What is an inflammation of the stomach and how is it treated?

Inflammation of the stomach (gastritis) can be acute or chronic and is limited to parts of the stomach or affects the entire stomach. The symptoms are also varied: gastritis can also have no symptoms. Typical symptoms are non-specific feelings of fullness and slight pain in the upper abdomen. The therapy consists on the one hand of treating the cause, and on the other hand of gastric-protecting food and taking acid-inhibiting medication.

In short, the most important things are:

• With inflammation of the stomach, the gastric mucosa is attacked by the stomach acid.
• A distinction is made between acute and chronic gastritis.
• Causes can include food poisoning, medication, infections, psychological stress, alcohol and smoking.
• Possible symptoms include pain or discomfort in the upper abdomen, nausea, loss of appetite, acid regurgitation and vomiting.
• A good medical history is sufficient to determine acute gastritis. In the case of chronic symptoms, a gastroscopy can also be indicated.
• General measures (light diet, discontinuing medication, stress reduction) and medication (acid inhibitors and in some cases antibiotics) play an important role in treatment.

How does gastritis develop?

The ingested food initially stays in the stomach for a while and the chyme is initially mixed with the stomach acid, which is produced by acid-producing gastric mucosal cells. The stomach acid serves to kill any bacteria that may be present in the food and also to activate an enzyme that is responsible for the further breakdown of proteins.

The stomach acid is very acidic. Therefore, the gastric mucosa protects itself from the aggressive stomach acid with an alkaline, bicarbonate-containing mucus. This mucus is formed and secreted by special mucus-producing cells of the gastric mucosa. The mucus, in turn, covers the gastric mucosa like a protective film.

The balance between gastric protection (mucus formation) and the production of stomach acid can get out of harmony due to various factors. With insufficient mucus formation or overproduction of stomach acid, the stomach mucosa is attacked by the stomach acid and it becomes inflamed.

What are the causes of gastric mucosal inflammation?

A distinction is made between acute and chronic inflammation of the stomach. The acute inflammation of the stomach starts suddenly and the symptoms are very clear. Causes of acute inflammation of the stomach can be, for example:

• Food poisoning from eating food that is spoiled by bacteria or fungi.
• Taking medication, e.g. some pain relievers such as aspirin, ibuprofen or diclofenac, iron substitution and also drugs from cancer therapy
• Alcohol consumption - however, it varies individually how much alcohol is tolerated before symptoms are triggered.
• Infections with bacteria or viruses. An infection with the Helicobacter pylori bacterium is common.
• Stress or mental illness such as depression.

Chronic gastric mucosal infections can also arise from untreated acute gastric mucosal infections. There are three different types of chronic gastric inflammation:

• Type A: Autoimmune gastritis. In this form, the body's immune system destroys the acid-producing cells in the stomach.
• Type B: Chronic gastric mucosal inflammation caused by bacteria, in 98% of cases by Helicobacter pylori.
• Type C: Chemically induced chronic gastritis through medication (painkillers), alcohol, nicotine.

What are symptoms of gastrointestinal inflammation?

An inflammation of the stomach can occur without symptoms and remain undetected. The symptoms of gastric mucosal inflammation are varied. Possible symptoms include:

• A rather unspecific feeling of discomfort in the upper abdomen, which does not correspond to a real pain, but is uncomfortable. For example, some patients report the “feeling of having a stone” in their stomach.
• Abdominal pain or in the entire abdomen, which can be dull or stinging. Sometimes the pain is also in the back or chest.
• Nausea
• Bloating
• Anorexia
• Vomiting
• Acid regurgitation
• Bloating
• General feeling of sickness.

Acute gastric mucosal inflammation leads to more severe and sudden symptoms, while chronic gastric mucosal inflammation is accompanied by lighter symptoms that develop gradually. Chronic gastric mucosal inflammation can lead to anemia if it goes undetected for a long time.

How is it diagnosed?

A good medical history is sufficient to diagnose acute gastric mucosal inflammation, in which typical symptoms and their duration as well as medication and alcohol intake are queried.

If the symptoms persist despite a stomach-friendly diet, chronic gastritis is suspected. Gastroscopy with removal of mucosal biopsies is then indicated to determine the exact clinical picture and to rule out other possible diagnoses. If an infection with Helicobacter pylori is suspected, a special breath test can be carried out, which becomes suspect with an existing infection.

How is gastric mucosal inflammation treated?

The most important thing for the treatment of inflammation of the stomach is finding the cause and then eliminating the cause:

• Acute inflammation of the stomach caused by food poisoning will go away on its own after a few days.
• Medications that could have caused the symptoms should, if possible, be discontinued or replaced with medication that is more gentle on the stomach.
• If there is a bacterial infection, targeted antibiotic therapy with tablets must always be initiated.
• In the event of stress or mental illness, relaxation procedures and psychological or psychiatric treatment can help.

General measures that also provide relief include the following:

• Refrain from alcohol, nicotine and coffee
• Eat easily digestible, gastric food (more information here)
• Chew food well and take your time eating
• Consume multiple smaller meals throughout the day instead of three large ones

What drugs are used to treat inflammation of the stomach?

In addition to antibiotics used for type B gastritis, drugs that inhibit the production of stomach acid or neutralize stomach acid also play an important role in the treatment of gastric mucosal inflammation:

• So-called proton pump inhibitors (PPIs) are commonly used, for example omeprazole or pantozole. These drugs inhibit the formation of acid and thus counteract the inflammation caused by the relative excess of acid in the stomach.
• Antacids, such as hydrotalcite or magnesium hydroxide, neutralize stomach acid.

How long does the inflammation last?

Gastric mucosal inflammation usually disappears after a few days if the trigger (stress, alcohol, spoiled food) is avoided. With chronic gastric mucosal inflammation, the most important thing is to eliminate the cause on the way to healing. Unfortunately, there is no causal therapy for type A gastritis, only vitamin B12 is added here. Type B and Type C gastritis should resolve a few weeks after treatment. Otherwise, the treatment may not be enough. In the case of type B gastritis, a control gastroscopy is also carried out regularly to check the success of the therapy.

Conclusion: Nutritional therapy, lifestyle changes and medication play a key role in the treatment of gastric mucosal inflammation.