Conditions

Gastritis

Gastritis is a general term meaning, "inflammation of the stomach." In most cases, it involves erosion (if not perforation) and bleeding of the stomach lining. The most common causes are alcohol and certain drugs. Medications used to control inflammation in other parts of the body are among the most serious offenders.

Another type of gastritis is "stress" gastritis, which occurs in surgical patients and people with serious medical problems, such as burns, trauma, massive infection, organ failure, cirrhosis of the liver, and acute local infection caused by a variety of bacteria, viruses, fungi, and even parasites. Exposure to radiation or caustic substances such as acids and drain cleaners can also cause this type of gastritis.

Helicobacter pylori (H. pylori), a bacterium, can cause inflammation underneath the mucous layer that coats the stomach and has been implicated in stomach ulcers. Another form of gastritis in which the surface remains intact is associated with pernicious anemia.

Signs and Symptoms:

Gastritis can be painless even if there is considerable disruption of the stomach lining. If there are symptoms, they can include:

• Loss of appetite
• Nausea
• Vomiting
• Indigestion
• Bloating
• Abdominal pain (may be made worse by eating)

Diagnosis:

Your doctor will likely diagnose the condition with a physical exam and analysis of the symptoms along with your medical history.

An endoscopic examination is the primary diagnostic technique (for a definite diagnosis) used to examine the stomach lining. However, sometimes a patient undergoes a gastroscopy, an examination of the stomach and the duodenum, the first section of the small intestine.

Either procedure involves inserting a flexible fiber-optic tube through the mouth and guiding it down the throat into the stomach. The doctor can then look directly at the stomach lining and determine the presence and extent of bleeding or eroding areas. This is not usually done, however, unless there is some question as to whether there is a more serious condition, such as an ulcer; or unless gastritis has become a chronic problem.

Other procedures include a complete blood count to detect anemia, and a guaiac test of stool or vomitus to detect gastrointestinal bleeding.

Treatment Options:

No specific treatment is required for gastritis; however, in symptomatic patients, treatment is given to help reduce discomfort.

Traditional Treatments:

• Over-the-counter antacids such as Mylanta, Maalox, or Rolaids are usually tried first. These agents have a short span of action, but with repeated use, they may inhibit stomach acid enough to disrupt digestion and interfere with the absorption of nutrients.
• A popular treatment (and preventative) is sucralfate (Carafate). This drug, primarily used for ulcers farther down in the gastrointestinal tract, is used for gastritis because it seems to act as a protectant against acid, bile, and pepsin.
  Warning: Because serious side effects associated with sucralfate, read package inserts carefully, and discuss your situation with your doctor.
• Acid-blockers may be used for variable lengths of time. Examples include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac). These drugs block acid secretion thereby lowering stress on irritated stomach tissue.
• A more recent type of medication used for gastritis is the proton pump inhibitor. Omeprazole (Prilosec) and lansoprazole (Prevacid) are two examples. These drugs also inhibit the production of stomach acid, but by a different mechanism than the one the acid-blockers use.
• Gastritis due to infection may be treated with antibiotics. Inflammation due to chemical or toxic insults may require gastric lavage (stomach pumping) or treatment with activated charcoal.
• Avoid all nonsteroidal anti-inflammatories unless specifically directed to take them by your doctor.

Complementary and Alternative Therapies:

Nutritional and herbal support help to heal gastric mucosa, fight infection, and reduce recurrence.

Nutritional Supplementation:

• Take a good multivitamin and mineral supplement daily to protect against deficiencies of the major nutrients.
• Duodenal extract is often helpful for reducing the pain of stomach inflammation. Take 350 mg three to four times daily for two weeks.
• Probiotics replenish the natural intestinal flora and are soothing to the gastrointestinal tract. If you must take antibiotics, once antibiotic therapy is finished, take an acidophilus supplement, as directed on the product label, two to three times daily.
• Vitamin E is a natural mild anti-inflammatory. Choose a product containing mixed tocopherols and take 400 IU at bedtime.
  Warning: If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• If anemia is a problem, consider taking supplemental chlorophyll. Chlorophyll is high in trace minerals and minute amounts of bioavailable, easily digested iron. Take 2 capsules three times daily.
• Zinc (30 to 50 mg/day) enhances healing.

Alternative Therapies:

• Licorice is very effective for healing an ulcerated gastrointestinal tract. Be sure to select deglycyrrhizinated licorice (DGL), and chew 350 to 600 mg twenty to thirty minutes before each meal.
  Warning: Ordinary licorice can elevate blood pressure and should not be taken on a daily basis for more than ten days in a row. DGL should not have this effect, however.
• Slippery elm soothes the entire gastrointestinal tract. Take 500 mg three times daily.
• Ginger root tea (Zingiber officinale) is a warming carminative that increases circulation and enhances digestion. Drink 2 to 3 cups/day with meals.
• For H. pylori, bismuth subcitrate (120 mg four times a day for eight weeks) may be helpful in eradicating H. pylori and reducing recurrence. It is poorly absorbed, which decreases the likelihood of side effects; however, it is associated with neurotoxicity if used long-term. Patient may still need antibiotics if H. pylori has not resolved after eight weeks.

General Recommendations:

• Do not smoke, and avoid secondhand smoke.
• As much as possible avoid stress, and learn ways to manage the stress you can not avoid.

Warnings:

• Ordinary licorice can elevate blood pressure and should not be taken on a daily basis for more than ten days in a row. DGL should not have this effect, however.
• If you are taking blood thinners, consult your doctor before taking supplemental vitamin E.
• Because serious side effects associated with sucralfate, read package inserts carefully, and discuss your situation with your doctor.