1 Causes and Treatment
1.2.2 Helicobacter pylori
5 See also
Gastritis is an inflammation of the lining of the stomach, and has many possible causes. The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori. Certain diseases, such as pernicious anemia, chronic bile reflux, and certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting. Some may have a feeling of fullness or burning in the upper abdomen. A gastroscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis. Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, or avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given.
Erosive gastritis is gastric mucosal erosion caused by damage to mucosal defenses. Alcohol consumption does not cause chronic gastritis. It does, however, erode the mucosal lining of the stomach; low doses of alcohol stimulate hydrochloric acid secretion. High doses of alcohol do not stimulate secretion of acid. NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the biosynthesis of eicosanoids in the stomach, which increases the possibility of peptic ulcers to form. Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach called prostaglandin. These drugs used in a short period of time are not typically dangerous. However, regular use can lead to gastritis.
If the cardiac sphincter fails to do its job properly, some stomach acid can escape up the esophagus. This causes very painful "heartburn" or "gastritis" in the chest as the esophageal walls are eroded by the hydrochloric acid. Chronic gastritis refers to a wide range of problems of the gastric tissues that are mainly the result of H. pylori infection. The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders, the body accidentally targets the stomach, believing it is a foreign protein or pathogen. It makes antibodies against, severely damages, and may even destroy the stomach and/or its lining. In some cases, bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach, because it had been removed during surgery or may not work properly. This also leads to gastritis. Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn's disease, certain connective tissue disorders, or liver/kidney failure.
Mucous gland metaplasia, the reversible replacement of differentiated cells, occurs in the setting of severe damage of the gastric glands, which then waste away (atrophic gastritis), which are progressively replaced by mucous glands. Gastric ulcers may develop; it is unclear if they are the causes or the consequences. Intestinal metaplasia typically begins in response to chronic mucosal injury in the antrum, and may extend to the body. Gastric mucosa cells change to resemble intestinal mucosa and may even assume absorptive characteristics. Intestinal metaplasia is classified histologically as complete or incomplete. With complete metaplasia, gastric mucosa is completely transformed into small-bowel mucosa, both histologically and functionally, with the ability to absorb nutrients and secrete peptides.