H. Pylori infection, possibly linked to genetic factors
  • Being 60 years of age or older, as older people have thinner stomach linings.
  • Being affected by certain other conditions including pernicious anemia/B12 deficiency, HIV/AIDS
  • Being affected by a parasitic infection

Habitual use of painkillers like aspirin, ibuprofen and naproxen can change the composition of the stomach lining, leaving it less protected and causing both acute and chronic gastritis. Excessive alcohol consumption is a common risk factor, as are using tobacco products and/or eating spicy food.[7]

Other factors which increase a person’s risk of developing acute gastritis include:

  • Obesity
  • Stress
  • Undergoing cortisone therapy, high dose oral iron substitution therapy and receiving certain chemotherapeutics

Diagnosis

To assist with the diagnosis of acute gastritis, a doctor will assess a patient’s lifestyle, including their use of medications such as aspirin, NSAIDs and antacids, as well as alcohol consumption. They will also conduct a physical examination of the belly.

Depending on these factors, a number of tests may be used to help with the diagnosis or for finding potential underlying problems, including:[1]

  • Blood tests for anemia
  • Stool tests for the presence of blood
  • Liver and kidney function blood tests
  • Testing for H. pylori; these tests may include a blood, stool or breath test

Read more about Blood Test Results »

Endoscopy

Also called an EGD (esophagogastroduodenoscopy), gastroscopy or upper endoscopy, an endoscopy is a visual inspection of the stomach lining, performed by passing an endoscope – a long, thin, flexible tube with a lighted camera – down the throat and into the esophagus, stomach and upper small intestine.

The doctor can examine the stomach lining for signs of inflammation and take a small tissue sample (biopsy) for further testing. The biopsy is an additional method to test for H. pylori. An EGD is more likely to be used if other test results are inconclusive, if the results are unusual, if the person is over the age of 55,[8] or if they are experiencing extreme fatigue and weight loss, among other more severe symptoms.

Upper gastrointestinal (GI) series

Also called a barium swallow, this test creates a series of X-rays of the GI tract. The affected person swallows a liquid containing barium (a metal compound) before the scan, which coats the inside of the stomach, esophagus and small intestine. This makes the organs, as well as an ulcer or any other abnormality, more visible by X-ray.

Acute gastritis treatment

Acute gastritis can, in most cases, be cured by effectively treating the underlying problem which is causing the stomach irritation and inflammation.

The treatment of acute gastritis varies according to the cause of the irritation, and a doctor will design a treatment taking into account factors such as the patient’s age, overall health, the severity of their symptoms and the cause of the inflammation.[9]

Most cases of acute gastritis resolve themselves in a few days or weeks, typically through adjustment of diet and removal of irritating substances, but both over-the-counter and prescription medications may also be used.

Acute gastritis diet and home remedies

People with acute gastritis should avoid irritant pain relievers and anti-inflammatory drugs, such as NSAIDs or aspirin. Patients who drink alcohol or smoke will be advised to stop. After the gastritis heals, they may be able to resume drinking small amounts of alcohol.

Other lifestyle changes that may help include eating smaller, more frequent meals rather than larger meals, weight reduction and managing stress. Some research suggests that herbal supplements including clove, slippery elm, licorice, wild indigo and myrrh can improve digestive health and bring down numbers of H. pylori.[10]

Most minor cases of acute gastritis will respond to these treatments within a few days, with no need for further medication.

Acute gastritis medications

Patients may use over-the-counter antacids, such as milk of magnesia and antacid tablets, to neutralize acid and reduce pain. Side effects of these medications can include constipation and diarrhea. They should not be used for an extended time, as they do not cure the underlying problem, instead, they simply suppress symptoms.[11] Therefore, it is important to seek a medical opinion if symptoms last longer than a week or are severe.

Prescription medications that can treat acute gastritis include histamine (H2) blockers, such as famotidine and cimetidine, as well as the more effectively acid decreasing proton pump inhibitors like omeprazole and esomeprazole.[12]

If H. pylori infection is a cause of the acute gastritis, antibiotics like amoxicillin, clarithromycin and tetracycline may be given in conjunction with these other medications. These are not appropriate for children under 12. If a person is affected by a certain kind of anemia or B12 deficiency, B12 shots can be a solution.

Prevention

Though gastritis arises from several different causes, a few steps can help safeguard against it:

  • Avoiding smoking or using other nicotine products
  • Drinking moderately and within recommended guidelines
  • Limiting consumption of irritant foods
  • Taking NSAIDs moderately, if possible only short-term and with food and water to prevent stomach irritation

Good to know: If a person feels the need to take NSAIDs for longer than a few days, they should discuss this with their doctor. They may need a medical evaluation to work out if they should be using a different type of painkiller or if additional treatments are necessary to address the cause of the pain. If NSAIDs are indeed necessary, a proton pump inhibitor may be prescribed to help protect the stomach from associated damage.

Foods to avoid with acute gastritis

Diet does not play a major role in causing gastritis, though to ease symptoms, people may find it advisable to stop eating things that irritate their stomach for a while, such as fatty, spicy or highly acidic foods, once they have identified the specific foods that trigger their symptoms.

Some people choose to reduce foods containing lactose or gluten, but this will only help if they have a diagnosed problem with these substances, like coeliac disease. Other lifestyle changes that may help include eating smaller, more frequent meals rather than larger meals, weight reduction and stress management.

The particular foods that can trigger the symptoms of gastritis may vary between people. Alcoholic or acidic drinks and spicy foods are commonly cited as causes. However, it may take an affected person a certain period of time to entirely work out which specific foods they may need to eliminate from their diet in order to prevent attacks of acute gastritis.

Possible foods to avoid in order to try to prevent bouts of acute gastritis include:

  • Alcohol
  • Caffeinated beverages such as tea, coffee, and energy drinks
  • Juices with citric acids
  • Sweetened drinks, such as sodas
  • Highly processed foods, i.e. pre-cooked ready meals
  • Confectionary
  • Foods containing gluten if the person is gluten-intolerant

Good to know: The lists on food provided in this resource should only be taken as possible ideas for preventing gastritis by eliminating or substituting certain foods from one’s diet. Not everybody affected by acute gastritis will experience a flare up after consuming these kinds of foods. Furthermore, a person may find that their symptoms are caused by foods which are not mentioned here.

Maintaining a varied and balanced diet is important for everybody. Focussing too heavily on avoiding different kinds of foods, without being sure whether they are actually causing gastritis in a particular person, can lead to an overly restricted diet. Complications of this type include nutrient deficiencies, such as vitamin B12 deficiency, and even the possibility of developing eating disorders. Always consult a doctor before eliminating foods as a means of trying to prevent or help with gastritis; they can help ensure that any dietary changes made are medically sensible.

Foods to eat with acute gastritis

There is no specific diet that can prevent acute gastritis. However, by using a common sense approach to avoid specific foods which are known to trigger their symptoms in an individual person, it is sometimes possible to avoid bringing on, or worsening, bouts of gastritis.

For example, during a bout of gastritis, a person may find it helpful to choose unprocessed, blander, less sweetened or seasoned food options and to avoid strongly flavoured, spicy or salty food.

Good to know: In general, to give the body the access to the vitamins and nutrients that it needs to function at its best, it is recommended that one maintains a varied, balanced diet. This involves eating plenty of fresh vegetables and fruit, maintaining a relatively low salt intake and limiting one’s intake of highly processed foods.

Foods which may be able to help reduce symptoms of acute gastritis

For some people, incorporating certain foods with antibacterial properties into their diet may help to reduce numbers of H. Pylori bacteria. This may reduce the bloating, irritation, inflammation and feelings of nausea associated with acute gastritis, thereby possibly minimising the severity of an attack. These may include:[13][14]

  • Broccoli sprouts
  • Cranberry juice
  • Highbush blueberry juice
  • Probiotic formulations based on fermented milk
  • Plant oils, other forms of essential oil, including blackcurrant seed oil, clove oil, fish oil, carrot seed oil and grapefruit seed oil

Acute gastritis FAQs

Q: What are the early warning signs of an attack of acute gastritis?
A: The symptoms of acute gastritis vary between people, and there is no uniform sequence of stages in which symptoms occur. Many people may find that the milder digestive symptoms, such as loss of appetite, feeling full or having stomach discomfort or pain occur first, before they develop any of the more severe symptoms. However, severe symptoms, such as passing melena (black, tarry stools) or vomiting blood, can sometimes be present at the same time as milder symptoms, or, in even rarer cases, may occur before, or instead of the milder symptoms.

Rather than looking out for early warning signs of an attack of acute gastritis, it is more helpful to look at the attack of acute gastritis itself as a possible warning sign of being affected by another condition, such as an H. pylori infection.[12] Identifying and treating this specific cause of acute gastritis early can help prevent complications from developing. Tests such as an endoscopy may be ordered to help reach a diagnosis.

Q: Can acute gastritis come back after effective treatment?
A: If acute gastritis occurs as a result of a treatable condition, such as an H. pylori infection, then, after the cause is diagnosed and appropriate treatment is prescribed, acute gastritis should not easily recur, unless new circumstances develop that can cause it. Despite successful treatment, in rare cases, a new infection with H. pylori may occur, which may cause another bout of gastritis.

If acute gastritis attacks are caused by intolerances to particular foods or food groups, then a person may need to make a succession of changes to their diet in order to identify and eliminate all the possible irritants to prevent recurrent gastritis attacks. For more information on dietary changes that may help prevent gastritis, see the section on Prevention.

Q: Can acute gastritis cause back pain?
A: Some people report experiencing back pain during an attack of acute gastritis. The abdominal pain associated with gastritis can radiate outwards to affect the back. If back pain persists after the underlying cause of acute gastritis has been treated effectively, i.e. all other symptoms of acute gastritis have cleared up in response to treatment, this could indicate that the back pain relates to another condition, and a medical opinion should be sought.

Q: Can acute gastritis cause diarrhea?
A: Due to the fact that gastritis only affects the stomach, it is unlikely to cause diarrhea or loose stool. A person is much more likely to experience this symptom if they are affected by gastroenteritis, in which both the stomach and the intestines are affected.[15]

Q: Can acute gastritis become chronic?
A: Yes. When gastritis is caused by infection with Helicobacter pylori bacteria, it usually only affects a portion of the lining of the stomach at first. At this stage, a person will usually experience acute gastritis, i.e. sudden, short-lasting gastritis attacks rather than constant discomfort. However, if the cause of the gastritis remains present, over time, a bigger part of the gastric lining or the entire gastric lining may become inflamed and irritated.

For example, gastritis symptoms may worsen and/or continue to be present if they occur due to an untreated bacterial infection or as a result of erosive damage from the continued long-term or heavy use of NSAID painkillers. When the symptoms of gastritis are considered to be persistent, a diagnosis of chronic gastritis will be made.[1] Worried that you may have acute or chronic gastritis? Download the free Ada app and start symptom assessment.

Q: How long does acute gastritis last?
A: The duration of an attack of acute gastritis depends on the underlying cause of the condition. For example, if an attack is caused by a bacterial infection with Helicobacter pylori, a person may find that their symptoms get better over days or weeks, depending on the length of their prescribed course of antibiotic treatment. In contrast, if an attack of acute gastritis is caused by consumption of an irritant food, for example, a person eating cereal containing gluten while they are gluten-intolerant, symptoms may get better on their own in days if no further irritants are consumed.

Q: Is acute gastritis contagious?
A: Many of the causes of acute gastritis, for example, irritation and inflammation of the stomach lining due to overuse of NSAIDs or consumption of alcohol, are not contagious. However, when acute gastritis is caused by H. pylori infection, it is important to treat this to prevent a person passing the infection on to others.[16]

H. pylori is believed to be transmitted from person to person via the oral-fecal route – when, due to poor sanitation, particles of fecal matter are transferred to the mouth – or by ingesting contaminated water or food.[1] For this reason, infection with H. pylori is more likely to occur in developing countries or economically deprived areas. Safety measures which can be taken to prevent the spread of infection include washing the hands thoroughly and regularly with plenty of warm water and soap, particularly after touching communal items or spending time in public spaces.

Good to know: Care should be taken to ensure that warm water used to wash the hands is not too hot.

Q: Can acute gastritis cause cancer?
A: Acute gastritis is by far less likely to potentially cause cancer than chronic gastritis, in which it is a possible but still, overall, rare complication. In the long-term, the inflammation and irritation of the stomach lining which a person experiences when affected by chronic gastritis can increase the risk of developing tumours in the stomach, which may or may not be cancerous. It is always advisable, therefore, to seek a medical diagnosis and devise a treatment plan if you are affected by gastritis to prevent rare complications such as this as far as possible.[4]


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