Gastritis

Gastritis is an inflammation of the stomach's lining. It can be caused by smoking, drinking too much alcohol, long-term use of aspirin or other nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen, infection with the bacterium Helicobacter pylori, severe injury, or shock. Sometimes gastritis is an autoimmune condition, in which the immune system mistakenly attacks the cells that line the stomach.

Symptoms of gastritis

Symptoms of gastritis can include:

• abdominal pain or discomfort
• constant pain between the navel and lower ribs
• nausea, sometimes with vomiting
• poor appetite
• belching, bloating, or a feeling of fullness in the abdomen that is made worse by eating

Serious gastritis can lead to erosion of the stomach lining, which can cause painful ulcers and black stools (a sign of bleeding in the stomach). It can also cause anemia, or too few red blood cells in circulation. This can lead to fatigue and being short of breath with physical activity.

Diagnosing gastritis

Your story of your symptoms and a physical examination may be all a doctor needs to diagnose gastritis.

A breath test may be needed to see if your stomach harbors Helicobacter pylori. Some people need a procedure called gastroscopy. In this procedure, a doctor passes a flexible, lighted instrument down your throat and into your stomach. With this instrument, he or she can inspect your stomach lining directly take a small tissue sample (biopsy) to be examined in the laboratory.

Treating gastritis

Treating gastritis begins with stopping or removing the cause, such as drinking too much alcohol or smoking. If you take nonsteroidal anti-inflammatory drugs for arthritis or other pain, trying an alternative such as misoprostol may be important.

Modifying diet. If you think that certain foods make your symptoms worse, keep a food diary and track what you eat against your symptoms. If you see connections between certain foods and symptoms, don't eat the offending foods for a while and see if your gastritis improves. Problem foods tend to be those that are fatty, spicy, or very acidic, like coffee, orange juice, tomato juice, and colas.

Medication. A common treatment for gastritis is taking medication to decrease stomach acid. Several classes of medication can do this:

• over-the-counter antacids
• over-the-counter or prescription H2 blockers (also known as acid reducers) such as Tagamet, Zantac, Pepcid, and their generic equivalents
• and proton pump inhibitors such as omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), and pantoprazole (Protonix).

Proton pump inhibitors are the strongest acid blockers, but are usually more expensive.

Triple therapy. If your test for Helicobacter pylori is positive, a two-week course of "triple therapy" may stop the infection and improve your symptoms. Triple therapy includes a proton-pump inhibitor plus two different antibiotics, amoxicillin and clarithromycin.