Gastritis (nervous, chronic): see symptoms, remedies, diet

What is gastritis?

Gastritis is a disease that causes inflammation of the lining of the lining of the stomach. From there, it can cause a series of symptoms, such as heartburn , pain and burning, swelling, nausea, vomiting and, in severe cases, bleeding.

The causes of gastritis, as well as the symptoms, are varied. Among the main ones are the infection caused by the Helicobacter pylori bacteria , poor diet, excessive alcohol consumption, smoking , stress and anxiety .

The most well-known types of gastritis are acute gastritis , which usually occurs suddenly, lasting a few days, and its cause is more easily recognized; and the chronic form of the disease, which usually persists for a longer time, and can last for months or years.

Both manifestations can be treated and cured, when a correct diagnosis and treatment occurs. However, when it doesn’t, complications like ulcers can occur.

In the International Code of Diseases, in its 10th edition (ICD 10), gastritis can be found by code K29.7.

Although the term gastritis is commonly used to refer to most gastrointestinal discomforts, gastritis needs to follow certain criteria for diagnosis. Continue reading and understand the types and causes for this condition.

Types of gastritis

There are different types of gastritis, which can be classified according to the time of symptoms or the region of the stomach affected. The chronic and acute types, for example, are the best known, but in addition to these there are also eosinophilic and enantematous gastritis. Learn more about the most common types:

Acute gastritis

Acute gastritis is the sudden manifestation of the disease, usually with rapid evolution of symptoms and with an easier cause to be recognized.

It can occur due to several factors, such as medication use, infections, smoking, alcohol abuse, inadequate nutrition, physical and psychological stress, which induce acid secretion, allowing an increase in gastric acidity and a decrease in blood flow, causing damage directly to the body. stomach lining.

Chronic gastritis

Chronic gastritis refers to the type of gastritis with prolonged duration, which can be divided into mild, moderate or severe.

The causes of chronic gastritis can be similar to those that cause acute gastritis, the main difference being the length of stay. In general, it is caused by some autoimmune variation, by infections ( H. pylori ) and also by factors such as smoking and alcohol abuse.

In this type, there is the presence of chronic inflammatory changes, in which there is an infiltration of leukocytes (white blood cells), responsible for the defense of the organism.

Among the complications caused by the chronic condition of gastritis, there is the possibility of atrophy, changes in the lining of the mucosa and metaplasia, a condition in which one adult cell is replaced by another, causing changes in the tissues.

Erosive gastritis

It is the type of gastritis characterized by erosion of the gastric mucosa, being, in the great majority, an acute manifestation of the disease. Due to erosions, the patient may experience bleeding.

As in other cases, factors such as alcohol, smoking, physical stress (injuries) and infection may be the cause.

Non-erosive gastritis

In this condition, there is generally no erosion of the gastric mucosa. When they occur, they are associated with the most aggravated conditions (deep gastritis). In such cases, the patient may present an asymptomatic condition. Therefore, the diagnosis is usually made by performing an endoscopy. Among the causes, the most common is infection caused by the bacteria H. pylori .

Nervous gastritis

Although it is quite common to hear about nervous gastritis, scientifically, it is not a valid classification, as there is no inflammation or injury to the stomach mucosa. Emotional factors, such as stress, can aggravate the symptoms of gastritis, but they are not responsible for triggering the condition.

However, the term is commonly used to refer to cases of gastritis that worsen due to nervousness, stress and anxiety.

In the past, in cases where the patient had symptoms of heartburn, burning and stomach pains along with these emotional states, the name of nervous gastritis was generally attributed, even in the medical environment.

But it is important to note that the term has become popular and consolidated in common uses, but without representing a recognized type of gastritis.

Eosinophilic gastritis

Eosinophilic gastroenteritis has as its main characteristic the increase in the volume of immune cells in the stomach (antibodies), which cause symptoms such as heartburn, vomiting, nausea and stomach pain.

It can be triggered by allergic processes or infections, requiring treatment based on corticosteroid medications.

Enanthematous gastritis

Enanthematous gastritis is considered a common type of gastritis, causing inflammation of the stomach wall that can occur for different causes, such as infections, food or medications.

It is possible to subclass this type according to the location of the affected stomach, such as the antrum (beginning of the stomach), body (the whole stomach) or the bottom (final part of the stomach).

What is atrophic gastritis?

Atrophic gastritis is caused by an autoimmune response, in which the patient’s own body antibodies attack the gastric mucosa. In this type of disease, the chances of developing anemia pernicious are greater, as the absorption of vitamin B12 is impaired.

This malabsorption occurs in response to the reduction of gastric glandular cells, which are replaced by intestinal and fibrous tissues. With the alteration of the stomach tissue, the substance intrinsic factor has its production altered. Without it, the absorption of B12 in the intestine is impaired.

In addition, patients with atrophic gastritis may produce gastric acid at low or excessive levels, which increase the risk of tumors in the stomach.

Causes

There are several factors that can trigger inflammation of the gastric mucosa, resulting in gastritis. Learn more about some of the most frequent:

H. pylori

The infection caused by the Helicobacter pylori bacteria is one of the main causes of gastritis worldwide.

Contagion happens through contact with contaminated saliva and feces, causing one of the risk factors for the transmission of the bacteria to be the lack of hygiene.

For these reasons, contamination may be more common among family members, nursing homes or other environments where personal objects are shared.

The prevalence of this type of infection, however, is higher in childhood, and can occur in up to 50% of children aged up to 8 years.

Once inside the organism, the bacteria settles in the stomach, settling in places where there is less exposure to acidic juices from the organ.

Although it can cause symptoms such as nausea, burning, vomiting and stomach pain, it is possible that, after a period, the condition becomes chronic and stops showing symptoms.

Medicines

Gastritis caused by medications usually occurs from the prolonged use of certain medications, such as non-steroidal anti-inflammatory drugs ( ibuprofen and aspirin , for example).

Autoimmune

Gastritis can also be caused by an autoimmune response from the body, although it is a rarer condition.

In these cases, antibodies are released and start to improperly attack the gastric mucosa, causing the characteristic symptoms of the disease. The autoimmune type is generally related to the onset of pernicious anemia , causing malabsorption of vitamin B12.

Physical stress

Physical stress involves any type of injury or involvement of the stomach, caused for example by surgery, accidents, intense burns or blows in the abdominal region.

Dysfunctions in the production of gastric juices can occur, altering acidity and causing inflammation of the mucosa. In some cases, ulcers and bleeding are possible.

Other causes

  • Excessive consumption of alcoholic beverages;
  • Smoking;
  • Crohn’s disease;
  • Cancer of the lymphatic system (lymphoma).

Risk factors

There are some risk factors that increase the chances of some type of gastritis developing or worsen existing symptoms:

  • Excessive consumption of irritating foods, such as those rich in fats or very spicy (salt, mustard, olive oil, pepper, ketchup, vinegar and sugar);
  • Excessive consumption of coffee;
  • Excessive alcoholic beverages;
  • Smoking;
  • Prolonged use of medications such as painkillers and anti-inflammatory drugs;
  • Autoimmune diseases;
  • Viral infections;
  • Stress and anxiety;
  • Inadequate chewing;
  • Meals with a very large space of time;
  • Use of drugs;
  • HIV carriers.

In addition to all these factors, age is also considered a risk. Older people may have a greater chance of developing gastritis, because over the years the lining of the stomach tends to become more flabby.

It is also believed that aging facilitates infections by viruses and bacteria, or the development of some autoimmune disease, which make up factors associated with gastritis.

Symptoms

In chronic and acute gastritis, it is possible that there are symptoms in varying degrees (milder or more intense), however, the chronic type may be asymptomatic frequently.

When there are manifestations, the patient may report several complaints, such as malaise, mild burning and epigastric pain. This pain is characterized by discomfort in the region just below the rib, usually being reported as that pain ‘in the pit of the stomach’. Depending on the condition, it may spread or become more intense.

In addition, other signs are:

  • Heartburn;
  • Loss of appetite;
  • Nausea and vomiting;
  • Headache;
  • Weakness;
  • Reflux;
  • Indigestion;
  • Flatulence (gases);
  • Sensation of slow digestion or full stomach;
  • Burping;
  • Weight loss;
  • Swelling;
  • Hiccup;
  • Weakness;
  • Burning sensation on the tongue (glossitis);
  • Irritation in the corner of the lips (commissuritis).

In more severe cases, there may be vomiting with blood, which indicates internal bleeding from the stomach wall.

Diagnosis

The diagnosis of gastritis can be made by analyzing the patient’s clinical history, symptoms and ordering laboratory tests. General practitioners and gastroenterologists are the most suitable for the diagnosis and follow-up of the condition.

In general, just analyzing the symptoms is enough to raise suspicions about gastritis. But the doctor will order tests to confirm the diagnosis.

Exams

In order to confirm or establish the diagnosis of gastritis, as well as to discover its cause, the doctor may direct the patient to the following tests:

Blood test

A blood test may be ordered to confirm the presence of antibodies to the bacterium Helicobacter pylori, one of the factors most associated with the development of gastritis.

The test is done with a simple blood collection, performed in the laboratory. However, it is still possible that there will be referral to other tests in order to confirm the effectiveness of the result.

Breath Exam

The breath test is an alternative to diagnose diseases related to the stomach, and can be performed before the need for more invasive tests, such as endoscopy.

In the breath test, the patient ingests a liquid that contains urea, a substance responsible for breaking up the protein particles in the stomach, and blows a kind of air bag. When the patient has H. pylori , the body produces and releases carbon dioxide along with breathing.

Thus, the result of the laboratory investigation is obtained.

Stool culture

This examination is performed using a stool sample, in which the intention is to identify whether there is the presence of blood or any atypical bacteria to those that are normally found in the digestive tract.

The test is non-invasive and should be performed following the recommendations of each laboratory.

High gastric endoscopy

It is an exam that allows the doctor to view the esophagus, stomach and the first part of the small intestine (duodenum).

For this, a thin tube is inserted, which has a camera at the end, through the mouth to the stomach.

Thus, it is possible to diagnose if there are changes such as ulcers, for example.

In addition, when necessary, a small sample of stomach tissue can be taken. Called a biopsy, the collection allows to identify if there are bacteria and changes in the gastric mucosa.

The exam is usually done under anesthesia and usually has a fast recovery.

Does gastritis have a cure?

Depending on the type of gastritis and the cause, yes. Acute gastritis, for example, usually has its cause more easily identified, which allows a more effective diagnosis and treatment. In this way, healing of the condition usually takes place.

In chronic conditions of the disease, on the other hand, persistence may be greater. With the introduction of treatment, the reduction in inflammation may decrease or have complete remission. However, some symptoms may persist, which requires the patient to continue treatment and care for habits.

In some cases, for example, gastritis caused by the use of medications, it is necessary to eliminate the triggering agent. However, it is not possible to resolve the sensitivity to that substance, causing the symptoms to reappear if ingested in the future.

It may be recommended and necessary to maintain preventive treatment, through adaptation or exchange of medications, dietary adjustments or changes in lifestyle.

Treatments

Gastritis should be treated according to the cause, so each patient must follow the doctor’s recommendations. Options include, above all, the need to use medications, change food and reduce stress.

Medicines

When the doctor understands that a drug treatment may be necessary, the prescription of medications such as antibiotics , gastric protectors and antacids can be done. Knowing that self-medication can pose health risks,

Antacids

Antacids contribute to the treatment of gastritis because they increase gastric pH and help to relieve symptoms, reducing the number of lesions in the mucosa and decreasing inflammation.

Medicines that perform this action in the body include aluminum hydroxide , calcium carbonate and magnesium hydroxide .

Antibiotics

They are recommended when the cause of gastritis is due to a bacterial infection, such as H. pylori or other agents. Some of the medications listed include:

  • Clarithromycin ;
  • Amoxicillin ;
  • Pyloripac
  • Metronidazole .

Proton pump inhibitors

They are drugs used to minimize the production of hydrochloric acid, indicated for the treatment of gastritis and ulcers. Examples of proton pump inhibitors are Omeprazole , Esomeprazole, Pariet , Tecta and Pantoprazole , for example.

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Diet for gastritis

In some cases, it may be necessary for the patient to have to make some variations in the daily diet, to avoid gastritis or not to aggravate the condition further.

Some foods can be added to meals and others should be avoided. Are they:

What to avoid in gastritis

Gastritis patients should avoid irritating foods, such as coffee, soft drinks, fatty foods (fast foods, sausages, canned foods and other very spicy foods such as pepper, vinegar, ketchup and others).

Very acidic foods, such as some fruits, should be avoided so as not to further irritate the condition. For example, when choosing some type of natural juice, it is more advisable to opt for those that are not citrus.

In addition, alcohol, one of the causes of gastritis, should also be avoided, or reduced.

What to eat in gastritis

To help alleviate gastritis, it is important to include some items in the diet and also to change some habits.

Foods that should be added to the diet include those that are rich in fiber and probiotics, in addition to those that have a low percentage of fat, acidity and caffeine.

In general, it is recommended that the patient maintain regular feeding schedules, avoiding long periods without eating, as there may be production of gastric juice and irritation of the mucosa due to lack of food.

Home remedy for gastritis

There are some homemade recipes for gastritis that aim to alleviate the symptoms and make living with the condition more pleasant. However, they are usually tips with little or no scientific basis, having no proof that they really work.

In addition, they should never replace the conventional treatment prescribed by a doctor. In this sense, they can play a complementary role. Ideally, these prescriptions should be used after prior consultation with the doctor, to avoid complications.

Knowing this, we have listed some possible tips to do at home and relieve gastritis:

  • Espinheira-santa tea;
  • Rice water;
  • Chamomile tea;
  • Potato juice.

Prognosis

The prognosis of gastritis is variable, as it depends on the cause and the condition of the patient. After proper diagnosis and treatment, the problem is usually alleviated or resolved.

In chronic cases of gastritis, when infection by the bacteria H. pylori occurs , the remission of the disease also occurs through drug treatment. However, in a portion of these conditions, the disease can progress to the appearance of ulcers, which requires a longer treatment time.

The chances of recurrence of ulcers caused by H. pylori infection can be greater than 50% in people who have not received adequate treatment.

In the cases of patients who used antibiotics, the percentages of recurrence are much lower, corresponding to less than 10%. It is also important to note that the correct elimination of H. pylori can also cure resistant ulcers.

Complications

When the patient does not receive treatment properly, some complications can occur.

Gastric ulcers

Gastric ulcers are sores in the stomach that, in most cases, are caused by the presence of the bacteria H. pylori, but can also occur for other causes, such as stress and poor diet. They usually hurt when they come in contact with gastric juice.

Hemorrhage

Hemorrhage is a complication that occurs when the patient also suffers from ulcers. Bleeding can occur when the ulcers are painless.

In such cases, you need to be aware of whether the patient has nausea with blood or darkened stools.

Stomach cancer

The cancer in the stomach is considered a complication of gastritis because the infection by Helicobacter pylori bacterium is a risk factor for the development of this cancer.

Atrophic gastritis, a type of gastritis that can occur due to an autoimmune response in the body or due to chronic infection, is also considered a risk for stomach cancer.

How to prevent?

There are some habits that favor the development of gastritis, as this, we have listed some measures that help prevent the disease.

Do not smoke

Smoking is harmful to the health of the digestive system as it stimulates acidity in the stomach, and can cause damage to the gastric mucosa. In addition, smoking can weaken the diaphragm, the muscle responsible for preventing stomach fluid from returning and reflux from occurring.

Thus, the contact of gastric acid with the esophageal mucosa becomes more frequent.

Smoking also favors infection by the Helicobacter pylori bacteria and stimulates the passage of bile salts from the intestine to the stomach.

For these and other reasons, not smoking is a way to avoid gastritis and other health complications.

Chew your food well

Chewing food calmly helps to form the bolus, facilitating the digestive process. When this process does not happen, the body needs to produce more gastric juice to cope with digesting these foods in larger sizes, which can cause irritation to the stomach lining.

Avoid irritating foods

Normally, foods high in fats are digested more slowly, so the digestive system understands that it is necessary to produce more gastric juice.

However, this excessive production, when trying to facilitate the digestion of fatty foods, can end up irritating the gastric mucosa.

Therefore, it is considered a preventive measure to maintain a healthier and more balanced diet.

Read more: Excessive acidity in the stomach may favor the appearance of ulcers

It is also a form of prevention to eat meals at shorter intervals, as gastric juice is released constantly. Consequently, being on an empty stomach for a long time allows this gastric juice to affect the organ’s own mucosa.

It is recommended to have meals every 3 hours, choosing to eat lighter and easier to digest foods, especially at night. This prevents the stomach from becoming more susceptible to contact with gastric acid.

Cereals, yogurt, juices and fruits that are not too acidic are good options. In general, priority should be given to foods rich in fiber, low in fat and probiotic foods. On the other hand, the consumption of fried foods, soft drinks, alcoholic beverages and very spicy foods, for example, should be reduced.

Read more: What is kefir (milk, water), benefits, recipes, how to make and care?

Reduce coffee consumption

Coffee is a naturally acidic drink (with a pH below 7) and is therefore able to irritate the stomach lining, especially when it is inflamed. Thus, people who have gastritis, when drinking this drink, may feel quite uncomfortable pain at the time.

For those who do not suffer from the disease and want to prevent it, reducing the amount of coffee consumed daily or replacing with less caffeinated versions can be interesting.

But it is important to always follow what the doctor and a nutrition professional guide for treatment.

Avoid excessive consumption of alcoholic beverages

Excessive consumption of alcoholic beverages, as well as excessive consumption of coffee and fatty foods, favors the development of gastritis because they have irritating substances for the stomach.

Because it affects the mucosa region, alcohol makes the stomach less protected against the action of gastric acids, which increases the chances of gastritis developing ulcers or worsening symptoms.

Therefore, people who want to prevent or already have the condition, should consume moderately alcoholic beverages or as directed by the doctor.

Keeping anxiety and stress under control

When we are stressed and anxious, our body releases a greater amount of cortisol and adrenaline. These hormones can increase the secretion of gastric juice, which makes the stomach less protected and worsen the burning and burning symptoms.

Therefore, as well as taking care of physical health, paying attention to mental health is also to prevent gastritis. People who lead stressful lives should keep in mind that a change in habits may be necessary.

Practicing more relaxing activities, such as taking time for hobbies, exercising, meditating or being with loved ones can be important suggestions to ease the stress of everyday life.

Understanding what is causing this feeling is the first step in reversing the situation.

To help manage stress and anxiety, the accompaniment of a psychologist can help.

Read more: What is Pilates, what is it for, benefits, exercise, lose weight?

Common questions

Is gastritis hereditary?

No, gastritis is not a hereditary disease. Gastritis is an acquired condition, usually caused by an infection caused by the bacteria H. pylori .

However, because it is caused by some irritating agents, such as food, people in the same family who share meals may have a higher risk of developing the condition. That is, it does not mean that the disease is hereditary.

Can candy and chewing gum worsen gastritis?

Chewing is part of the digestion process, so by constantly chewing gum and candy, our body understands that it is necessary to produce gastric juice to digest the food it is waiting for.

However, candy and chewing gum are not swallowed and gastric juice acts on the lining of the stomach. Therefore, this is indeed a factor that worsens gastritis.

Can stress cause gastritis?

Stress, anxiety and nervousness can aggravate gastritis, as these are conditions that can cause greater release of hormones that increase the secretion of gastric juice.

Therefore, it is common that they are factors that aggravate the condition of patients who already have gastric symptoms, not being the main cause.

Does drinking milk solve gastritis?

Despite temporarily relieving the symptoms of gastritis, drinking milk does not resolve the condition. In some cases, it can be even worse, as milk can stimulate the production of stomach acid. Thus, it may end up aggravating the gastritis picture even a few hours after ingestion.


We seek in this article to clarify what gastritis is, a disease responsible for causing great discomfort and pain in patients who suffer from this condition. Share this information so that more people know how to prevent it!

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