Chronic gastritis is a condition that occurs when your stomach lining becomes inflamed. Unlike acute gastritis, in which irritation appears quickly in the stomach lining, chronic gastritis develops gradually and can be more difficult to get rid of.
Chronic gastritis usually gets better with treatment, but may need ongoing monitoring. Long-term inflammation can become erosive, wearing away at your stomach lining and leading to further medical issues.
The stomach lining, or mucosa, is full of glands that produce stomach acid and enzymes that break down food and protect you from infection. Because gastric acid is abrasive, the mucosa also secretes a protective protein-filled mucus that coats the stomach. In cases of gastritis, this mucus layer is damaged, allowing the stomach acids to reach and irritate the lining itself.
When inflammation occurs, your stomach lining changes and loses some of its protective cells. It may also cause early satiety. This is where your stomach feels full after eating just a few bites of food.
Chronic gastritis has a number of possible causes, some of which overlap with the possible causes of acute gastritis.
The following can cause irritation in the lining of your stomach and lead to chronic gastritis:
- bacterial infection, most commonly with Helicobacter pylori bacteria
- excessive alcohol consumption
- bile reflux
- drug use (certain recreational and over the counter drugs can irritate the stomach linings if used frequently)
- certain illnesses, such as diabetes or kidney failure
- a weakened immune system
Chronic gastritis is organized into three types based on related causes:
- Type A is caused by your immune system destroying stomach cells. And it can increase your risk of vitamin deficiencies, anemia, and cancer.
- Type B, the most common type, is caused by H. pylori bacteria, and can cause stomach ulcers, intestinal ulcers, and cancer.
- Type C is caused by chemical irritants like nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, or bile. And it can also cause stomach lining erosion and bleeding.
Other types of gastritis include giant hypertrophic gastritis, which can be related to protein deficiencies. There is also eosinophilic gastritis, which can happen alongside other allergic conditions like asthma or eczema.
Chronic gastritis doesn’t always result in symptoms. But people who do have symptoms often experience:
- upper abdominal pain
- loss of appetite
- weight loss
Internal signs and symptoms
Chronic gastritis can lead to the appearance of other health problems inside the stomach.
In some cases, irritation in the stomach lining is associated with the growth of gastric polyps, small masses of tissue inside the stomach. They appear most frequently in type B chronic gastritis. The types of polyps associated with chronic gastritis can indicate a higher risk of stomach cancer.
Many gastric polyps are completely benign and will heal with treatment. If your doctor discovers polyps, they may choose to biopsy and test a tissue sample just to be safe. There are many different kinds of polyps, and the majority are usually inconsequential.
Sores called peptic ulcers can also appear in cases of chronic gastritis. Peptic ulcers are common, and larger ones in the stomach may cause abdominal pain. Thankfully, the medications used to treat chronic gastritis also give peptic ulcers a chance to heal.
Your risk for chronic gastritis increases if your lifestyle and dietary habits activate changes in the stomach lining. It may be useful to avoid:
- high-fat diets
- high-salt diets
Long-term consumption of alcohol can also lead to chronic gastritis.
A stressful lifestyle or a traumatic experience can also decrease your stomach’s ability to protect itself. In addition, your risk increases if you have an autoimmune disease or certain illnesses such as Crohn’s disease.
Stomach irritation is common, but it isn’t always a symptom of chronic gastritis. Call your doctor if your stomach irritation lasts longer than a week or if you experience common symptoms of chronic gastritis regularly.
Get medical help right away if any of the following occur:
- vomiting blood
- rapid heartbeat
- difficulty breathing or swallowing
- extreme drowsiness
- passing out suddenly
Chronic gastritis puts you at risk for bleeding in your stomach and small intestine. Also seek treatment right away if you have black stools, vomit anything that looks like coffee grounds, or have a persistent stomachache.
Your doctor will ask about your medical history and symptoms. A series of tests may also be necessary, including:
- a test for the bacteria that cause stomach ulcers
- a stool test to look for stomach bleeding
- a blood count and an anemia test
- an endoscopy, in which a camera attached to a long tube is inserted into your mouth and down into your digestive tract
Medications and diet adjustments are the most common ways of treating chronic gastritis. Your specific treatment plan will depend on the type of chronic gastritis you have.
If you have Type A, your doctor will likely address the problems related to the nutrients you are lacking. If you have Type B, your doctor will use antimicrobial agents and acid blocking medications to destroy H. pylori bacteria. If you have Type C, your doctor will likely tell you to stop taking NSAIDs or drinking alcohol to prevent further damage to your stomach.
Your doctor may prescribe medication to weaken your stomach acid. The most common medicines to reduce gastric acid are:
- antacids, including calcium carbonate (Rolaids and Tums)
- proton pump inhibitors, such as omeprazole (Prilosec)
Reducing or eliminating aspirin and similar medicines is recommended to decrease stomach irritation.
Symptoms of chronic gastritis can sometimes go away in a few hours if medications or alcohol are causing your gastritis to act up. But typically chronic gastritis takes longer to disappear.
Without treatment, chronic gastritis may persist for years.
Your doctor may recommend changes to your diet to reduce stomach irritation. You may be instructed to avoid the following:
- a high-salt diet
- a high-fat diet
- alcohol, including beer, wine, or spirits
- a diet high in red meat and preserved meats
Recommended foods generally include:
- all fruits and vegetables
- foods high in probiotics, such as yogurt and kefir
- lean meats, such as chicken, turkey, and fish
- plant based proteins like beans and tofu
- whole grain pasta, rice, and breads
Some foods may help your stomach get rid of H. pylori and relieve your symptoms:
- Garlic may have antimicrobial properties that are especially effective against H. pylori bacteria.
- Cranberries may kill the bacteria, along with changing how it interacts with the stomach.
- Ginger may block the growth of the bacteria.
- Turmeric may aid in healing ulcers and blocking growth of the bacteria.
Though these alternative treatments may help, they do not eliminate the need to see a doctor if your symptoms are severe.
Your recovery from chronic gastritis depends on the underlying cause of the condition.
If chronic gastritis continues without treatment, your risk of stomach ulcers and stomach bleeding increases.
As gastritis wears away at your stomach lining, the lining weakens and often causes changes in the cells, which can lead to gastric cancer. Your stomach’s inability to absorb vitamins can also cause deficiencies that keep your body from forming red blood cells or affect nerve function. This may lead to anemia.
If left untreated, chronic gastritis can worsen and become reclassified as atrophic gastritis. Gastritis is considered atrophic if the irritation of the stomach lining persists for a longer time, around a few years.
Gastritis caused by environmental factors, such as alcohol, NSAIDS, and stress, generally does not become atrophic, as treatment primarily relies on stopping a certain behavior.
You can help control the complications of gastritis by monitoring your diet and stress levels. Limiting alcohol and the use of NSAIDs, like ibuprofen, naproxen, and aspirin may also help to prevent the condition. Proper hygiene can also help you avoid H. pylori infection.
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