The discomfort of gastritis can be acute but many patients make the mistake of neglecting the problem, “doctor hopping” and popping antacids instead of seeking proper treatment, says Dr. Shyama Fernando.
This leads to patients having to deal with side effects and occasionally means that a possibly more sinister underlying problem is left untreated. This week, Dr. Fernando talks to Mediscene about the causes of gastritis and what treatment options look like.
What is gastritis?
The stomach as you know is a J shaped organ which collects the swallowed food. The stomach lining contains special cells that produce acids and enzymes and this breaks down the ingested food, churns it and grinds it and passes it down to the small intestine.
The irritation or inflammation of the stomach lining is called gastritis and this can be sudden (acute) or develop over a long period (chronic).
If chronic gastritis is not treated this may last for a long time interfering in one’s daily activities. Sometimes the inflammation could be more severe and wear away the lining – this is called erosive gastritis and leads to bleeding and ulcers.
It is noted that all people who have gastritis do not have symptoms and this term gastritis is mistakenly used by many to describe any upper abdominal pain or discomfort. This commonly occurs after a meal and subsides slowly after sometime. However if this is severe and interferes with the patient's normal lifestyle it needs investigation and treatments.
What are the usual
symptoms of gastritis?
Upper abdominal discomfort or pain, heartburn or the burning feeling behind the breastbone, reflux of acid or sour contents in the mouth, nausea ‘bloating’ sensation or vomiting, fatigue or breathlessness (chronic cases), blood stained vomit or dark stools.
What causes gastritis?
Drugs such as aspirins, NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) or pain killers. These drugs when taken for short spells cause no problems but when taken for long periods can lead to ulcers. In certain individuals alcohol can cause damage to the stomach lining and stimulate acid production.
Helicobacter Pylori bacteria that can live in the lining of the stomach can infect the underlying tissue and lead to ulcers and even to stomach cancers in certain people. However, now there are ways to make this diagnosis and treat it.
Generally the body’s defence systems make antibodies that can fight off infection and keep the body healthy. However in certain individuals the body mistakenly attacks its own proteins as foreign and damages it. The stomach lining too can be attacked by these cells and damaged. This can result in a condition called Pernicious anaemia or auto-immune gastritis where the body no longer can absorb the vitamin B12 and this leads to anaemia.
How is gastritis diagnosed?
The physician usually listens to your medical history and performs certain tests.
During a blood test your doctor will check for anaemia where the iron containing substance – haemoglobin - could be diminished if there is bleeding in the stomach. A stool test could be used to check for the presence of occult blood in the stools and indicates presence of bleeding. Upper GI Endoscopy is an examination done under mild sedation.
Here a lighted flexible tube with a camera is passed through the mouth into your stomach and the lining is visualized by your doctor. If any suspicious area or bleeding point is seen, a biopsy specimen could be taken through the scope and examined. The test for H.pylori infection is also done.
How do you approach
treatment?
This would depend on the cause. If H.pylori is present a suitable course of antibiotics is given. However, in all cases reduction of the stomach acid is the main – stay of treatment and dietary adjustment is also advised. Eating moderate portions, at regular times in a relaxed fashion is a good idea.
Prioritise rest and relaxation. Just as work is important in one’s life, rest and relaxation is vital. This would help you to focus your mind better at work, calm your anxiety and reduce or relieve your daily anxiety and tension be it physical or mental. If the symptoms occur after certain foods or activities those should be avoided. Keeping a diary will help you identify these foods and activities. You can then continue to enjoy their activities which do not provoke symptoms so that your lifestyle is not restricted unnecessarily.
Patients should review their symptoms with their doctors who will then evaluate their condition and advise them on the treatment options. Also other “trigger factors “should be eliminated. |
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