Acute gastritis (inflammation of the gastric mucosa)

Acute gastritis (inflammation of the gastric mucosa)
International Classification (ICD) K29.1
Symptoms epigastric pain, gastrointestinal haemorrhage, Symptoms of poisoning, Fever, Circulation, Pain, Nausea, frequent belching, Heartburn, Loss of appetite
Possible causes Alcohol, Nicotine, stomachic stimulants, Painkiller, Stress, Runner's Stomach, Helicobacter pylori

Basics

Gastritis, or inflammation of the gastric mucosa, is an inflammation-related damage of the gastric mucosa(lat. Tunica mucosa gastrica), whereby, depending on the variation, superficial to deeper changes in the glandular tissue may occur. In principle, a distinction is made between acute and chronic gastritis.

Possible cause of stomach pain

The gastric mucosa is a protective layer that lines the inside of the stomach. This protects the stomach wall from the digestive juices. Injuries to the mucosa, also called erosions, allow the juices of the stomach to destroy the cells of the stomach wall. The affected person usually experiences gastrointestinal discomfort when this happens. However, gastritis can also go unnoticed for a long period of time.

Multiple causes and serious consequences

The causes of gastritis are very diverse, but in many cases acute gastritis can heal without any residual damage. In some cases, however, gastritis can develop into a stomach ulcer. This is a deeper wound of the mucous membrane. This can then lead to stomach bleeding, a gastric perforation or even stomach cancer.

Causes

As already mentioned above, the causes for gastritis can be manifold. Harmful substances or other factors that cause an excess of gastric acid can be the causes. In principle, the following triggers of acute gastritis can occur:

  • Excessive intake of alcohol
  • Above-average intake of nicotine
  • Above-average, frequent consumption of stomach-irritating stimulants (e.g. coffee, hot spices)
  • Above-average, overdosed consumption of certain medications (painkillers, anti-inflammatory drugs)
  • Psychological and physical stress
  • Bacteria-induced food poisoning (e.g. staphylococci, salmonellae) The ingested bacteria play less of a role here than their metabolic products. These act like a poison in our body, destroying the stomach lining. In some cases, gastritis can be contagious. In this case, the pathogens can spread through the same toilet use of several people.
  • Irritation of the gastric mucosa by foreign bodies such as a stomach tube
  • Acids or alkalis
  • Surgical procedures or circulatory failure (i.e., shock)
  • "Runner's stomach" due to factors such as running, diet and hormones causing acidity of the stomach

Infections

In principle, the stomach is very well protected against all kinds of pathogens. However, acute gastritis can still occur due to pathogens, especially in the course of gastroenteritis.

A special form of acute gastritis is triggered by the bacterium Helicobacter pylori. In this case, it is important to detect the exact pathogen so that a therapy can be carried out.

Symptoms

The most important symptom of acute gastritis is pain, which is called epigastric pain. This is located directly above the stomach, that is, in the upper abdomen. But this does not mean that everyone with acute gastritis must also suffer from stomach pain. In contrast, the inflammation of the gastric mucosa often proceeds without pain. Gastritis can cause a variety of different symptoms. The main symptoms are characteristic of both acute and chronic gastritis. However, there is one difference: in acute gastritis the symptoms appear abruptly, whereas in a chronic form they develop over a longer period of time.

Provocation by meals

In general, it can be observed that the symptoms of acute gastritis are particularly pronounced after meals. Thus, one may be completely painless between these, but any ingestion of food triggers severe pain due to the stretching of the stomach wall.

This then also affects the feeling of satiety. So even without stomach pain, many sufferers notice that they simply get full sooner. However, nausea, frequent belching, heartburn, loss of appetite, a bland taste in the mouth or an unpleasant feeling of fullness may also occur.

Blood in vomit

In the context of severe (erosive) gastritis, blood may also be present in the vomit. The symptoms are similar to upper gastrointestinal bleeding, a potentially dangerous clinical picture, which is why a specialist should always be consulted.

Depending on the cause of the mucosal inflammation, acute gastritis can lead to a whole range of other symptoms. These include not only general symptoms of poisoning, but also fever and circulatory weakness.

Diagnosis

In the case of stomach problems, the general practitioner is usually visited first. If necessary, he or she can refer you to a gastroenterologist, a stomach specialist.

The suspected diagnosis of acute gastritis can be made with the help of an anamnesis, a questioning about your medical history. This may be followed by a physical examination. This usually involves listening to the abdominal region. The doctor will listen for bowel sounds and the pulse of the larger blood vessels. By tapping the abdomen, accumulations of air or fluids can be registered. Palpation of the region, including the liver and spleen, can also detect indurations.

Reliable diagnosis by endoscopy

One method of clearly detecting acute gastritis is endoscopy. For this purpose, a tube with a camera is inserted through the mouth into the stomach.

In the case of acute gastritis, a red and swollen mucous membrane can be seen. Tiny samples can be taken with a small forceps to also find out the definite cause of the gastritis (i.e. biopsy).

Only through the samples can it be ruled out that there is a more dangerous condition. In this way, stomach cancer or a stomach ulcer can be ruled out. In addition, pathogens can also be detected in order to exclude a dangerous infection with Helicobacter pylori (e.g.: with the help of a urease rapid test).

Therapy

Mild forms of acute gastritis can also heal spontaneously on their own in most cases. The use of medication can also prevent further injury to the gastric mucosa and promote healing. More severe gastritis must be treated with more specific methods.

Supporting spontaneous healing

There are a few ways that healing can be supported. For example, one should definitely check all medications taken and also over-the-counter remedies to see if they can damage the stomach lining.

As a first measure, everything that irritates the stomach lining can be avoided during the period of acute gastritis. Abstaining from coffee, alcohol and nicotine could considerably improve the healing process.

In addition, one could completely abstain from solid food for one or two days, or at least eat a light diet. Sufficient fluid intake can help the gastritis to subside more quickly.

Symptomatic treatment of accompanying symptoms

If, in addition to stomach pain, nausea and vomiting also occur, it is of course advisable to prevent this as much as possible. So-called antiemetics are available for this purpose, which curb the urge to vomit.

Non-prescription acid inhibitors

If the problem persists, you can think about taking so-called acid inhibitors, which are freely available in pharmacies. These curb the acidification in the stomach, which can relieve the symptoms. However, this should be done with moderation and purpose, as the acid in the stomach also has the purpose of protecting against infections. Active substances that neutralize stomach acid, indicate the stomach acid pH and improve acid-related complaints are also called antacids.

Eradication in case of a bacterial cause

If it can be determined that the acute gastritis was caused by bacteria, such as Helicobacter pylori, then it makes sense to perform a so-called eradication. This temporarily destroys all bacteria in the stomach.

H2 blockers and proton pump inhibitors in severe cases

In severe cases of acute gastritis, H2 blockers or proton pump inhibitors can also be considered. Both ensure that less acid is produced in the stomach, which naturally irritates the injured stomach lining and prevents healing. These drugs should be taken only after the exact clarification by a doctor.

Forecast

Especially mild cases of acute gastritis should heal spontaneously within a few days without drug therapy. In severe cases, medication must be administered, but these can usually also be treated well.

Helicobacter pylori worsens prognosis

The situation is somewhat different in acute gastritis caused by Helicobacter pylori. In this case, a chronic inflammation of the gastric mucosa can often develop. For this reason, acute gastritis should not be treated lightly - medical clarification is always necessary. Only in this way can eradication prevent chronification (i.e. transition from temporary to chronic disease).

Gastric ulcers and gastric bleeding as a dangerous consequence

Close observation is indicated in any case. This is because in some cases gastritis can also develop into a gastric ulcer. The occurrence of life-threatening gastric bleeding cannot be ruled out either.

Prevent

Prophylaxis is especially important if you have already gone through acute gastritis. Because then you can assume that the stomach lining tends to become inflamed.

In general, it can be said that a healthy and balanced diet could be helpful. This includes reducing the amount of fat and taking in enough fiber. Lush seasoning, citrus fruits, coffee, alcohol and nicotine should be avoided as much as possible.

When eating, it is helpful to eat slowly and in a relaxed manner.

Avoid medicines that are harmful to the stomach

In addition to these behaviors regarding diet, one should also avoid overdosing on medications that irritate the mucous membrane. These include, for example, a large proportion of anti-inflammatory and painkilling drugs, such as acetylsalicylic acid, ibuprofen or naproxen.

Ensure sufficient relaxation and recuperation

Stress and strain are all too likely to affect the stomach. That's why you should make sure you find opportunities and times when you can relax and unwind. Not only relaxation techniques, but exercise can also help provide balance.

In general, prophylaxis with anti-acid medications can reduce the incidence of acute stress gastritis in high-risk patients receiving intensive care. This involves intravenous injection of H2 blockers, proton pump inhibitors, or agents that neutralize gastric acid.

This may also be the case for the following patients:

  • severe burns
  • craniocerebral trauma
  • coagulation disorders
  • sepsis
  • Circulatory failure
  • Polytrauma
  • certain organ failures or a history of peptic ulceration or gastrointestinal bleeding

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