What Are the Symptoms of Gastritis?

Gastritis is inflammation, irritation, or erosion of the stomach lining. It can come on suddenly and last a short time (acute), or begin gradually and last a long time (chronic). The acute form is usually caused by an infection, too much alcohol, or medications that irritate the stomach. Worldwide, about half of the population is thought to have chronic gastritis linked to Helicobacter pylori (H. pylori) infection.

What Are the Types of Gastritis?

In addition to the acute and chronic forms, gastritis can also be classified by how it affects the protective lining of your stomach. Erosive gastritis. In this type, whatever is causing the gastritis leaves wounds or ulcers in your stomach lining. Nonerosive gastritis. People with this type of gastritis have stomach irritation but no ulcers. If you have a type of nonerosive gastritis called atrophic gastritis, the irritation causes your stomach lining to thin.

Doctors may also diagnose gastritis according to its cause, for example:

• Alcohol-induced gastritis
• Autoimmune gastritis
• Drug-induced gastritis
• Infectious gastritis
• Stress-induced gastritis

What Causes Gastritis?

Gastritis is your body’s response to weakness or damage in your stomach lining. Many things can lead to it, including:

• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or naproxen
• Excessive use of alcohol, tobacco, or cocaine
• Repeated vomiting
• Stress, such as that caused by injury, surgery, or a serious illness
• Infections caused by bacteria such as H. pylori
• Other infections, including parasitic infections, HIV/AIDS, and viruses that cause the “stomach flu”
• Bile reflux, which occurs when a digestive fluid called bile flows back into your stomach
• An autoimmune reaction in which your immune system attacks the cells of your stomach lining
• Inflammatory conditions such as Crohn’s disease, celiac disease, or sarcoidosis
• Chemotherapy and radiation treatments

The stomach lining thins with age, so older people have a higher risk of gastritis.

Symptoms of Gastritis

Symptoms of gastritis vary from person to person, and many people with gastritis have no symptoms at all. Symptoms of gastritis may include:

• Indigestion, a burning or gnawing feeling in the stomach between meals or at night
• Nausea and vomiting
• Bloating
• Stomach pain in the abdominal area
• Hiccups
• Loss of appetite

If gastritis has led to a bleeding ulcer, you may experience:

• Vomiting blood or material that looks like coffee grounds
• Black, tarry-looking stools.

Tests for Gastritis

To diagnose gastritis, your doctor will review your personal and family medical history and perform a physical examination. They may also recommend any of the following tests:

Upper gastrointestinal (GI) series or barium swallow. This is an X-ray that gives your doctor a view of the upper part of your digestive system. Before the X-ray, you swallow a chalky liquid called barium. It coats your organs to help your doctor see them. It can reveal whether there is erosion in your stomach lining.

Upper endoscopy. An endoscope, a thin tube with a tiny camera, is passed through your mouth and into your stomach to check for signs of inflammation in your stomach lining. At the same time, your doctor may perform a biopsy, taking a small tissue sample and sending it to a laboratory for analysis.

Blood tests. Your doctor may check your red blood cell count to see whether you have anemia, which occurs when you don’t have enough red blood cells. They can also use blood tests to screen for H. pylori infection and pernicious anemia.

Fecal occult blood test (stool test). This test checks for blood in your stool, a possible sign of gastritis.

H. pylori breath test. If your doctor thinks you may be infected with H. pylori bacteria, you may have this test. You swallow a substance called urea, which the bacteria break down into carbon dioxide. You then breathe into a bag, and the breath sample is tested for extra carbon dioxide.

Treatment of Gastritis

Treatment of gastritis depends on its cause and how severe the condition is. Acute gastritis may go away on its own or improve once you stop smoking, drinking alcohol, or taking certain medications. If you have an alcohol or drug use disorder, your doctor may refer you to treatment programs. If NSAIDs are causing your gastritis, they may recommend alternative pain relievers. If you have chronic gastritis, you will need treatment to heal it for good.

Acute gastritis may go away on its own or improve once you stop smoking, drinking alcohol, or taking certain medications.

Medications for gastritis may include:

Antacids. These are over-the-counter medications you can buy to relieve indigestion and heartburn. They work by neutralizing stomach acid. There are many different kinds, including Maalox, Mylanta, Rolaids, and Tums. You should talk to your doctor about which medication to use.

H2 blockers. Histamine (H2) blocker medications, available over the counter or by prescription, reduce the amount of acid your stomach produces. These include cimetidine (Tagamet), famotidine (Pepcid), and nizatidine.

Proton pump inhibitors. These medications help block the production of stomach acid. They are also available over the counter or by prescription. They include dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex).

Surface-coating agents. These prescription medications protect damaged stomach tissue from acid and enzymes so that it can heal. They include sucralfate (Carafate). Misoprostol (Cytotec), a prostaglandin analog, reduces acid secretion and supports the stomach's protective lining; it must not be used during pregnancy.

Antibiotics. If your gastritis is caused by a bacterial infection such as H. pylori, your doctor will likely prescribe antibiotics along with medications that reduce stomach acid.

Anti-nausea medications. If you have nausea because of gastritis, you can take over-the-counter or prescription medications to relieve this symptom.

If an autoimmune disorder is causing your gastritis, your doctor may prescribe medications to treat that disorder. For autoimmune gastritis, they may recommend vitamin B12, folic acid, or iron supplements. If you have bile reflux or gastrointestinal (GI) bleeding, your doctor may recommend surgery to repair the problem. However, this is rare.

Complications of Gastritis

Gastritis usually doesn’t cause long-term problems. However, when it damages your stomach lining, complications such as the following can occur:

Peptic ulcers. These painful sores in your stomach lining can cause bleeding and scarring.

Gastric outlet obstruction: Scar tissue from ulcers or long-term inflammation can partially or completely block the opening between your stomach and your intestine. This can interfere with digestion and cause pain, nausea, and vomiting.

Gastrointestinal perforation. An ulcer can eventually turn into a hole (perforation) in the wall of your stomach. This can lead to an infection in your abdominal cavity called peritonitis.

Anemia. Iron-deficiency anemia can result from blood loss due to bleeding ulcers or from constant irritation of your stomach lining. It can also be caused by H. pylori infection or autoimmune gastritis, which prevent your body from absorbing iron as well as it should. Gastritis can also lead to pernicious anemia, in which your body cannot absorb enough vitamin B12.

Atrophic gastritis. Even nonerosive gastritis can lead to complications over time. The mucus layer in your stomach lining may thin and stop working as it should. Your body may not be able to properly absorb nutrients such as vitamin B12, folic acid, and iron. This can lead to nutritional deficiencies and anemia.

Achlorhydria or hypochlorhydria. Atrophic gastritis sometimes prevents your stomach from producing enough (hypochlorhydria) or any (achlorhydria) hydrochloric acid, a component of stomach (gastric) acid. This can interfere with digestion and keep your body from absorbing enough nutrients.

Gastric intestinal metaplasia. This is a rare condition in which chronic gastritis leads to changes in the cells of your stomach lining, increasing your risk of stomach cancer.

Stomach cancers: Atrophic gastritis increases your risk of gastric adenocarcinoma, mucosa-associated lymphoid tissue (MALT) lymphoma, and neuroendocrine tumors.

How Can You Prevent Gastritis?

If you have gastritis, the following can help protect you from it or keep your symptoms from getting worse:

Good hygiene. H. pylori can pass from person to person or through contaminated food or water. The most important way to prevent its spread is to wash your hands often, especially after using the toilet and before touching food.

Quit smoking. Smoking increases the risk of H. pylori infection and peptic ulcers.

Limit alcohol. Alcohol can irritate your stomach lining and make it more prone to damage, so if you drink, do so in moderation.

Don’t overuse NSAIDs. NSAIDs such as aspirin, ibuprofen, and naproxen can also irritate your stomach lining. Don’t take them for long periods or in high doses. See your doctor if you need other pain relief options.

Manage stress. Because stress can contribute to gastritis, look for healthy ways to cope with it. Relaxation techniques such as mindfulness meditation, tai chi, or yoga may help.

Avoid foods and drinks that can irritate your stomach lining. Things like coffee and spicy or fatty foods don’t cause gastritis, but they can make your symptoms worse if you already have it.