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

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