Acute gastritis


An acute (sudden) inflammation of the gastric mucosa begins very quickly and often shows a connection with the ingestion of substances that damage the mucosa. The mucous membrane of the stomach has an alkaline protective film that protects it from the aggressive gastric acid and enzymes of the stomach. This protective layer can be attacked by various factors, so that the gastric mucosa can be attacked.

Acute gastritis is often caused by an excess of alcohol and/or excessive nicotine (smoking) or by the excessive use of medication, such as some painkillers such as acetylsalicylic acid (ASS 100), and NSAIDs (e.g. diclofenac (Voltaren ®), ibuprofen). In some cases, gastritis is the result of food poisoning, which is often associated with vomiting. Excessive coffee consumption and spicy foods can also affect the stomach lining.

If children accidentally drink acids or alkaline solutions, this leads to caustic gastritis, which is a life-threatening emergency ) Radiation therapy often involves the risk of partially irradiating the stomach lining, resulting in radiation-induced inflammation of the gastric mucosa. Gastritis often occurs as a concomitant disease of serious general illnesses. Especially intensive care patients who require respiration, have had a serious operation or have severe burns are at risk of so-called stress gastritis.

These patients suffer from a disturbance of the blood microcirculation in the stomach mucosa. In the majority of intensive care, seriously ill patients, superficial defects in the stomach lining (erosions = stomach ulcer) can be detected endoscopically (gastroscopy) and in 6 % of patients there is even gastric bleeding (ulcus ventriculi). The section shows the stomach mucosa enlarged. The mucous membrane defects are clearly visible as red spots in the mucous membrane, as areas of locally increased blood circulation and in some cases bleeding into the mucous membrane tissue of the stomach.

Symptoms / Complaints

The signs (symptoms) of acute gastritis are pain in the upper abdomen, which can be crampy and even radiate into the back. Nausea and vomiting can occur, especially in the case of food poisoning. Patients also complain of frequent belching, bad taste in the mouth and loss of appetite. Non-specific symptoms such as flatulence, digestive problems and general malaise are also part of the symptom complex. – Mucosa (mucous membrane)


A serious complication is gastric bleeding. This can occur in the form of small punctiform (petechial) bleedings in the stomach mucosa, which can be detected with an endoscope. In the worst case, a fulminant bleeding with vomiting of blood (haematemesis) can occur.

If the bleeding is quite slow and the stomach acid has time to decompose the blood, the result is coffee-like vomit. This brown to black blood mass can also be observed in the stool if the bleeding is not strong enough to cause vomiting. This phenomenon is also called tarry stool (melena).

If it bleeds, however, light-coloured blood is vomited very quickly. With such heavy bleeding, the lack of blood can quickly lead to a circulatory shock (life-threatening drop in blood pressure). Smaller bleedings are only detected in a stool examination, which is able to detect even the smallest blood components (so-called occult, hidden blood).

With the naked eye such amounts of blood cannot be detected. Of course, a significant loss of blood can also be detected by a blood test. It shows a reduced value for the red but dye (haemoglobin (Hb)). The clinical picture of anaemia is called anaemia.