Understanding Gastritis

Understanding Gastritis

Gastritis is a common condition that occurs when the lining of the stomach becomes irritated or inflamed. A wide array of factors can cause it, from stress, to medications, to spicy foods. But don’t worry, whether you’ve got a case of the stomach bug blues, or you’re just looking for ways to keep your tummy happy and healthy, this post has all the info you need!

What is gastritis?

Gastritis is estimated to affect over half of the world’s population and it can be chronic or acute. Acute gastritis refers to a sudden onset of inflammation that only lasts for a short period of time (think days or weeks). Whereas chronic gastritis refers to a long-term inflammation of the stomach lining (think months or years). Chronic gastritis can be very destructive – causing changes in the stomach lining, increasing stomach ulcer risk, and can even increase risk of stomach cancer.

There is a wide array of potential causes of gastritis – with some being a more likely cause of acute gastritis, as opposed to chronic gastritis, and vice versa. Here are some of the most common causes:

Acute

  1. Helicobacter Pylori: Pylori is a type of bacteria that can infect the stomach lining and cause acute gastritis in some people. However, it does not always cause problems. The bacteria are usually passed through contact with bodily fluids but it can also be spread via food or water.
  2. Other infections: Infections by other microorganisms, including the norovirus or Herpes simplex can also cause acute gastritis.
  3. Excessive alcohol intake: Alcohol – specifically types with low ethanol content such as beer and wine – can increase the production of stomach acid which can cause acute gastritis [1]
  4. Stress: Like alcohol, cortisol and other stress hormones can increase the production of stomach Stress hormones also decrease the production of protective mucus in the stomach lining which can lead to acute gastritis. [2]

Chronic

  1. Helicobacter Pylori: In addition to being a cause of acute gastritis, it is also the cause of a majority of chronic gastritis [3]. The inflammation caused by the bacteria can cause stomach ulcers if the gastritis is left untreated.
  2. Autoimmune conditions: In some cases, a person’s immune system may attack the cells of the stomach lining – this is known as autoimmune gastritis, a sub-category of chronic gastritis. This type of gastritis is often associated with other autoimmune conditions like type 1 diabetes
  3. Chronic NSAID use: Nonsteroidal anti-inflammatory drugs (NSAID), such as ibuprofen and aspirin are used to relieve pain and inflammation. However, chronic, prolonged use of these drugs can irritate and inflame the stomach lining and cause chronic
  4. Older age: As we get older, the risk of chronic gastritis increases due to thinning of the stomach lining that happens over time. [4]

Symptoms of gastritis

The most common symptoms of gastritis include:

  1. Abdominal pain: The pain associated with gastritis is often described as a gnawing, burning sensation in the upper abdomen.
  2. Nausea and vomiting: The nausea and vomiting associated with gastritis can be mild to severe. If your vomit is red in colour or looks like ground coffee – seek emergency medical
  3. Bloating and excess gas: The inflammation of the stomach lining can affect food in the digestive tract being moved along correctly which can cause gas to build up in the
  4. Loss of appetite: The inflammation of the stomach lining can lead to a feeling of fullness

What might Gastritis be mistaken for?

Gastritis shares symptoms with several other gastrointestinal disorders which it may be mistaken for.

One of these disorders is gastro-oesophageal reflux disease – or GORD. GORD is a chronic condition in which the stomach acid flows back into the oesophagus. The symptoms of GORD including bloating and gassiness, and pain, are similar to those of gastritis.

Gastritis may also be mistaken for an IBS flare up as the symptoms can be identical in some cases. However, during an IBS flare, there will typically not be inflammation of the stomach lining. Therefore, if you believe you may have gastritis but are concerned that it may be an IBS flare, seek medical attention to receive a proper diagnosis!

Deficiencies associated with Gastritis

Whilst acute gastritis may cause a temporary loss of electrolytes, particularly when vomiting occurs, chronic gastritis can lead to several vitamin and mineral deficiencies that have the potential to complicate the condition further[5]:

  • Vitamin B12 – Also known as cobalamin, vitamin B12 is a water-soluble vitamin used to make DNA and red blood cells. Sufferers of chronic gastritis may become deficient in vitamin B12 due to the damage that is done to the lining of the stomach which prevents the body from absorbing the vitamin. Symptoms of vitamin B12 deficiency include fatigue, weakness, and pins and needles.
  • Iron – Iron is an important nutrient in our body which is required for the production of haemoglobin, therefore, without it, the body may be unable to produce enough healthy red blood cells. Iron deficiency occurs in chronic gastritis cases due to blood loss from the stomach lining. Symptoms of iron deficiency include fatigue, pale skin, dizziness, and weakness.
  • Vitamin C – Also known as ascorbic acid, vitamin C is a water-soluble vitamin which our body cannot make on its own – meaning we have to get it through our diet to avoid deficiency. This vitamin plays an important role in immune function and the production of collagen and serotonin. Chronic gastritis may cause vitamin C deficiency via damage to the stomach lining reducing the body’s capacity for absorbing the vitamin. Symptoms of vitamin C deficiency include weakness, joint and muscle pain, and increased infection risk.
  • Calcium – Calcium is an essential mineral that is used in so many parts of the body including, bone and teeth health, muscle function, nerve transmission, and maintenance of the body’s pH balance. Calcium deficiency can occur in chronic gastritis cases due to the reduced absorption of the mineral. Symptoms of calcium deficiency include muscle cramps, muscle weakness, and fatigue.

How is Gastritis diagnosed?

Gastritis can be diagnosed using a variety of methods. For example, your GP may utilise blood tests to check for inflammation or infection markers, or a breath test to check for H.pylori infection. The upside of both of these methods is that neither of them are invasive.

However, the most definitive method of diagnosing gastritis is through upper GI endoscopy, or a gastroscopy, which allows a doctor to view and examine you stomach lining. This will allow the doctor to determine how severe the inflammation of the stomach lining is and can also help highlight what is causing the symptoms. This procedure is much more invasive than a blood or breath test.

Dietary Treatment

The treatment for gastritis depends on the cause. For example, cases of gastritis that are caused by H.pylori, antibiotics are prescribed.

However, there are some lifestyle and dietary tips that could help relieve or minimise symptoms:

 

 

 

 

 

Importance of reducing anxiety

If you are experiencing gastritis symptoms, call your GP to get to the bottom of what may be causing the symptoms. However, if you are looking for a way to ease your symptoms whilst you await your appointment, it is important to manage stress and anxiety levels as these have the potential to exacerbate your symptoms.

When we experience high levels of stress, our “fight or flight” response is triggered and stress hormones – such as cortisol and adrenaline – are released. A natural result of this response is a slowing or even a complete halt in the digestive processes that occur in our bodies which can cause us to feel a bit nauseous or bloated.

Reducing anxiety and stress can be achieved through a variety of methods – sometimes it is just a case of trial and error before you find exactly what works for you. Here are some ideas to get you started:

  • Deep breathing – Take slow, deep breaths in through your nose and out through your mouth. Try to really be intentional with it. You can also try square/box breathing – this is a technique where you inhale for 4 seconds, hold that breath for 4 seconds, exhale for 4 seconds, and keep your lungs empty for the final 4 seconds. If that sounds complicated, don’t worry! Here’s a helpful visual to demonstrate it a little more clearly:

 

[6]

  • Mindfulness meditation – Mindfulness meditation is a type of meditation that focuses on paying attention to the present moment with a non-judgmental attitude. Try taking 5 minutes a day where you focus on your breathing and observe your thoughts without judgement. Over time, this can help improve your stress and anxiety management skills!
  • Exercise – Whether its walking, yoga, or cycling, exercise can be a great way to reduce your anxiety levels! Exercise can increase blood flow and release endorphins which can help alleviate anxiety symptoms. It can also provide a bit of a distraction if you find your thoughts running a bit out of control!

 

If you are struggling with gastritis please contact me to discuss this further hello@lesleyreiddietitian.co.uk

 

References

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1374273/

(2) https://www.ncbi.nlm.nih.gov/books/NBK310265/

(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673514/

(4) https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807

(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292330/

(6) https://www.aclboulder.org/blog/tag/Square+Breathing

What does the colour of my poop mean?

The colour of our poop is a fascinating but often overlooked indicator of our digestive health. Whilst we might feel shy to discuss it, the colour of your poop can tell you a lot about what is going on inside your body and can let you know if something isn’t working quite as well as it should be!

Usually, changes in the colour of your poop isn’t a sinister sign, but rather it comes as a direct result of the food that you have eaten. However, if you are concerned, have no fear, this blog post will inform you of the possible causes for any interesting colours you’ve seen in your loo recently!

Brown: This is the most common colour of poop and it is an indication that everything is functioning normally. The brown colour is a result of the poop being exposed to the right amount of bile in the digestive tract!

Green: Whilst green might seem like an unusual colour for poop, it is usually not a cause for concern. Instead, the green colour could be due to the presence of bile, especially when you are experiencing diarrhoea. Otherwise, it is an indication that you have been consuming a lot of green leafy vegetables (such as kale, spinach, or broccoli), green food colouring, or iron
supplements.

Black: Black poop may be caused by the consumption of certain medications (iron supplements, Pepto-Bismol, and activated charcoal). However, it can also indicate that you are experiencing bleeding in your upper digestive tract as a result of a peptic ulcer, gastritis, or another digestive condition. If you are passing black stools and believe it is not a result of what you have eaten, seek medical attention.

Yellow: Poop that is consistently yellow or greasy looking can be an indication that there is a problem with your liver or bile ducts which is affecting the way your body is digesting the fats that you eat. You should consult your GP to rule out any underlying digestive issues such as coeliac disease.

White or Pale: If your poop is lacking in colour, it is likely related to medications you have taken. In fact, it is not uncommon for diarrhoea medications to cause your poop to lose some colour. If, however, you have not taken any diarrhoea medication recently, white or pale poop may come as a result of a lack of bile. It is important to seek medical attention if your poop is
consistently pale or white in colour.

Red: Passing stools which have a red tint to them may be a result of the consumption of red coloured foods such as beets, cranberries, or foods with red food colouring. However, if your poop is red in colour and you have not consumed any of these foods recently, it could be a sign of bleeding in the lower digestive tract. This could be a result of haemorrhoids,
diverticulitis or IBD. You should seek medical attention if you frequently pass red stools.

If you notice any changes in your poop colour which persists more than a few days, you should consult your GP to rule out any underlying health issues.

If you have any questions relating to the above please get in touch hello@lesleyreiddietitian.co.uk

Temporary vs Chronic Diarrhoea

Temporary vs Chronic Diarrhoea

Diarrhoea can be a real pain in the … gut! But did you know that there are two different types of diarrhoea? Whilst some cases of diarrhoea are temporary and go away on their own within a week or so, other cases are chronic and may require a visit to the doctor.

Temporary Diarrhoea

Temporary diarrhoea – also sometimes to referred to as acute diarrhoea – is a bit like a thunderstorm. It comes on suddenly, but it doesn’t stick around for long. This type of diarrhoea is typically caused by short-term infections and lasts anywhere from a few days to a couple of weeks.

Causes:

  • Stomach flu: Stomach flu (also known by its scarier name Viral Gastroenteritis) is highly contagious and causes symptoms such as nausea, vomiting, stomach cramps, and diarrhoea. But worry not! Although it may sound intimidating – it tends to clear up on its own within a week.
  • Bacterial infections: Infections by various types of bacteria, including E.coli, Salmonella, Campylobacter, V.cholerae, Shigella, and Staphylococcus aureus can cause food poisoning and bring on acute diarrhoea through contaminated water or food. This diarrhoea is common when travelling as food preparation or water quality may be different from what your body is used to!
  • Medications: Anyone who has had a course of antibiotics knows the havoc it can wreak on your gut! So, if you’ve recently been prescribed some and have a case of the runs, worry not – it is an expected side effect. Other medications such as laxatives and chemotherapy drugs may also cause diarrhoea.
  • Overconsumption of alcohol: Alcohol in large amounts can irritate your digestive system which may result in softer stools and a more frequent urge to go. Plus, alcohol’s dehydrating effect can exacerbate the situation.
  • Stress: When you’re feeling stressed out or anxious, your body releases stress hormones such as adrenaline and cortisol which impact your digestive system.

What should you do?

For most cases of temporary diarrhoea, you can expect it to clear up on its own without you lifting a finger. However, if you want to help the process along, here are some things you can try to ease the discomfort:

  1. Drink plenty of fluids. Staying hydrated becomes especially important when you have been suffering a bout of diarrhoea as your body loses much more liquid than usual. Increasing your intake of water can help prevent dehydration (which can worsen diarrhoea). Bonus points if you include coconut water, fresh fruit juice, or clear broth as these drinks can help you restore your electrolyte balance and replenish other lost minerals!
  2. Consider eating some probiotic-containing foods. Foods such as yogurt, sauerkraut, kimchi, and kefir are all rich in beneficial bacteria. Incorporating these foods can not only help prevent future cases of diarrhoea but can help alleviate your symptoms by restoring the natural balance of your gut microflora.
  3. Avoid certain foods. Consuming caffeine, alcohol, fatty foods, and foods high in fibre when you are experiencing diarrhoea can exacerbate your symptoms – instead opt for simpler foods which you know your body can easily digest.
  4. Try some over-the-counter medication. Certain medications such as Pepto Bismol and Imodium are available OTC and can offer some quick relief from diarrhoea symptoms.

Chronic Diarrhoea

Unlike temporary diarrhoea, chronic diarrhoea is a bit like a leaky tap at your sink – it just never seems to stop. This type of diarrhoea is usually a sign of an underlying medical condition such as inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or certain food intolerances such as coeliac disease and lactose intolerance. As a result, chronic diarrhoea cases last much longer (>4 weeks).

What should you do?

If you have been experiencing frequent, loose/watery stools for several weeks, it is important to talk to your GP.

Treatment for chronic diarrhoea is dependent on what the underlying cause is – however, it may include antibiotics, anti-inflammatory drugs, dietary changes/restrictions, or lifestyle modifications.

However, if you have some time to wait before your GP appointment, try incorporating some of the previously mentioned tips to ease the discomfort and reduce your symptoms.

Remember, diarrhoea is no fun, but there are ways to manage it – no matter if your case is temporary or chronic!

If you wish to discuss any of the above issues with me, or if you have any questions relating to any of my other blogs please contact me info@lesleyreiddietitian.co.uk

How much gas is normal?

How much gas is normal?

Let’s face it, nobody wants to feel like a social pariah or clear a room with their flatulence. However, it is important to remember that passing gas is completely normal and that we all do it! In fact, the average person can have anywhere between 0.5 and 1.5 litres of gas in their digestive tract and can pass gas up to 20 times per day! So if you’re feeling a little gassy after eating, don’t worry – it is actually a sign that your digestive system is working properly.

What causes it?

Now, you may be thinking – “what causes all this gas?”. The answer is, there are two main sources of gas in the digestive tract: swallowed air, and the breakdown of food by your gut bacteria.

Swallowed air can come from a variety of sources: perhaps you’re a big fan of chewing gum, or fizzy drinks. Maybe you just have a habit of talking when you’re eating. All of these actions can cause air to make its way into your digestive tract where it will eventually be released as gas.

Certain foods, including broccoli, beans, and brussels sprouts can also cause gas when they are broken down by the friendly bacteria of your gut. This is because they contain complex carbohydrates that cannot be entirely broken down in the stomach. Once those carbohydrates get to the colon, the bacteria get to work breaking them down, and gas is produced as a by-product.

When should I be concerned?

Whilst gas is an entirely normal part of the digestive process, significant changes in your usual patterns can be a sign of underlying digestive issues. It is important to speak with your doctor or dietitian if these changes occur.

Additionally, if you have an onset of any of the following symptoms alongside excessive gas, seek medical attention as it is possible you could be suffering a more serious condition such as inflammatory bowel disease (IBD), coeliac disease, Crohn’s disease, or ulcerative colitis:

  • Abdominal pain
  • Blood in your stools
  • Unintentional weight loss
  • Fever

Management of excessive gas

If you are looking to manage excessive gas, keeping a food diary, and noting which foods cause the most gas can be helpful in identifying the culprits. Once you are aware of your dietary triggers, you may find it helpful to reduce the portion sizes of these foods, or choose to consume them less frequently.

Here in the UK, we tend to eat less than our daily recommended intake of fibre. Whilst this information might tempt you to suddenly start consuming twice the amount of fibre you usually do, be sure to increase your fibre intake gradually over a period of a few weeks to avoid excessive gas and bloating.

If you have any questions or concerns please contact me at info@lesleyreiddietitian.co.uk

How to treat bloating

Bloating is a very common condition to experience. In fact, when asked, as many as 10-30% of healthy individuals reported that they regularly felt bloating.[1] However, when IBS sufferers were asked the same question 90% reported bloating as being one of their main symptoms, with a higher occurrence found in women than men.[2] When discussing bloating it is important to differentiate between bloating and distension.

So, what is the difference?

Bloating describes a feeling of fullness or inflation in the abdomen which can happen without any visible physical changes whereas with distension you can actually see an increase in the size of the abdomen. Nowadays, after eating, many people refer to it as having a ‘food baby’ because the tummy is so distended that it looks as though they are pregnant. Bloating and distension can be experienced separately as well as simultaneously, but they both share similar effects.[3]

Bloating and distension tend to be caused by a build-up of gas in the digestive system and regular features of them can include:

  • Increasing in effect as the day goes on. (For example, that feeling of not being able to wait to take your constrictive clothes off and put comfy, stretchable clothes on when you get home.)
  • It happens temporarily after a meal.
  • It tends to reduce naturally overnight.

What is normal bloating?

It is perfectly normal to have a small amount of bloating after eating a meal because it is naturally caused by the process of eating and digesting food and it then moving through the intestinal system. If you feel gas moving in your abdomen or a bit of tightness after eating this is all normal if it passes with no real discomfort.

What is not normal bloating?

It is not normal if you experience bloating with: pain; nausea; heartburn; diarrhoea; cramps; excessive wind; or foul-smelling wind. If your bloating comes with any other symptoms you should speak to your doctor especially if the bloating persists and you have a constant feeling of fullness all the time.

If you often feel bloated it could be due to:

Eating too fast: Not chewing food properly before swallowing it can cause bloating. This is because saliva in the mouth starts to break down proteins as you chew. If you are not chewing your food enough then saliva is not being distributed through the food, so it makes it harder for your body to digest the food. So, follow your grandmother’s advice and “Chew each mouthful 20 times before swallowing!”.

  1. Caffeinated or fizzy drinks: Caffeine in these drinks act as a stimulant which causes the gut to spasm. Also, the bubbles in fizzy drinks contain carbon dioxide which puts gas directly into your digestive system, leading to feelings of bloating and distension.
  2. Chewing gum: This is one of the first questions I ask patients during a digestive health consultation because most sugar-free chewing gum contains sorbitol which is a laxative that can cause gut issues, such as bloating.
  3. Skipping meals: Long gaps between meals can cause your body to produce excessive wind and bloating.
  4. Tight clothing: We can all be found guilty of wearing clothing that is too tight. However, if the clothes constrict the abdomen it makes it harder for food and gas to pass through the digestive system, causing discomfort.
  5. Large meals: When you eat too much food in one sitting it all arrives in your gut at the same time which forces the digestive system to work harder and can cause discomfort.
  6. Drinking fluids while eating: It is best to avoid drinking while eating a meal because it dilutes your digestive juices. Saliva contains amylase (an enzyme which breaks down the starch in foods), so if you drink liquids while eating it makes your digestive juices less effective, leading to bloating. As a result, try to drink fluids in between meals.
  7. Monitor your food intake: Certain foods can naturally produce gas during digestion, such as beans, cabbage, onions, sprouts, broccoli and cauliflower. However, they are nutritionally beneficial, so if you can tolerate them try to include smaller portions of them within your diet.
  8. Holding in a motion (poo): Many people feel uncomfortable about passing a motion in public, communal or workplace toilets. This is understandable, but doing this can cause a build-up of gas and unnecessary bloating.
  9. Increasing fibre too quickly: Increasing your fibre intake too much too quickly can cause the gut to work harder as it struggles with the elevated amount. This can lead to increased wind and bloating. As a result, it is best to increase your fibre intake gradually over a few weeks to try and prevent this.
  10. Stress: Stress is renowned for causing upset to the gut because of the tight gut-brain connection.[4] In order to combat this, try to take time to relax and de-stress.
  11. Eating position: If you are eating most of your meals off your lap or bent over a desk this can restrict the movement of food through your digestive system leading to wind and bloating. To prevent this, sit comfortably at a table and try to eat your meal slowly and mindfully. Talking and eating at the same time also makes you swallow air, so try to finish your mouthful before speaking.
  12. Hormonal Changes: It is common for women to experience bloating during or around the time of their menstrual period. The fluctuations in progesterone and oestrogen levels can cause the digestive system to become sluggish and cause water retention, bloating, and constipation. Similar symptoms can be experienced during menopause.
  13. Small Intestine Bacterial Overgrowth (SIBO): SIBO is a condition in which the amount of bacteria within the small intestine increases. This means that more food can be fermented by the bacteria in the gut which leads to increased gas and bloating.

 

Strategies to avoid bloating

Whatever the cause, there are some strategies that we can use to prevent bloating – with some as simple as drinking water! Check out some easy strategies below:

All of these tips will help with your bloating, but if problems persist consult your doctor.

If you have any questions please drop me an email – info@lesleyreiddietitian.co.uk

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