How can we easily define acute gastritis?

The Inflammation of the lining of the stomach (gastritis) is a very common inflammatory disease of the stomach lining. It is not contagious, can be acute or chronic and occurs more frequently with age.

Definition of gastritis

Usually the stomach is lined with a mucous membrane that protects the deeper layers of the stomach from the aggressive gastric acid, which is important for digestion.
If the mucous layer of the stomach is not sufficiently effective, the gastric mucosa can be attacked by its own stomach acid and gastritis can occur.

One differentiates between one

  • acute gastric mucosal inflammation,
    which occurs acutely, usually also causes discomfort and usually heals again relatively quickly, and the
  • chronic inflammation of the gastric mucosa,
    which is more insidious and permanent, causes less symptoms and can also be symptom-free.
Acute gastritis can turn into chronic gastritis.

Symptoms

While the acute gastric mucosal inflammation is caused by sudden symptoms such as B.
  • Feeling of pressure,
  • more or less severe pain in the upper abdomen,
  • Nausea,
  • Vomit,
  • unpleasant taste in the mouth or
  • Loss of appetite
noticeable, the chronic inflammation of the gastric mucosa usually develops slowly.
Some people have an aversion to certain foods, while others report that the symptoms are related to the food they eat.

Causes of Gastritis

There are several causes that can lead to inflammation of the stomach lining:
  • Infection with bacteria, viruses or mold
  • Food poisoning
  • excessive consumption of alcohol, nicotine, coffee
  • stress
  • Medication or chemical burns
  • Autoimmune cause
  • radiotherapy

Different types of gastritis

Chronic gastric mucosal inflammation is differentiated based on its triggers:
  • Type A gastritis (type A gastritis):
    The rarest form of chronic gastric mucosal inflammation, type A gastritis, is an autoimmune disease (only 5% of all gastritis cases) that predominantly affects the stomach (corpus). This leads to the formation of antibodies against the body's own gastric mucous membrane (autoimmune disease) without a previously known cause, which then loses its function (protection, mucus formation, etc.) and regresses. This can be demonstrated with a sample from the gastric mucosa. Only in the advanced stage of the disease can the organism no longer absorb sufficient vitamin B12, which results in the form of anemia (pernicious anemia) typical of this disease, caused by vitamin B12 deficiency. The B12 deficiency can also - possibly even before anemia - cause typical nerve damage. Type A gastritis can be associated with other autoimmune diseases. Type A gastritis is also considered a precancerous disease, i.e. H. that patients with type A gastritis have a statistically higher risk of malignant degeneration.
    Patients with type A gastritis should undergo regular endoscopic examinations in consultation with their attending physician.
  • Type B gastritis (type B gastritis):
    The most common form of chronic gastric mucosal inflammation, type B gastritis (85% of all gastritis cases), predominantly affects the section of the stomach in front of the stomach gate (antrum). Because type B gastritis is caused by a bacterial infection with the Helicobacter pylori bacterium, it is also known as "bacterial gastritis". Helicobacter pylori infection increases the risk of gastric and duodenal ulcers, and people with type B gastritis are also more likely to develop gastric cancer than others.
  • Type C gastritis (type C gastritis):
    Type C gastric mucosal inflammation is a chemical-induced gastritis (10% of all gastritis cases) that primarily affects the pylorus.
    Type C gastritis can be triggered by bile juice flowing back from the small intestine into the stomach (gall reflux), or by drugs such as aspirin (ASA), diclofenac, or other non-steroidal anti-inflammatory drugs (NSAIDs). Excessive alcohol consumption and smoking also increase the risk of developing type C gastric mucosal inflammation.

Complications

Due to gastritis, complications such as:
  • Stomach ulcer (ulcer),
  • Gastric bleeding and
  • Rupture of the stomach requiring immediate medical attention.

Diagnosis of gastritis

In order to reliably diagnose gastritis, a detailed anamnesis discussion is necessary, in which the patient explains his symptoms, describes his lifestyle (smoking, alcohol, stress) and provides information about the medication he is taking. The diagnosis can only be confirmed by a gastroscopy (→ gastroscopy), in which a tissue sample (→ biopsy) is taken from the gastric mucosa and examined for cell changes and infections (especially Helicobacter pylori).

Even if Helicobacter pylori infection is suspected, a gastroscopy with a biopsy should be done to confirm the diagnosis. A → 13C-urea breath test, which can detect the pathogen in the exhaled air with a high degree of probability, is usually used for control after treatment of a Helicobacter infection and paid for by the statutory health insurance companies. A stool test for Helicobacter can do the same thing. However, this test does not prove whether the patient also has type B gastritis.


An x-ray of the stomach is usually never necessary.

Therapy of gastritis

First of all, one should try to avoid anything that irritates the stomach lining. Affected people are advised to avoid smoking, alcohol, fatty and spicy foods as much as possible and to avoid stress.
Gastritis can be treated with different drugs that work differently:
  • Antacids (Neutralization of stomach acid in the stomach)
    Antacids are medicines that neutralize stomach acid. Although you cannot stop the production of stomach acid, you can reduce the effective amount. Their effects do not last long and they need to be taken several times a day after meals and / or before bed.
  • H2 blockers (Inhibition of histamine-induced gastric acid production)
    H2 blockers are active ingredients that block the gastric acid production stimulated by histamine in the stomach wall. Cimetidine, ranitidine and famotidine are among the active substances that block the histamine-2 receptors (H2 receptors). H2 blockers are stronger and longer effective than antacids, but quickly lose their effectiveness if taken regularly (tachyphylaxis).
  • Proton pump inhibitors (Inhibition of gastric acid production in the stomach cells)
    So-called acid blockers, which inhibit the production of gastric acid, can help against the acidic gastric juice as the cause of the inflammation. Most proton pump inhibitors (proton pump inhibitors, PPIs) with the active ingredients omeprazole, pantoprazole or esmoeprazole are used. These block an enzyme in the cells of the stomach lining (stomach cells) that normally pumps stomach acid into the inside of the stomach. Proton pump inhibitors are the most effective acid blockers available. You should - like the H2 blockers - i. d. Usually taken once a day and before breakfast. They do NOT lose their effectiveness even with regular use.
  • Prokinetics (Stimulation of stomach movement)
    Prokinetics with the active ingredient metorclopramide or domperidone help to stimulate and coordinate the peristalsis of the gastrointestinal tract and thus the movement of the stomach. Gastric emptying is accelerated to counteract bloating, nausea and vomiting. The herbal drug Iberogast® also has a comparable effect, albeit a weaker one.
  • Eradication (Elimination of Helicobacter pylori)
    The aim of therapy for type B gastritis is to treat the cause of the infection. This is called eradication therapy. In the eradication of Helicobacter pylori infection, at least two different antibiotics are used in addition to proton pump inhibitors. Bismuth salts are also used in combination treatments.
Type A gastritis cannot be treated causally. Here one will at best treat symptomatically, i. H. If a vitamin B-12 deficiency is found, therapy with this vitamin is carried out through muscle injections.
If certain drugs are the cause of type C gastritis, an attempt will be made to replace them with better tolerated ones.

Tips

In the case of gastritis, attention should be paid to diet.
  • Eat slowly and only in small portions.
  • Avoid spicy and particularly fatty foods.
  • Avoid smoking, alcohol, coffee and stress.
  • Avoid drugs that are harmful to the stomach (e.g. NSAIDs).
  • if you have a history (e.g. previous stomach ulcers) protect your stomach (e.g. with proton pump inhibitors) if you are dependent on drugs that are harmful to the stomach.