Gastritis or inflammation of the gastric mucosa

Gastritis or inflammation of the gastric mucosa is the inflammation of the inner protective skin of the stomach, the gastric mucosa.

Acute gastritis occurs suddenly and causes intense pain, while chronic gastritis can run untreated for years.

A rarer form of the disease is erosive gastritis, which does not cause severe inflammation, but can provoke bleeding and peptic ulcer in the gastric mucosa.

The inner wall of the stomach contains specialized cells that produce stomach acid and enzymes that break down food and aid digestion; in addition, they produce a viscous mucus that lies protectively over the gastric mucosa.
When the walls of the stomach are inflamed, they produce less acid, enzymes and mucus.

The link between gastritis and symptoms is not entirely clear. Gastritis is a specific term for inflammation of the gastric mucosa. Those who suffer from gastritis may feel abdominal pain in the upper abdominal region, but there are also cases when gastritis is symptom-free.
The term gastritis is often mistakenly used to describe pain or discomfort in the upper abdomen; however, most individuals with pain in the upper abdominal region do not have gastritis.


Forms of chronic gastritis

Gastritis caused by Helicobacter pylori infection
This is a primary infection of the stomach, it is the most common form of gastritis.

Lymphocytic gastritis is a disease similar to celiac disease (gluten intolerance) and lymphocytic colitis.

Granulomatous gastritis can be caused by tuberculosis, mycosis, Boeck’s disease, Crohn’s disease or is part of a diffuse vasculitis syndrome.
Gastroscopy reveals some small superficial granulomas and small ulcers caused by H. pylori.

Antrum gastritis Symptoms of this type of gastritis
begin with inflammation of the lower part of the stomach, the antrum. If the stomach antrum becomes inflamed, indigestionnausea and gas development, as well as general stomach discomfort may occur.

Atrophic gastritis is characterized by the thinning of the gastric mucosa, while with hypertrophic gastritis, the mucous membrane increases in thickness.

Causes of chronic gastritis

Mucosal inflammation can be caused by infection, irritation, autoimmune disease (in which the body mistakenly attacks its own stomach) or the reflux of bile into the stomach (bile reflux).
Stress, feelings of guilt, difficult family or professional moments can favor the appearance of nervous gastritis.
This explains why some people with gastritis do not experience any discomfort, while “stressed” people feel the symptoms of gastritis.

Infections can be caused by:

Various substances can provoke stomach irritation:

  • Permanent use of anti-inflammatory drugs, such as ibuprofen (Dolormin) or naproxen (Aleve)
  • Alcohol
  • Smoke
  • Chronic vomiting
  • Coffee and acidic drinks
  • Too much acid in the stomach (e.g. due to severe stress)
  • corrosive or caustic substances (such as poison)
  • Other (e.g. radiotherapy or swallowing a foreign body)

The very rare causes of gastritis include:

Symptoms of gastritis

The symptoms of gastritis do not always correspond in intensity to the changes in the walls of the stomach.
Severe gastritis may be present even if the stomach does not cause discomfort.
On the other hand, severe discomfort can occur, even if the stomach walls are only slightly changed.

Especially in the elderly, damage to the stomach often develops without pain.
You may only notice the disease if there is heavy internal bleeding.

Typical symptoms of gastritis include stomach pain, especially in the upper abdomen and below the sternum, in the so-called pit of the stomach.
The pain can also occur in the upper left corner of the abdomen and radiate into the back, it seems to spread like a knife knife.
Those affected describe the symptoms as burning, persistent pain or pinching.
As a rule, a vague feeling of discomfort is present, but the pain can also be acute, stabbing and very intense.

Other symptoms of gastritis:

  • Belching: Belching usually does not relieve pain or only for a short time.
  • Nausea and vomiting: The vomit may be light, green or yellow, have bloody welts or consist entirely of blood, depending on the severity of the stomach inflammation.
  • Bad breath.
  • The pain can radiate backwards and cause back pain in the upper back region.
  • Feeling of fullness or burning in the upper abdomen.

In the more severe cases of gastritis, gastric bleeding may occur. In addition to the complaints already mentioned, any of the following symptoms may be noticeable:

One or all of the symptoms may occur suddenly. This is especially true for people over the age of 65.

There is a link between headaches, especially migraines, and stomach inflammation.
They have some risk factors in common, such as stress, certain foods, smoking, and alcohol.

What complications can gastritis bring?

Most forms of nonspecific chronic gastritis do not cause symptoms.
Nevertheless, this disease is a risk factor for stomach ulcers, gastric polyps, benign and malignant stomach tumors.

Some individuals with chronic gastritis caused by H. pylori or with autoimmune gastritis develop atrophic gastritis.
Atrophic gastritis destroys the cells of the stomach wall, which produce enzymes and digestive juices.
It can lead to two forms of cancer: stomach cancer and gastric mucosa-associated lymphoid tissue lymphoma (MALT).

Autoimmune atrophic gastritis or type A gastritis is a chronic and progressively progressive inflammatory disease in which the immune system attacks the cells of the stomach wall and intrinsic factor. This substance is responsible for the absorption of vitamin B12 necessary.
A lack of intrinsic factor can lead to pernicious anemia. In this disease, the lack of vitamin B12 the production of a sufficient amount of healthy red blood cells is difficult or impossible.

Diagnosis of gastritis

The doctor first inquires about the family medical history; this is followed by a thorough physical examination, possibly supplemented by one of the following examination methods:

Gastroscopy. The endoscope (a thin tube equipped with a camera) is inserted through the mouth to examine the walls of the stomach. The doctor examines the inflammation and can take a tissue sample (biopsy), which is later examined in the laboratory.

Blood test. The doctor can use a blood sample to determine whether there is anaemia, i.e. a lack of red blood cells. Infection by H. pylori and pernicious anemia can also be detected in the blood.

test for hidden blood in the Stuhl will show if the stool contains blood, which could be a possible sign of gastritis.

Therapy and medication

Most people go directly to the doctor for stomach pain or burning stomach or take tablets to relieve symptoms.
Unfortunately, there is no pill that dissolves anxiety and stress into thin air, so it often makes more sense to avoid stomach pain in other ways, without resorting to drugs with contraindications and side effects.

Like all organs, the stomach must have a certain freedom of movement; that is, it must be able to expand to eat, contract again and transport the digested food into the duodenum.

If the movement of the stomach is hindered by excessive tension of muscles and ligaments, stomach pain or gastric acid reflux (gastroesophageal reflux) may occur.
In this case, osteopathy is the best form of treatment, a manual therapy that helps the body regain its proper functioning.

Treatment of gastritis always depends on the cause of the disease. Acute gastritis caused by anti-inflammatory drugs or alcohol can already be improved by avoiding these substances. Chronic gastritis caused by a Helicobacter infection is treated by eradication of the bacteria. Most therapies also involve taking acid-neutralizing drugs (antacids) to reduce signs and symptoms.

Drugs for the treatment of gastritis:

If H. pylori is in the digestive system, the doctor may prescribe a combination of antibiotics that must be taken for about two weeks to kill the bacterium.
For example: amoxicillin (Amoxibeta, Augmentin), clarithromycin (Biaxin, Klacid), metronidazole (Flagyl) and tetracycline.

Gastric acid blockers
Proton pump inhibitors (PPIs) are drugs that suppress the formation of stomach acid by inhibiting the activity of gastric acid-producing cells. These drugs are partly over-the-counter, partly prescription.
Some representatives are: omeprazole (Antra MUPS, gastracid), lansoprazole (Lanzor or Agopton), rabeprazole (Pariet), esomeprazole (Nexium) and pantoprazole (Rifun, Pantozole, Pantoloc).

Side effects with long-term use, especially with high-dose PPI therapy, include an increased risk of fractures of the hip jointwrist and spine.

Acid-neutralizing drugs
Acid-neutralizing agents, including antacids and H2receptor antagonists, which reduce the amount of stomach acid released into the digestive system, which reduces gastritis-related pain and promotes healing.
Remedies available over-the-counter or prescription at the pharmacy include ranitidine (Zantac), famotidine (Pepcid), and cimetidine (Tagamet).

Antacids neutralize gastric acid. They provide rapid pain relief because they counteract stomach acid. A commonly used medicine is Maalox plus. Possible side effects include constipation or diarrhea.

Change of lifestyle habits

Treatment of gastritis provoked by gastric irritants is based on avoiding these substances.
These include:

  • Alcohol
  • Nicotine
  • carbonated or acid-forming beverages, such as coffee (also caffeine-free), and fruit juices with citric acid
  • certain anti-inflammatory drugs (NSAIDs), such as aspirin and dolormine – other painkillers should be used (e.g. Ben-u-ron)

Against nervous gastritis, there is no medicine; a different treatment strategy must be followed: it is advisable to approach problems differently, spend more time in the fresh air and do a lot of sports.

How long does gastritis last?

Chronic gastritis can last for many years, one can not say when it will cure.
Acute gastritis comes and goes, so there are phases when the patient often leads under it and others when he is doing well. Even in this case, it is not known when it will heal and whether it will come back, because its occurrence is very much influenced by personal factors, such as severe stress.


Which foods should be avoided?

Not all foods have the same effect on the stomach. You have to learn which of them trigger the symptoms.
Spices such as pepper increase acidity in the stomach and can have an irritating effect.
Chocolate, spicy and very fatty foods can aggravate the symptoms of gastritis.
Alcoholic and caffeinated beverages can also cause the symptoms.
The following drinks and foods should be restricted or avoided altogether.

  • hot milk, cocoa and chocolate
  • Whole milk, cheese, cream and ice cream
  • Coffee (with and without caffeine)
  • green tea (with and without caffeine)
  • alcoholic beverages, e.g. beer
  • Orange and grapefruit juice
  • carbonated mineral water and sweetened soft drinks


  • black and red pepper
  • Garlic powder
  • Chili powder

Other foods:

  • Dairy products made from whole milk
  • spicy or strongly flavoured cheese
  • matured and fatty meats, such as sausages, salami, bacon, ham and other sausages
  • Paprika and chilli
  • Onions and garlic
  • Tomato products, such as tomato paste, tomato juice and tomato sauce

What can you eat and drink?

A healthy and balanced diet is important. This includes fruits (e.g. bananas and apples), vegetables (zucchini, broccoli, avocado, cabbage, etc.), honey, cottage cheese, eggs, whole grains and dairy products with little or no fat. Whole grains include bread, cereals, pasta and rice. In addition, eat lean meat, poultry (chicken and turkey), fish, beans, eggs and nuts.
The nutrition plan for gastritis provides for a small amount of unhealthy fats, salt and added sugars. Healthy fats include olive oil.
Red wine is also on the diet plan, but only half a glass because it is an excellent antioxidant.
Gastritis patients often suffer from vitamin B12-deficiency due to the stomach’s inability to produce an enzyme necessary for the absorption of vitamin B12 responsible, the intrinsic factor.
Meat and fish should not be missing on the menu of a gastritis patient, because they provide the body with sufficient vitamin B12 provide.

Does glutamine help with gastritis?
Glutamine is one of the amino acids with the largest amount in the human body and can be obtained as a dietary supplement or through the diet. The anti-inflammatory properties have a soothing effect on the inflamed stomach tissue. A diet high in glutamine includes: meat, poultry, milk, yogurt, spinach and cabbage. Nutritional supplements are available as powders, capsules and tablets.

Does the alkaline diet work for gastritis?
The alkaline diet follows the principle that all foods can change pH by increasing or decreasing acidity.
To balance the pH value in the organism, the alkaline diet prefers the following foods: fresh vegetables, avocado, grapefruit, lemons, tomatoes, almonds, lentils, flaxseeds and seeds. However, some of them (tomatoes, lemons and grapefruit) are quite difficult to digest for an already inflamed stomach.

Does milk help with gastritis?
Milk is slightly more acidic than water and has a relatively high fat content. Acid and fat are difficult to digest for an inflamed stomach, so milk is not helpful for curing gastritis.
The consumption of milk and dairy products should be restricted; preferably choose skimmed milk products.

Can a low-carbohydrate diet eliminate the symptoms of gastritis?
If the carbohydrates come from finished products such as biscuits, crackers, cakes, pies and white bread, the symptoms of gastritis can be alleviated by avoiding these foods.
However, it is not necessary to follow a strict diet without carbohydrates.
Some carbohydrates (e.g. in fresh fruits, beans and whole grains) are useful part of the diet to fight gastritis.
So this important nutrient must not be avoided in principle, but care must be taken to where the carbohydrates come from.

Medicinal plants and medicinal herbs

Why take medicines with various side effects to treat a disease? Shouldn’t you try natural remedies first?
Medicinal plants and medicinal herbs are usually a safe way to strengthen and stimulate the body.
The herbs can be used in the form of dry extract (capsules, powder, herbal tea) or tincture (alcohol extract).
For the preparation of infusions, unless otherwise indicated, a teaspoon with herbs is placed on a cup of hot water.
Leaves and flowers need to steep about 5-10 minutes, roots 10-20 minutes.
Drink 2-4 cups a day. The concentrates can be used alone or combined.

Cranberry (Vaccinium macrocarpon), 400 mg twice daily – some preliminary studies have shown that the berry can inhibit the growth of Helicobacter pylori in the stomach.

One of the most effective plants for treating gastritis is ginger. This remedy relieves almost all stomach ailments, such as indigestion and bloating. ginger relieves inflammation and ulcers; it has an anti-inflammatory and antibacterial effect. It is used for nausea, is said to promote fat digestion and is also a natural antibiotic.

Wild pistachio extract (Pistacia lentiscus), 1-2 g daily – Wild pistachio is a classic remedy for ulcerative gastritis and for inhibiting Helicobacter pylori in laboratory tests. Further studies are needed to investigate the effect in humans.

Standardized extract of licorice or licorice (Glycyrrhiza glabra), chew 250-500 mg three times a day, both one hour before meals and two hours after. Licorice helps protect the stomach from the harmful effect of anti-inflammatory drugs.

Glycyrrhizin is a chemical product found in licorice root that causes side effects and pharmacological interactions.
Some people who suffer from acute gastritis can relieve symptoms with black tea after the meal, even though tea is actually discouraged.

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