Diagnosis of gastric mucosa inflammation
In the patient interview (anamnesis) the path-breaking symptoms and causes of the acute gastritis can often already be determined. During the physical examination, a pressure in the upper abdomen area (gastric triangle below the breastbone) is often noticeable. Sometimes the typical change in laboratory values with signs of inflammation (leukocytes, CRP value) are shown to be elevated during blood tests.
Finally, the diagnosis can be confirmed by gastroscopy. Gastroscopy: The “endoscopy” of the stomach is used for direct assessment and classification of mucous membrane damage. A tube camera (endoscope) transmits images to a monitor so that the examiner can see the inner life of the stomach.
During the endoscopy, tissue samples (biopsy) can also be taken from suspicious mucous membrane areas (tissue with suspected gastric mucosa inflammation) and examined under the microscope (histological=fine tissue). (The mucosa appears reddened and swollen in acute gastritis. It may also have small punctiform (petechial) bleedings or appear strongly reddened, which indicates a strong tendency to bleed (haemorrhagic gastritis).
In microscopic examination, the immigration of inflammatory cells (leukocyte infiltrate) into the mucosa is often noticeable. In addition, bleeding can be detected with an endoscope, which can then be stopped if necessary. Depending on the extent of the inflammation of the gastric mucosa, the therapy can be very different.
First, however, one should always strictly avoid the triggering substance (alcohol, nicotine and medication). In the harmless cases, it is sufficient to follow a diet, which in most cases is self-evident, as the patients often do not feel any appetite and cannot tolerate food at this time anyway. Later, a slow diet with tea and rusk should be initiated (diet in case of gastritis).
In the case of mild forms, a hot water bottle on the stomach can also be very beneficial and pain-relieving. With more severe forms, it may be necessary to start a drug therapy. For nausea and vomiting, drugs for nausea (antiemetics) such as metoclopramide (Paspertin®) or dimenhydrinate (Vomex A®) are administered.
In the case of very rapid and persistent vomiting, an infusion with electrolytes to prevent salt loss is sometimes necessary. Medication against heartburn such as proton pump inhibitors (Omeprazole (Antra®)) and for binding stomach acid such as antacids (Riopan®) can prevent further damage to the mucous membrane. For severe stomach cramps, an antispasmodic drug such as Buscopan® helps.
A gastric bleeding is a medical emergency and must be treated as soon as possible. Since bleeding tends to be diffuse in a haemorrhagic gastritis, the drug sucralfate is given, which deposits on the stomach lining like a precipitate and forms a kind of protective layer. In this way it protects especially erosions and ulcers (peptic ulcer) from the aggressive gastric acid and thus accelerates their healing.
Probably the most commonly used group of drugs for acute gastric mucosal inflammation is the group of so-called proton pump inhibitors. The problem of an inflamed stomach mucosa is gastric acid. This acid is permanently produced in the stomach, whereby the production reaches its maximum during food intake.
Stomach acid contains hydrochloric acid, which causes extreme damage to the cells of the stomach mucosa. The most effective therapy is therefore to prevent the production of gastric acid. Without gastric acid, the cells of the stomach lining can recover without being constantly exposed to further aggressive acid.
By inhibiting the so-called proton pump, which is responsible for the production of gastric acid, it can be prevented that gastric acid is produced at all. The best known representatives of the so-called proton pump inhibitors are pantoprazole and omeprazole. These drugs are only available on prescription from your family doctor in pharmacies.
There are many alternatives to this group of drugs. The enormous effectiveness of proton pump inhibitors, which do not produce stomach acid in the first place, cannot be achieved by them, however, because they only reduce or attack the production when the stomach acid has already been produced. Nevertheless, they are still of great importance when proton pump inhibitors must not be used and also in the case of slight courses of gastric mucosa inflammation.
The so-called H2-receptor blockers can reduce (but not completely inhibit) the production of gastric acid. These block the binding sites of the stomach lining to which substances that normally bind the substances that stimulate the production of gastric acid normally bind. If these binding sites are already blocked by the drugs, the stimulus cannot penetrate and less gastric acid is produced.
The production of gastric acid can be reduced by less than half with these drugs. The most common members of this group are cimetidine, ranitidine and other derivatives. A few members of this group are also available without a prescription.
Another group of substances cannot influence the production of gastric acid, but can neutralize existing gastric acid, which means that the acid can no longer harm the stomach. The most important representatives here are the so-called antacids. There are over 50 different substances, some of which are available without a prescription in pharmacies.
For stomach cramps, which are often associated with an acute gastritis, there are antispasmodics such as butylscopolamine (e.g. Buscopan®). Although these cannot effectively relieve the cause, they are very effective in combating the cramping pain. Furthermore, there are effective drugs that effectively relieve nausea and vomiting, another distressing symptom of acute gastritis.
A frequently used agent is dimenhydrinate (Vomex®). In the therapy of acute gastritis, there are a number of home remedies in addition to the above-mentioned drugs that can support the therapy and are very popular. For mild forms of acute gastritis, home remedies can help to reduce the drug therapy to a minimum.
Warm compresses that are applied to the abdomen are suitable as a simple household remedy to relieve the pain. Care should be taken here, however, to avoid hot compresses, as these can possibly cause burns to the skin and should therefore only be used when the temperature is controlled. Many plant substances from domestic foods are also suitable for treating acute gastritis.
For example, potato juice is easy to make, which can be drunk before every meal and supports the healing of the inflammation. Alternatively, raw potatoes can also be eaten. In both cases, the mucilage of the potatoes is stored protectively over the inflamed areas of the stomach mucosa.
Carrot and spinach juice are just as easily prepared. Mixing these juices is also possible. Taking ginger, for example as tea, can also relieve pain and improve digestion.
It is recommended to take ginger before meals to stimulate the digestion at the same time to relieve pain. Furthermore, ground cloves or cardamom can be taken in the mouth for a few minutes and chewed lightly to improve the symptoms. Tea can also help to soothe the stomach lining further.
Soothing ingredients such as camomile, fennel or caraway are preferred. Green tea has also been shown to be very effective against acute inflammation of the stomach lining, as the substances it contains bind and thus neutralise the cell toxins released by the inflammation. After the inflammation of the stomach mucosa has subsided, the long-term consumption of green tea can reduce the risk of further inflammation of the stomach mucosa.
