Introduction
Inflammation of the stomach is a widespread clinical picture which represents a not insignificant problem both for the affected person and in our society in general. Every fifth person in Germany has been affected by it at least once. In other nations, too, gastritis with its many different characteristics and diverse causes is a topic of discussion.
Not only do the respective food components and the infection of the stomach with certain pathogens play a role, but risk factors such as smoking, alcohol, stress, etc. also play a large part. It is therefore important to be aware of how an inflammation of the stomach occurs, how it can be recognized and what can be done about it.
In the case of an acute inflammation of the stomach, symptoms such as nausea and pressure-like to stabbing pain in the stomach area are in the foreground. In addition to the nausea, one automatically feels less appetite. It is not uncommon for nausea to result in increased belching and vomiting, as the stomach lining is very irritated by the inflammation.
If the disease is very pronounced, vomiting of blood may even occur. In addition, there is a general feeling of illness and weakness, which is related, among other things, to the reduced food intake due to the inflammation in the stomach and the inflammatory process in general. In extreme cases, there may even be gastric bleeding and deeper damage to the stomach lining.
Depending on the location in the stomach, this manifests itself as vomiting of blood (hematemesis) or tarry stool (misery). The intensity of the pain varies greatly. In the case of chronic gastritis, the symptoms are not so clear-cut.
In many cases, no symptoms occur and if they do, they take the form of unspecific pain in the upper abdominal area. In type A gastritis, a vitamin B12 deficiency anemia may develop over the course of the disease. In some cases, those affected then feel exhausted and powerless.
Identifying an inflammation in the stomach is therefore not always so easy. A distinction must also be made between acute and chronic causes of inflammation of the stomach. One of the causes of acute inflammation is excessive consumption of food or alcohol.
Any over-expansion of the stomach due to too much food or a narrowing of the stomach outlet promotes the production of large quantities of gastric acid. On the other hand, drugs from the group of non-steroidal anti-inflammatory drugs, such as acetylsalicylic acid (a headache medicine), but also drugs such as cortisone or cytostatics (chemotherapy) irritate the stomach lining. Food poisoning caused by bacteria ingested with food also leads to an inflammatory reaction.
Stress also plays an important role in the development of inflammation in the stomach. Stress also includes injuries or burns of the stomach, which can occur during an operation, or a state of shock. But psychological stress can also subconsciously manifest itself in an increased production of gastric acid and lead to inflammation.
Three different forms of gastritis and thus three different causes have been described for chronic gastritis: All the causes mentioned are based on two principles that damage the stomach lining: On the one hand, cells in the stomach are stimulated to produce more gastric acid, so that gastric acid is present in harmful concentrations and the environment becomes more acidic overall. On the other hand, the cells that produce the natural protective mucus layer are inhibited, so that infections occur more easily.
- Type A inflammation (autoimmune): The cause is unknown.
Nevertheless, in some cases there is a connection with an autoimmune disease, such as diabetes mellitus type 1 or Hashimoto’s thyroiditis. In the course of a long-term disease, reduced vitamin B-12 intake eventually leads to pernicious anemia.
- Type B inflammation (bacterial): This inflammation is caused by an infection with the bacterium Helicobacter pylori, which becomes more frequent with age.
- Type C inflammation (chemical): This type of inflammation of the stomach occurs when non-steroidal anti-inflammatory drugs are taken continuously (see above) or when there is increased backflow of bile into the stomach.
In the acute form of the inflammation in the stomach, it is already helpful to simply avoid the harmful substances such as alcohol. In addition, a meal break, the duration of which should be made dependent on the symptoms, contributes to a faster recovery of the stomach lining.However, a sufficient fluid intake should not be neglected.
If the symptoms improve, dietary food intake can be slowly resumed. Drug therapy with so-called proton pump inhibitors, which prevent the release of gastric acid, or other gastric medication (e.g. antacids) can be given as an adjunct. If the nausea and vomiting do not go away on their own, special drugs can also be used to treat them.
In chronic inflammation type B, where the focus is on infection with Helicobacter pylori, the aim is to kill this bacterium. For this purpose, two different so-called “triple therapies” are used, each consisting of a combination of three drugs: a proton pump inhibitor (stomach acid inhibitor) and two antibiotics. This therapy takes about seven days and has a high success rate.
Helicobacter pylori treatment can also be helpful in type A inflammation. If there is an additional vitamin B12 deficiency, this vitamin can be replaced with medication. The treatment of type C inflammation primarily involves discontinuing the non-steroidal anti-inflammatory drugs and taking proton pump inhibitors.
Acute inflammation of the stomach is diagnosed on the basis of the symptoms associated with gastroscopy and sampling. The sample taken from a suspicious area of the stomach during gastroscopy is then histologically examined. This means that the tissue, supplemented with special staining, is viewed and evaluated at high magnification.
If an increased number of white blood cells are visible in the upper layer of the mucous membrane and this layer is no longer intact, this supports the suspicion of an inflammation of the stomach mucous membrane. The chronic form of the inflammation in the stomach urgently requires gastroscopy and testing for Helicobacter pylori, as the symptoms are not always indicative. In this case, too, a sample of the gastric mucosa should be taken during gastroscopy in order to be able to assess the tissue and the extent of the inflammation histologically more precisely.
Testing for the bacterium is usually performed two weeks after antibiotic triple therapy. The bacterial pathogen can be detected in various ways. One possibility is to detect it in a sample taken from the mucosa.
Furthermore, there is the possibility of a breath test, in which a certain concentration of marked carbon dioxide in the exhaled air is indicative of Helicobacter pylori. Furthermore, the bacterium itself or antibodies against it can be searched for in stool and blood serum. Ultimately, however, only the sample taken from the stomach mucosa is conclusive.
