The symptoms of gastritis are caused by inflammation of the protective inner wall of the stomach. 
Acute gastritis occurs suddenly and is very intense, while chronic gastritis can last for years if left untreated. 
A less common form of the disease, erosive gastritis, usually does not cause much inflammation but can lead to bleeding and ulcers in the lining of the stomach (inner wall).

The inner wall of the stomach contains special cells that produce stomach acids, enzymes that help degrade food for digestion  and create the mucus that protects the stomach’s inner wall from the acid. 
When the stomach walls are inflamed, they produce less acid, enzymes and mucus. 
The relationship between gastritis and symptoms is unclear. 
Gastritis is a term that specifically refers to inflammation of the inner wall of the stomach. People who have gastritis may experience pain or discomfort in the upper abdomen, but some people with gastritis have no symptoms.
Often the term gastritis is used incorrectly to describe pain or discomfort in the upper abdomen, but most people who have upper abdominal pain do not have gastritis.


Types of chronic gastritis

Helicobacter pylori gastritis
This is a primary infection of the stomach and is the most common cause of chronic gastritis.

Lymphocytic gastritis is a disease similar to celiac disease and lymphocytic colitis. 

Gastritis g 
ranulomatous can be caused by  tuberculosis , ringworm, sarcoidosis, Crohn ‘s disease , or is part of a diffuse vasculitis syndrome . 
Gastroscopy shows some small superficial granulomas and small ulcers caused by h. Pylori.

Antral Gastritis
The symptoms of antral gastritis begin with inflammation of the lower stomach called the antrum. When the den of the stomach becomes inflamed, the individual may have indigestion , nausea , gas , in addition to other diseases of the stomach in general.

The atrophic gastritis is characterized by thinning of the gastric mucosa, while hypertrophic gastritis causes thickening of the superficial layer of the stomach wall.


Causes  of gastritis

Gastritis can be caused by an infection, irritation, an autoimmune disease (where the immune system attacks the stomach by mistake) or reflux of bile in the stomach (bile reflux). 
Stress , guilt, difficult situations in the family or work can promote nervous gastritis. 
This may explain why some people with inflammation of the stomach mucosa have no symptoms, while others “stressed” feel the symptoms of gastritis. 
Infections can be caused by:

Different substances may cause irritation, including:

  • Prolonged use of anti-inflammatory drugs , such as ibuprofen (Advil) or naproxen (synflex),
  • Alcohol,
  • Smoke ,
  • Chronic Vomiting
  • Coffee and sour drinks,
  • Too much acid in the stomach (eg, stress),
  • Eating or drinking caustic or corrosive substances (poisons),
  • Other (eg radiation treatment or after ingesting a foreign body).

Other causes of gastritis are very rare, including:

  • Systemic disease (eg, Crohn’s disease),
  • Sarcoidosis.


Symptoms of gastritis

The symptoms of gastritis do not always correspond to the severity of changes in the stomach wall. 
Severe gastritis may be present when the stomach does not cause symptoms. 
On the contrary, severe symptoms of gastritis may be present, even if there are only slight changes in the stomach wall. 
The elderly, in particular, have a much greater chance of developing damage without stomach pain. 
They may notice the disease only when they have a significant internal bleeding .

In people who have symptoms of gastritis, stomach pain in the upper and central part of the abdomen is the most frequent symptom. 
The pain is usually in the upper and central part of the abdomen (“mouth” of the stomach). 
Sometimes the pain of gastritis sits on the upper left side of the abdomen and back . It seems like the pain stretches like a stab. 
People often use terms such as burning , continuous pain to describe the symptoms. 
Generally, there is a vague sense of discomfort, but the pain can be sharp as a stitch. 
Other symptoms of gastritis are as follows:

  • Burping: belching usually does not relieve pain or relieve temporarily,
  • Nausea and vomiting: vomiting may be transparent, green or yellow, with streaks of blood or blood only, depending on the severity of the inflammation of the stomach,
  • Bad breath ,
  • The pain can radiate later and cause pain in the spine in the central part (back pain),
  • Abdominal distension,
  • Sensation of fullness or burning in the upper abdomen.

In severe cases of gastritis, bleeding may occur inside the stomach. Any of the following symptoms may occur other than those already mentioned.

One or all of these symptoms may occur suddenly. This is especially true in adults over 65 years of age. 
There is a link between headache and inflammation of the stomach, especially migraine . 
Some risk factors are common to both, for example stress, certain foods, smoke and alcohol.


What are the complications of gastritis?

Most forms of non-specific chronic gastritis cause no symptoms. 
However, chronic gastritis is a risk factor for peptic ulcer, gastric polyps, benign and malignant gastric tumors.
Some people with chronic gastritis due to h. pylori or autoimmune gastritis develop atrophic gastritis. 
Atrophic gastritis destroys the cells of the stomach walls that produce digestive acids and enzymes. 
Atrophic gastritis can lead to two types of cancer: gastric cancer and lymphoma of lymphoid tissue associated with gastric mucosa (MALT).

Autoimmune atrophic gastritis is an inflammatory, chronic and progressive disease in which the immune system attacks the cells of the inner wall of the stomach and the intrinsic factor. This substance is required for the absorption of vitamin B12. 
Lack of intrinsic factor can cause pernicious anemia . In this disease, a B-12 deficiency makes it difficult or impossible to produce a sufficient amount of healthy red blood cells.


Diagnosis of gastritis

To diagnose gastritis, the doctor examines the family medical history, performs a thorough physical examination, and can recommend any of the following tests. 
Gastroscopy . The endoscope (a thin tube containing a small camera) is inserted into the stomach through the mouth to see the walls of the stomach. In  gastroscopythe doctor controls the inflammation and can perform a biopsy, a procedure in which a small sample of tissue is removed and then sent to a laboratory for analysis. 
Blood tests . Your doctor can perform multiple blood tests ( complete blood count ) to find out if there is anemia, which means that there are not enough red blood cells. He or she can also look for infection by h. pylori and pernicious anemia. 
Examination of fecal occult blood  checks for the presence of blood in the stool, a possible sign of gastritis.


Treatment and medication for gastritis

When most people feel stomach pain or heartburn runs from the doctor and takes a pill to relieve the symptoms. 
Unfortunately there is no pill that removes stress and anxiety, so often it would be better to look for a way to avoid stomach pain without taking medications with contraindications and side effects.

Like every organ, the stomach must be free to move to digest, so it must expand to accommodate food, shrink when it is empty and must move the digested food into the duodenum. 
If gastric movement is hampered by looseness and excessive muscle tension, stomach pain  or gastroesophageal reflux may appear . 
In this case, the best therapy is osteopathy , it is a manual therapy that helps the body to recover the correct functionality.

Treatment of gastritis depends on the specific cause. Acute gastritis caused by non-steroidal anti-inflammatories or alcohol can be attenuated by stopping the use of these substances.

Chronic gastritis caused by h. pylori is treated by eradicating the bacteria. Most gastritis treatments include medications that reduce stomach acid to reduce signs and symptoms.

The medicines used to treat gastritis are:

Antibiotics . 
H. pylori is found in the digestive system, your doctor may recommend a combination of antibiotics for about two weeks to kill the bacteria. 
You may take amoxicillin (Amoxil), clarithromycin (Klaricid), metronidazole (Flagyl), and tetracycline.

Drugs that block acid production. 
Proton pump inhibitors reduce acid by blocking the action of cells that produce gastric acid. These medications may be over-the-counter or with a prescription. 
Some examples are: omeprazole (Losec), Lansoprazole (Prazol), rabeprazole (Pariet), esomeprazole (Nexium) and Pantoprazole (Pantozol). 
Among the side effects of prolonged use of proton pump inhibitors, particularly at high doses, there is an increased risk of fracture of the hip , wrist and spine .

Medicines to reduce acid production. 
Antacids – also called histamine H2 receptor antagonists – reduce the amount of acid released into the digestive system that relieves gastritis pain and promotes healing. 
Available as a prescription or over-the-counter medicine, these include ranitidine (Antak), Famotidine (Famox) and cimetidine (Tagamet). 
Antacids can give pain relief quickly because they neutralize stomach acid. For example, a widely used drug is Maalox plus. The side effects can be constipation or diarrhea depending on the main ingredients.


Lifestyle changes

Treatment for gastritis caused by irritants is based on preventing the use of these substances. 
These include:

  • Alcohol
  • Tobacco
  • Acidic beverages such as coffee (including decaffeinated), soft drinks, fruit drinks and citric acid juices
  • Non-steroidal anti-inflammatories, such as aspirin and Advil – it is better to switch to other analgesics (eg Efferalgan)

To solve nervous gastritis there are no pills, the advice is to spend more time outdoors and do a lot of sport.


How long does gastritis take?

Chronic gastritis can last for many years, we can not determine when it goes. 
Acute gastritis comes and goes, has periods where you feel frequently and others where you are well. Even in this case we can not tell when it will pass and if it would return because there are personal factors that influence how stress.


Diet for gastritis

What foods should I avoid? 
Not all foods affect the same way.We must learn what foods that cause symptoms. 
Condiments such as peppercorns increase the acidity of the stomach and can irritate the stomach. 
Foods that contain chocolate, spicy or high in fat can aggravate the symptoms of gastritis. 
Drinks that contain alcohol or caffeine can cause the symptoms. 
Below are some foods you should avoid:

  • Warm milk, cocoa and chocolate,
  • Whole milk, cheeses, sour cream, ice cream,
  • Decaffeinated and normal coffee,
  • Green tea, with or without caffeine,
  • Drinks with alcohol such as beer,
  • Orange juice,
  • Carbonated water and sugary drinks.

Spices and seasonings:

  • Black and red pepper,
  • Garlic powder,
  • Chilli powder,

Other foods:

  • Dairy products derived from whole milk,
  • Strongly flavored cheeses,
  • Fat meats, salsicha, salame, bacon, presumed,
  • Peppers and peppers,
  • Onion and garlic,
  • Tomato products such as tomato paste, tomato juice or tomato sauce

What foods and drinks can I eat and drink?

We need to eat a variety of healthy foods from all food groups. Eat fruits (eg, bananas and apples), vegetables (zucchini, broccoli, avocado, cabbage, etc.), honey, ricotta, eggs, whole grains and dairy products, fat or fat-free. 
Whole grains include bread, cereals, pasta and rice. Choose lean meats, poultry (chicken and turkey), fish, beans, eggs and nuts. 
gastritis diet has a low content of unhealthy fat, salt and added sugar. Among the healthy fats is olive oil. 
We can drink wine but only half a glass of red wine because it has excellent antioxidant properties.
People with gastritis often do not have enough vitamin B12 because the stomach can not produce an enzyme that is used for absorption: the intrinsic factor. 
Meat and fish can not be lacking in the diet of a person with gastritis because they give the body the required intake of vitamin B12.

Does Glutamine Help Gastritis?

One of the most abundant amino acid in the body is glutamine, we take it as a nutritional supplement or through diet. The anti-inflammatory properties of glutamine help to soothe the inflamed tissue of the stomach. A diet rich in glutamine includes: meats, poultry, milk, yogurt, spinach and cabbage. Supplements are available in tablets, capsules or powder.

Does alkaline diet work for gastritis?

Alkaline diet stems from the theory that all foods can alter the pH by increasing or decreasing the acidity once they are digested. 
To balance the body’s pH, the alkaline diet focuses heavily on certain foods: fresh vegetables, avocado, orange, lemon, tomatoes, almonds, lentils, flax seeds. Some of these foods, such as tomatoes, lemons and oranges, are actually quite heavy for an already inflamed heartburn.

Does milk drink help gastritis?

Milk is slightly more acidic than water and has a relatively high fat content. Since acids and fats are difficult to digest through the stomach with gastritis, milk does not help cure the disease. 
It is recommended to limit milk and dairy products by choosing low-fat milk when possible.

Can a low-carbohydrate diet eliminate the symptoms of gastritis? 
If carbohydrate intake comes from finished products such as biscuits, crackers, cakes and white bread, eliminating these foods from the diet will reduce the symptoms of gastritis. 
However, it is not necessary to follow a strict diet without carbohydrates. 
Some carbohydrates (for example those with grains and whole grains) are useful in a diet to eliminate gastritis. 
Instead of strictly limiting this important nutrient, you should choose good sources of carbohydrates.


Herbal Remedies for Gastritis

Why take medications with various side effects to cure a disease? Is not it better to try a natural substance first? 
Herbal products are generally a safe way to strengthen and tone the body. 
We can use herbs as dry extract (capsules, powder, herbal teas) or concentrates (alcoholic extracts). 
If not indicated otherwise, we can make an infusion with 1 teaspoon of the herb with a cup of hot water. 
Let infuse for 5-10 minutes the leaves or flowers and 10-20 minutes the roots. 
Drink 2 to 4 cups a day. You can use the concentrate, alone or in combination.

Cranberry (couscous) 400 mg twice daily, preliminary research shows that cranberries can inhibit the growth of Helicobacter pylori in the stomach.

One of the best herbs for the treatment of gastritis is Ginger (ginger) . This remedy relieves almost all gastric symptoms like indigestion and flatulence. 
Ginger reduces inflammation and stomach ulcers 
Ginger is an anti-inflammatory and an antibacterial agent. This is used to reduce nausea, stimulates fat digestion and is also a natural antibiotic.

Aroeira Extract (Schinus terebinthifolius Raddi), 1/2 g per day – Aroeira is a traditional treatment for ulcerative gastritis and inhibits Helicobacter pylori in laboratory tests. More studies are needed to see if it works in humans.

Standardized extract of licorice (Glycyrrhiza glabra), 250-500 mg 3 times daily, 1 hour before or chew or 2 hours after meals. Licorice can help protect against stomach damage by painkillers.

Glycyrrhizin is a chemical found in licorice and causes side effects and drug interactions. 
Some people who suffer from acute gastritis can relieve symptoms if they drink black tea after a meal, although generally tea is not recommended.

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