Brief overview
- Symptoms: Non-specific signs include bloating, pain in the upper abdomen, loss of appetite, nausea, heartburn, belching, bad breath; depending on the type of chronic gastritis, specific signs are added
- Treatment: Adapted diet, home remedies such as teas, healing clay and heat treatment; medications such as acid binders, proton pump inhibitors; relaxation exercises as well as alternative medicine such as homeopathy and acupuncture; in case of emergency, surgery.
- Diagnosis: Taking of medical history (anamnesis), physical examination, endoscopy, tissue and blood examination.
- Course and prognosis: prognosis usually very good; danger to life in case of bleeding ulcers; without treatment, long-term increased risk of stomach cancer
What is gastritis?
In acute gastritis, the disease develops rapidly and is usually accompanied by sudden symptoms such as severe stomach pain. These usually disappear after a short time, either by themselves or with appropriate treatment.
What are the symptoms of gastritis?
Gastritis is indicated by various non-specific complaints. The main symptoms are typical for both acute and chronic gastritis. However, they appear suddenly in the acute form, while chronic gastritis develops insidiously.
Common symptoms
- Feeling of fullness
- Pain in the upper abdomen
- Decreased appetite, hardly any feeling of hunger
- Nausea
- Vomiting
- Belching
- Bad breath
Rare symptoms
- Flatulence
- Bland taste in the mouth, coated tongue
- Early onset of feeling full
- Back pain
- Diarrhea
Symptoms of chronic gastritis
In chronic gastritis, there are often no symptoms for a long time or the same symptoms as in acute gastritis. Depending on the type of gastritis, other specific symptoms are added later in the course.
Symptoms of type A gastritis
Specific symptoms then include:
- Sensory disturbances (e.g. numbness, tingling in arms and legs)
- fatigue, exhaustion or feeling of weakness
- Dizziness
- Memory impairment
- Decreased attention
- Depression
People with type A gastritis and pernicious anemia often report that they have palpitations and have trouble breathing, i.e., shortness of breath.
Symptoms of type B gastritis
- Duodenal ulcer (ulcus duodeni)
- Stomach cancer (gastric carcinoma)
- MALT lymphoma (mucosa-associated cancer of the lymphatic tissue)
Symptoms of type C gastritis
Chronic type C gastritis also usually causes only nonspecific symptoms. Many patients report a feeling of discomfort in the upper abdomen. Often, the symptoms correspond to those of irritable stomach, with which gastritis is therefore often confused.
How can gastritis be treated?
Refrain from irritating substances
The first measure in gastritis is to avoid anything that irritates the stomach lining. Coffee, alcohol and nicotine should therefore be avoided as far as possible during gastritis. If the symptoms are severe, it is sometimes advisable to abstain completely from food or larger portions for one or two days. As a rule, you will then have no appetite anyway.
Read more about gastritis – nutrition here.
If stress is the trigger of gastritis, relaxation methods such as autogenic training, meditation or Jacobson’s progressive muscle relaxation can help.
Cure gastritis naturally with home remedies
Useful home remedies that are said to have a positive effect in the treatment of gastritis include:
- Hot water bottle or grain pillow (cherry stone pillow)
- Camomile tea (has an anti-inflammatory effect)
- Oatmeal (protects the mucous membrane of the stomach)
- Melissa or hop blossom tea (have a calming effect)
- Potato juice
- Healing earth
- Baking soda (e.g. dissolved in water)
You should not use sodium bicarbonate permanently, as it promotes the formation of kidney stones.
Rolling cure with chamomile tea
Home remedies have their limits. If the symptoms persist for a long period of time, do not improve or even get worse, you should always consult a doctor.
Treatment with medication
For the therapy of gastritis, there are various medications with different active ingredients – depending on the symptom and therapy goal – mostly in the form of tablets or capsules:
- H2 receptor blockers: Another option are so-called H2 receptor blockers (such as cimetidine or ranitidine). They reduce the production of stomach acid. In the process, the inflamed stomach lining recovers and is protected from further damage.
- Antibiotics: In chronic type B gastritis, the goal is to get rid of the bacteria that cause the disease. A combination of two or three antibiotics together with a proton pump inhibitor over seven days, for example, drives Helicobacter pylori away in over 90 percent of cases.
- Antispasmodics and anti-nausea drugs: Antispasmodics and painkillers include spasmolytics, and antiemetics help to relieve nausea.
Treatment with alternative medicine
- Homeopathy: Homeopathic remedies for gastritis include Carbo vegetabilis and Lycopodium. They are supposed to alleviate the symptoms.
- Schüßler salts: Schüßler salts for nausea or belching are, for example, No. 9 Natrium phosphoricum, which is said to regulate the acid balance in the body, and No. 7 Magnesium phosphoricum, which is said to have a relaxing, antispasmodic effect on digestive organs.
The concept of these alternative treatments and their specific efficacy are controversial in the scientific community and have not been proven beyond doubt by studies in most areas of application.
Emergency stomach bleeding
Gastritis: diet
In the case of gastritis, the main thing is not to irritate the stomach lining even further. Many patients with acute gastritis lack appetite anyway, so they go one or two days without eating at all. It is then important to take in sufficient fluids, for example chamomile tea or clear broth.
For more information on nutrition in gastritis, read the article Gastritis – Nutrition.
Gastritis occurs when the protective mucous membrane of the stomach is damaged. Causes include substances that irritate the stomach or factors that stimulate an overproduction of corrosive gastric acid.
Causes of acute gastritis
- Excessive consumption of alcohol
- Excessive consumption of nicotine
- Frequent consumption of foods that irritate the stomach, such as coffee or hot spices
- Mental stress
- Food poisoning caused by bacteria such as staphylococcus or salmonella
- Mechanical irritation, such as from a feeding tube or other foreign object
- Chemical burns from acids or alkalis
- Physical stress, such as long-term ventilation, traumatic brain injury, burns, brain disease, major surgery, shock (circulatory collapse)
- Competitive sports (“runners stomach”)
Causes of chronic gastritis
Type A gastritis
Type A gastritis is also called autoimmune chronic gastritis. Autoimmune means that the body’s own defense system is directed against the body itself: It forms antibodies that attack the body’s own structures. Type A gastritis is the rarest form of chronic gastritis, accounting for around five percent of cases.
Type A gastritis is hereditary and affects mainly northern Europeans. The inflammation is often localized in the main section of the stomach – the corpus. Many patients additionally suffer from other autoimmune diseases, for example:
- Addison’s disease
- Diabetes mellitus type I
- Hashimoto’s thyroiditis (autoimmune thyroiditis)
Type B gastritis
Type B chronic gastritis primarily affects the section of the stomach between the body of the stomach (corpus) and the outlet of the stomach (antrum).
Type C gastritis
The backwashing of bile into the stomach (bile reflux) also sometimes results in chronic gastritis type C.
Rare forms of chronic gastritis
Chronic gastritis has other causes in rarer cases. Among others, there are the following special forms:
- Eosinophilic (allergic) gastritis: for example, in cases of allergy to cow’s milk or soy.
- Granulomatous gastritis: in inflammatory diseases such as Crohn’s disease, sarcoidosis or tuberculosis.
How is gastritis diagnosed?
If you have stomach problems, first see your family doctor. If necessary, he or she will refer you to a stomach specialist, a gastroenterologist, down the road. First, your doctor will ask you in detail about your medical history (anamnesis). In doing so, he will ask, for example:
- How long have you had the symptoms?
- Are you taking medication such as painkillers?
- Do you experience a feeling of fullness?
Physical examination
Imaging – Endoscopy
Gastritis can only be clearly diagnosed by the doctor taking a look inside the stomach. During a so-called endoscopy, the doctor carefully advances a thin tube with a small camera at the tip through the esophagus into the stomach. This allows the doctor to see any changes in the mucosa, such as redness, swelling or bleeding.
Tissue sample – biopsy
Test for Helicobacter pylori
In addition, a rapid urease test for the stomach germ Helicobacter pylori is possible with the help of the biopsy. For this purpose, the physician adds urea to the tissue sample. If the bacterium is present, its enzyme (urease) converts the urea into ammonia. This reaction can be measured.
Other tests used to identify H. pylori as the cause of chronic gastritis are:
- Antigens in stool: Proteins from H. pylori are excreted by the body via the intestine. These can then be detected in the stool.
- Antibodies in serum: In the event of infection with H. pylori, the immune system forms antibodies against the bacteria. These can be detected in the patient’s blood even after the infection has passed.
Blood test
In addition, doctors check the level of vitamin B12 in the blood for indications of a corresponding deficiency and possible pernicious anemia.
Whether an intrinsic factor deficiency is present can be checked and assessed on the basis of certain antibodies in the blood, which are elevated in cases.
What is the course of the disease?
However, there are also severe courses, such as when patients have “erosive gastritis” – so-called hemorrhagic gastritis. In this case, bleeding occurs, which is sometimes life-threatening. In addition, gastritis sometimes develops into a gastric ulcer.
Since there are rarely life-threatening courses and these are usually well treatable, a normal life expectancy can be expected with gastritis.
Due to the constant irritation of the gastric mucosa, chronic gastritis increases the risk of cells degenerating and causing gastric cancer. Initially, the cells of the gastric mucosa transform into intestinal-like cells. This is then referred to as intestinal (= belonging to the intestine) metaplasia (= transformation).
