Gastritis

What is Gastritis?

Gastritis is an inflammation, irritation or erosion of the stomach mucosa. Gastritis is not one disease but a group of conditions, which are characterized by inflammation of the lining of the stomach. Gastritis can broadly be divided into acute gastritis and chronic gastritis.

Acute Gastritis:

Acute gastritis is a sudden inflammation of the lining of the stomach. Acute gastritis is a term covering a broad Spectrum of entities which include inflammatory changes in the gastric mucosa.

Inflammation of the whole stomach is called PANGASTRITIS and an inflammation of a part of stomach is called ANTRAL GASTRITIS.

Acute gastritis can divided into:

Causes include medications, alcohol, eating or drinking corrosive substances, extreme physiological stress, and infections. Acute gastritis is often associated with a severe, acute illness, or trauma. The risk factors include nonsteroidal anti-inflammatory drug use (NSAIDs), recent heavy alcohol use, and physiological stress such major surgery, head trauma, renal failure, liver failure, or respiratory failure.

Chronic Gastritis:

Chronic gastritis is an inflammation of the lining of the stomach that occurs gradually and persists for a prolonged time. Chronic gastritis may be caused by prolonged irritation from the use of nonsteroidal anti-inflammatory drugs (NSAIDs), infection with the bacteria Helicobacter pylori, pernicious anemia (an autoimmune disorder), degeneration of the lining of the stomach from age, or chronic bile reflux.

What are the Causes of Gastritis?

Bacterial infection:

Helicobacter pylori (H. pylori) that live deep in the mucosal layer, which coats the lining of the stomach. Although it's not entirely clear how the bacteria are transmitted, it's likely they spread from person to person through the oral-fecal route or are ingested in contaminated food or water. H. pylori infection frequently occurs in childhood and can last throughout life if untreated. It's now known to be the primary cause of stomach ulcers and is a leading cause of gastritis. Long-term infection with the bacteria causes a widespread inflammatory response that leads to changes in the stomach lining. One of these changes is atrophic gastritis, a condition in which the acid-producing glands are slowly destroyed.

Bile reflux disease:

Bile helps in digestion of fat. The liver secrets bile and stores it in the gall bladder. After releasing from the gallbladder, the bile goes into the small intestine through biliary ducts; the pyloric valve prevents bile from flowing back into stomach from the small intestine. Dysfunction of the valve gives rise to back flow of bile into the stomach, leading to inflammation of the gastric mucosa.

Pernicious anemia:

Permicious anemia can result in atrophic gastritis. People with pernicious anemia may have gastric polyps and get gastric cancer and gastric carcinoid tumors twice as often than the normal population.

Autoimmune Gastritis:

The immune system makes antibodies and other proteins that fight off infection and keep the body healthy. In some disorders, the body mistakenly targets one of its own organs as a foreign protein or infection. It makes antibodies against it and can severely damage or even destroy the organ. The stomach lining also may be attacked by the immune system leading to loss of the stomach cells. This causes acute and chronic inflammation which can result in a condition called pernicious anemia. The anemia occurs because the body no longer can absorb vitamin B12 due to a lack of a key stomach factor, destroyed by the chronic inflammation. A form of anemia that occurs when the stomach lacks a naturally occurring substance needed to properly absorb and digest vitamin B12. A lack of vitamin B12 may change the surface of the tongue and shrink or thin the stomach lining.

Regular use of pain relievers:

Non-steroidal anti-inflammatory drugs (NSAIDs) reduce prostaglandin which preserves the stomach mucosa thereby cause inflammation of stomach lining.

Stress:

Severe stress due to major surgery, traumatic injury, burns or severe infections can cause gastritis as well as ulcers and stomach bleeding.

Alcohol addiction:

It can irritate and erode the gastric mucosa.                                         

Cocaine:

Cocaine damages the stomach lining and may lead to hemorrhage. 

Radiation and chemotherapy:

Chemotherapy and radiation given for cancer can cause irreversible erosions of the stomach lining and destruction of acid-producing glands.

Other factors:

Gastritis may be associated with other medical conditions, including HIV/AIDS, parasitic infections, some connective tissue disorders, and liver or kidney failure.

What are the Signs and Symptoms of Gastritis?

The signs and symptoms of gastritis include:

• A gnawing or burning ache or pain in the upper abdomen that may become either worse or better after eating.
• Loss of appetite.
• Bloating: A feeling of fullness in upper abdomen after eating
• Weight loss.
• Belching: Belching either does not relieve the pain or relieves it only briefly.
• Nausea and vomiting: The vomit may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation.

In more severe gastritis, bleeding may occur inside the stomach. Any of the following symptoms can be seen as well as those already mentioned.

• Pallor, sweating, and rapid (or "racing") heart beat.
• Feeling faint or short of breath
• Chest pain or severe stomach pain
• Vomiting large amounts of blood
• Bloody bowel movements or dark, sticky, very foul-smelling bowel movements

How Gastritis is Diagnosed?

Gastritis is diagnosed on the basis of medical history and physical examinations of the patient and the following tests:

§         Blood tests. Blood test to detect presence of H. pylori antibodies. A positive test shows that you've come in contact with the bacteria at some time in your life, but it doesn't necessarily indicate current infection. Blood tests can also check for anemia, which may result from stomach bleeding associated with gastritis.

§         Stool tests. To check H. pylori presence in a sample of stool. A positive result shows current infection. Test for the presence of blood in stool, a sign of gastric bleeding.

§         Upper gastrointestinal X-ray. After swallowing barium liquid which coats the lining of digestive tract, it is easier to check signs of gastritis and other digestive problem.

§         Upper gastrointestinal endoscopy. On taking X-ray if gastritis is still doubtful then we will go for endoscopy. This procedure allows seeing abnormalities in the upper gastrointestinal (GI) tract that may not be visible on X-rays. If any tissue in your upper intestinal tract looks suspicious, your doctor can remove a small sample (biopsy) using instruments inserted through the endoscope. The sample is then sent to a lab for examination by a pathologist. Risks of the procedure are rare and include bleeding and perforation of the stomach lining. The most common complication is a slight sore throat from swallowing the endoscope.

What is the Treatment of Gastritis?

Conventional/Allopathic Treatment

Treatment depends upon the cause of gastritis. It may include lifestyle changes, medication or rarely surgery. Medication includes, Antacids, H2 blockers, Proton pump inhibitor, Antibiotics, antidiarrheal agents etc. In some patients the side effects of these drugs may seen:

§         Antacids: Antacids containing Aluminum and Magnesium are given but contraindicated in documented hypersensitivity, it can’t  be safely used in pregnancy as it  decreases effect of allopurinol, amprenavir, chloroquine, corticosteroids, diflunisal, digoxin, ethambutol, iron salt, H2 antagonists, isoniazid, penicillamine, phenothiazines, tetracycline, thyroid hormones & ticlopidine; increases effect of benzodiazepines & amphetamine; may cause Aluminum toxicity with ascorbic acid.

Magnesium containing antacids may cause diarrhea and may lead to dehydration.

Patient having history of gastrointestinal bleeding can not take Aluminum and Magnesium containing antacids.

§         H2 Blockers: Cimetidine [Tagmet] is commonly given to the patient, it may lead to confusional states; may cause impotence and gynaecomastia in young males.

§         Proton Pump Inhibiters: Omeperozol [Prilosec] drug given to patients may increase toxicity of warfarin, digoxin and phenytoin.

§         Antibiotics: Amoxicillin [Amoxil, Trimox], is contraindicated in hepatic dysfunction. It reduces efficacy of oral contraceptives. Tetracycline used during teeth development can cause permanent discoloration of teeth.

§         Antidiarrheal Agents: They are used along with antibiotics and proton pump inhibitors/H2 Receptor Antagonists to eradicate H.Pylori. Administration along with anticoagulants may increase risk of bleeding. It may cause darkening of tongue and black stool which is temporary.

 

Homeopathic Treatment of Gastritis

 

Reportorial rubric

Therapeutics

Nux Vomica, Lycopodium, Phosphorus, Arsenic album, Veratrum album, Bryonia alba, Belladonna, Graphites, Carbo vegetabilis, Argenticum Nitricum, Mercurious, Kali bichromicum, China officinalis, Sulphur, Kali carbonicum, Pulsatilla, Aconite

Gastritis Therapeutics:

Nux Vom:-

Heartburn with flatulence. Nausea and vomiting in the morning. He feels “If I could only vomit I would be so much better”. Alternating constipation and diarrhea. Eructations sour, bitter; nausea and vomiting every morning with depression of spirits, after eating. Heartburn. Drinking milk seems to cause acidity. Hunger, but if he eats ever so little, he is satisfied and feels quite full. Repeated, violent vomiting of sour mucus with headache or with blood. Nux vomica is mostly indicated in case of chronic gastritis which is caused by tobacco, alcoholic stimulants, aromatic or patent medicines, sedentary habits, highly spiced food. Contractive, squeezing stomachache. 

Lycopodium:-

It has pain in the pit of stomach when the hypochondria are pressed and pain in hypochondria when the pit of stomach is pressed. There is fullness even after a light meal, with no intestinal irritation. Offensive discharges. Eructation ameliorates gastric troubles. Bitter taste in mouth at night, sour vomiting. A grand characteristic of Lycopodium is, “The patient goes to meals with a vigorous appetite, but after eating a small quantity of food he feels so full and bloated that he has to force himself to swallow another mouthful; and he leaves the table with his hunger, only momentarily satisfied.”

Phosphorus:-

Gastritis with chronic erosion. Burning, gnawing circumscribed pain. The all gone, weak feeling at 11 a.m. starting from stomach to bowel.  Craves for cold food and cold drinks which give relief temporarily, but are vomited as soon as they become warm in stomach. Very useful remedy in the vomiting of chronic dyspepsia.

Arsenic Album:-

Foul, bitter or sour taste. Burning pain in stomach like fire, as if hot coals were applied to part, better by hot application, hot drinks. Acrid and bitter eructation. Irritative dyspepsia and acute inflammation. Nausea, retching and vomiting of slimy mucus tingled with blood. Trembling and coldness of extremities with pain in stomach and oppressive anxiety.

Veratrum album:-

Hiccups after hot drinks. Forcible eructations, mostly of air. After eating, empty eructation of air. After frequent eructation, copious ejection of mucus. Constant sick eructation with very violent cough. Voracious hunger, great thirst. Vomiting is -

Colicky pain with salivation, profuse cold perspiration. 

Bryonia Alba:-   

Is best adapted to persons of gouty or rheumatic diathesis. Great thirst for large quantities at long intervals. Pressure as from stone at pit of the stomach, relieved by eructation. Stool large, hard, dark, and dry, as if burnt. Diarrhoea during a spell of hot weather; bilious, acrid with soreness of anus; like dirty water; of undigested food; from cold drinks when overheated, from fruit or sour foods aggravated in morning, on moving, even a hand or foot and ameliorated by absolute rest. Aggravation from any motion, and corresponding relief from absolute rest, either mental or physical. Pains: stitching, tearing, worse at night;

Belladonna:-

Abdominal pain in short attacks, causes redness of face and eyes. Abdomen tender, distended; aggravated by least jar. Loss of appetite with desire to drink without thirst. Eructation and vertigo. Nausea and inclination to vomit. Violent stomachache after a meal. Bilious vomiting.

Graphites:- 

Distention of stomach and bowel, obliged to loosen clothing. Gastralgia. burning, crampy, colicky pain in the stomach, ameliorated after eating.  Cramps in the epigastrium and putrid eructation. Sweets nauseate and disgust, hot drinks disagree. Aversion to meat. Flatus rancid or putrid. 

Carbo vegetabilis:-

Violent burning in the stomach, with paroxysmal cramps which force the patient to double up; with flatulence. Putrid variety of dyspepsia. Slow digestion; feels as if a weight in the stomach, which is not relieved by eating; but after a few mouthfuls there is a sense of fullnesss. Eructations are rancid, putrid or sour.

Argentum Nitricum:-

Violent belching and great relief from it. Pain is gnawing, ulcerative, referred to the pit of stomach. Vomiting of glairy mucus, which can be drawn into strings. Longing for sugar which aggravates the complaints.  Pain in spot radiates to every direction.

Mercurious solubilis:-

It has deathly faintness at the pit of stomach. Profuse saliva in the mouth. Stool hot, scanty, bloody, slimy, and offensive, with terrible cutting, colicky pains. Useful in painful acute inflammation. Tenesmus, not relieved by stool. A never get done feeling in the rectum.

Kali bichromicum:-

Gastric complaints from bad effects of beer. Loss of appetite. Weight in pit of stomach. Flatulence aggravated soon after eating. Vomiting of ropy mucus and blood; round ulcer in the stomach. Can not digest meat.

China officinalis:-

It is best suited to weak patients having low vital power. Sensation of satiety after a few mouthfuls of food. Sour, bitter eructations; flatus is offensive. Slow digestion and patient faints easily. There is a sensation as if food had lodged in the oesophagus. In cases where the food does not digest, but lies a long time in the stomach, causing eructations and finally is vomited out undigested.    

Sulphur:-

Burning in the stomach. Gastritis caused by chronic alcoholism. When carefully selected remedies fail to produce favorable effects, especially in acute diseases, it frequently serves to rouse the reactive powers of the system. Weak, empty, gone or faint feeling in the stomach about 11.a.m. and can not wait for lunch. Congestion of abdomen. Stool acrid excoriating. It follows Aconite well. Sour eructation all the day. Long heartburn. Belching up of a portion of the food that had been eaten. In the morning inclination to vomit. Morning nausea. Bulked eructation on going to sleep.

Kali carbonicum: -

It is indicated where the system is broken by long term bacterial infection, pernicious anemia, hazards of radiation and chemotherapy. Putrid belching, dyspepsia with sleepiness. Before eating, there is a faint sinking feeling in the epigastrium out of proportion to the feeling of vacuity caused by hunger, with sour eructation, heartburn and with peculiar weak nervous sensation. Desire for sugar and sweet.

Pulsatilla:-

Adapted to persons of indecisive, slow, phlegmatic temperament; sandy hair, blue eyes, pale face, easily moved to laughter or tears. All gone sensation in the stomach. Great dryness of mouth. Diminished taste of all food. In the morning sour eructation, in the evening bilious eructation, in the night bitter eructation. Intolerable nausea; short and bilious vomiting. Inclination to vomit with grumbling and rumbling in the sub costal region. Flatulent colic. Stool mingled with little blood. Pinching pain in epigastrium.  Thirstlessness with nearly all complaints. Gastric difficulties from eating rich food, cake, pastry, especially after pork or sausage; the sight or even the thought of pork causes disgust; "bad taste" in the morning.

Aconite:-

Aconite is indicated in acute gastritis condition. Empty eructation, ineffectual effort to eructate. Nausea and vomiting with profuse perspiration, swollen, distended abdomen. Complaints are with mental anxiety accompanied with restlessness. Pains are intolerable, they drive him crazy.

Some Diet & Lifestyle Tips for Gastritis:

§      Eating habits. If you experience frequent indigestion, eat smaller, more frequent meals to buffer stomach acid secretion. Avoid any spicy, acidic, fried or fatty food. Practice good eating habits.

§      Avoid alcohol. It irritates and erodes the mucous lining of the stomach, causing inflammation and bleeding.

§     Don't smoke. Smoking interferes with the protective lining of the stomach, making the stomach more susceptible to gastritis as well as ulcers. Smoking also increases stomach acid; delays stomach healing and are a leading risk factor for stomach cancer. Still, quitting isn't easy, especially if you've smoked for years. Talk to your doctor about methods that may help you stop smoking.

§         Switch pain relievers. Some may cause stomach inflammation or make existing irritation worse.

§         Follow doctor's advice. Your doctor may recommend that you take an over-the-counter antacid or acid blocker to help prevent recurring gastritis.

§         Maintain a healthy weight. Heartburn, bloating and constipation tend to be more common in obese people. Maintaining a healthy weight can often help prevent or reduce these symptoms.

§          Exercise regularly. Aerobic exercise that increases your breathing and heart rate also stimulates the activities of intestinal muscles, helping to move food wastes through your intestines more quickly.

§         Manage stress. Stress increases risk of heart attack and stroke, increases stomach acid production and slows digestion. For relaxation practice yoga. Make a habit of regular exercise, morning walk, eat healthy, nutritious food, it boosts your immune system & makes you calm.