Gastritis: What It Is and How to Treat It
What is gastritis?
Gastritis can show up in many different ways. And different people can have different main symptoms. So while there aren’t “typical” symptoms, pain in the abdomen, nausea, vomiting are often described. —Dr. Shria Khumar
Our stomach is a highly acidic environment. Normally, this causes no problems, as the lining of our stomach is strong and can deal with it. Gastritis is when there is a disruption in the normal protections, and the lining of your stomach gets irritated and inflamed. That inflammation is your body's way of fighting off an infection or injury. The inflammation is caused by specific bacteria, alcohol, or certain medications.
Gastritis can happen all of a sudden (acute) or slowly over time (chronic). Symptoms can include nausea and vomiting, belly pain and bloating, indigestion or a burning feeling (like heartburn), and loss of appetite.
What causes gastritis?
Always ask your doctor, What is the cause of my gastritis? Since it can be caused by a lot of things. Talk to your doctor to figure out whether you need an endoscopy to look for gastritis. —Dr. Khumar
A certain type of bacteria called Helicobacter pylori (H. pylori) is the most common reason people get gastritis. Over half the world’s population picks it up at some point. Usually during childhood.
Most people never even know the bacteria is in their system because it doesn’t cause any problem. But in some, it causes inflammation of the stomach lining. That inflammation can begin to eat away at the lining. This lets digestive acids irritate the walls and create inflammation and cause gastritis.
Gastritis can also be triggered by certain irritants, like smoking or alcohol. Or nonsteroidal anti-inflammatory drugs (NSAIDs, like ibuprofen or naproxen). Or having stomach or bowel surgery. Remember though, this is nuanced: just because you smoke or use ibuprofen doesn’t mean you will necessarily get gastritis. Health conditions are complex and occur due to multiple factors in specific settings.
Another possibility—a rare one—is an autoimmune disorder called autoimmune gastritis. The immune system starts destroying the natural, acid-producing cells in the stomach. This creates gastritis inflammation.
What is the best treatment for gastritis?
What treatment you get depends on the cause of your gastritis.
The first step is to make sure your symptoms are caused by gastritis. And not another disorder of the digestive tract. Call your doctor, who will likely refer you to a gastroenterologist (a specialist in stomach diseases). The specialist will ask detailed questions about your medical history and possibly do blood testing, to rule out other things.
They may want to do an endoscopy. This test is done with sedation in an outpatient surgery setting. A very thin, flexible tube with a camera at the tip is placed in the mouth and fed down into the stomach area so the doctor can view the stomach lining.
They will also take a tissue sample—called a biopsy. The biopsy can be tested for H. pylori bacteria.
If H pylori bacteria is the cause, you will be prescribed antibiotics. After you finish taking the antibiotic, your doctor will do another test to make sure the infection is gone. Usually this a stool sample or a breath test. You will also need a prescription for a high-dose acid suppression medication, which reduces the amount of acid in your stomach.
If your gastritis is caused by smoking, stop smoking. If it’s caused by drinking, your doctor will recommend you cut back on alcohol. If it’s from taking NSAIDs (for pain or arthritis, for example), your doctor will probably recommend lowering the dosage or changing what you take. If the cause is an autoimmune response, you may need other medications and more follow-up.
Regardless of the cause, taking an over-the-counter acid suppression drug like a proton pump inhibitor (Nexium and Prilosec) can help your stomach heal.
Most people heal well from gastritis—with no future symptoms or issues. But it is important to be sure you don’t have anemia (low blood count), autoimmune gastritis, or H pylori. If you do, you need to continue seeing your doctor. —Dr. Khumar
Does gastritis go away?
How long gastritis lasts depends on two things: the trigger and treatment. For example, if bacteria caused the gastritis, the pain will improve within a few weeks. If it’s caused by too much alcohol, the length of the attack will depend on how quickly you can bring the trigger under control.
Dr. Kumar is a gastroenterologist, who completed her fellowship at the Hospital of the University of Pennsylvania in Philadelphia. She received her undergraduate degrees in Religious Studies and Chemistry from New York University (2010) and graduated from the Albert Einstein College of Medicine (2014), where she was inducted into the Alpha Omega Alpha Honor Medical Society. She is completing her therapeutic endoscopy fellowship at MD Anderson Cancer Center in Houston. She joined Buoy Health in 2020. She believes in the importance of patients being educated about their health, and joined Buoy in order to be part of a platform that helps disseminate clear and verified advice directly to patients.