Gastritis: Causes, Symptoms and Which Tests You Need

Heaviness and pain in the upper abdomen, nausea, heartburn after eating — with such complaints you often hear the diagnosis "gastritis." It is one of the most common stomach conditions, and in most cases it responds well to treatment once the cause is found. Let us go through it calmly: what gastritis is, what its symptoms and types are, what causes lie behind it, and which tests are really needed.

What Gastritis Is

Gastritis is inflammation of the stomach lining. It can be acute (arising and passing quickly) or chronic (lasting a long time, sometimes years). With prolonged inflammation the lining can thin — this is called atrophic gastritis. It is important to understand that "gastritis" is not a single diagnosis but a group of conditions with different causes, and the treatment depends on the cause.

Symptoms of Gastritis

Typical complaints: pain or burning in the upper abdomen, heaviness and fullness after eating, nausea, belching, reduced appetite, sometimes heartburn. In some people gastritis runs almost without symptoms and is found by chance. The symptoms themselves are non-specific — an ulcer, functional dyspepsia and other conditions can present similarly, so the diagnosis is not made "by eye."

Causes of Gastritis (H. pylori and More)

The most common cause of chronic gastritis is the bacterium H. pylori. Other causes: taking non-steroidal anti-inflammatory drugs (ibuprofen and the like) and aspirin, alcohol abuse, bile reflux, severe stress and critical illness, and an autoimmune process in which the immune system attacks the stomach cells. The cause directly determines how gastritis is treated.

Types of Gastritis (Acute, Chronic, Erosive, Atrophic)

Acute gastritis is more often linked to medications, alcohol or infection. Chronic is usually linked to H. pylori or an autoimmune process. Erosive gastritis is when surface defects (erosions) appear on the lining. Atrophic gastritis is prolonged inflammation with thinning of the lining; its autoimmune form impairs production of intrinsic factor and leads to vitamin B12 deficiency and a particular anemia.

Which Tests and Work-up Are Needed

The definitive diagnosis and type of gastritis are determined by gastroscopy with a biopsy of the lining — which also shows H. pylori and atrophy. In addition the bacterium itself is checked (how is in the article on H. pylori tests), and with suspected complications — a complete blood count, ferritin and vitamin B12. In autoimmune gastritis, antibodies to parietal cells and intrinsic factor are checked.

Treatment and Diet

Treatment depends on the cause: for H. pylori — a course of eradication (antibiotics on a doctor's schedule), for drug-induced gastritis — stopping the offending drug, and if needed — acid-lowering medication. Diet helps reduce symptoms: small frequent meals, without excess alcohol, coffee on an empty stomach, very spicy and fatty food. The specific regimen and doses are prescribed by a doctor — self-treatment by forums often drags the problem out.

When to See a Doctor

See a doctor for persistent or severe abdominal pain, for symptoms lasting more than 1–2 weeks, with a positive H. pylori test. Urgently — with "alarm" signs: vomiting blood or "coffee-ground" material, black stools, sharp weight loss, difficulty swallowing, marked weakness and pallor. These are a reason not to delay the work-up.

This article is for informational purposes only and does not replace a doctor's consultation.