Nearly all of us have thrown up from time to time after eating. Sometimes we ate food that wasn’t properly cooked. Vomiting can also be the first unwelcome sign of the flu. Throwing up material that looks like coffee grounds or finding tarry black stool in the toilet bowl is a different matter. These symptoms are signs something serious is going wrong in your digestive system. While many different digestive conditions share symptoms, black, tarry feces or throwing up coffee ground-like material is a good indication you may have gastritis. 

What Causes Gastritis?

Gastritis is an erosion of the lining of the stomach. This is caused by irritation and inflammation of the stomach lining when your body makes more stomach acid than it should. Gastritis can occur gradually over time, known as chronic gastritis, or it can develop suddenly in what is called acute gastritis. 

Acute gastritis, such as that caused by an infection of helicobacter pylori bacteria, will nearly always develop into chronic gastritis unless you begin treatment with antibiotics. Many factors can lead to gastritis, including other gastric or medical conditions, foreign bacteria or drugs like ibuprofen. The overly acidic environment in the stomach associated with gastritis can arise from a variety of causes, but the effects are usually the same.

An infection caused by Helicobacter Pylori bacteria is one of the most common causes of gastritis. Gastritis caused by this bacteria affects nearly two-thirds of the people on our planet, though many do not develop symptoms of an infection. This extremely common infection causes inflammation and damage to the stomach lining and the upper portion of the small intestine. The presence of H. pylori bacteria causes your body to release more acid into the stomach than usual. This increase in the amount of acid can eventually wear away at the lining of your stomach, leading to ulcers. 

It's not completely understood how H. pylori infections spread, but evidence suggests contaminated food and water could play a role, as well as person to person contact. To protect yourself from potential infections, wash your hands with soap and water frequently, especially before eating. You can further reduce your likelihood of exposure by only eating thoroughly cooked foods.

Infections are not the only reason your stomach lining may suffer. Your own body can sometimes be responsible for attacking cells in the stomach. Known as autoimmune gastritis, this form of gastritis occurs when your immune system begins attacking the tissues of your digestive tract. Eventually, this can wear away at the lining of the stomach, causing damage to the underlying tissues.

You are at a higher risk of autoimmune gastritis if you have already been diagnosed with other conditions such as type 1 diabetes or Hashimoto's disease or even HIV/AIDS. It is possible, though, that autoimmune gastritis may be related to vitamin B-12 deficiency even if you do not have diabetes or other autoimmune disorders. Autoimmune gastritis is not the most common form, but it can be difficult to treat since diet, lifestyle or an easily treatable bacterial infection are not the root causes. 

Lifestyle factors like excessive alcohol consumption, smoking, stress or illicit drugs can all contribute to gastritis. These factors contribute to ongoing irritation of the stomach lining by causing the stomach to produce more acid than usual, even when food is not present. Making changes to your lifestyle can go a long way to reducing your symptoms, and will be an effective part of recovery from gastritis even if your doctor prescribes other forms of treatment.

Eliminating chronic stress from your life wherever possible is very important. When you are stressed, you will likely have elevated levels of hormones such as cortisol in your bloodstream. These hormones can cause the stomach to release gastric acid even when there is no food present to be digested. Maintaining a healthy diet and eating at appropriate intervals can help reduce the damage caused by extra acid, but ultimately it is important to fix the underlying issue.  

The gastric erosions that result from damage to the lining of the stomach and duodenum are sometimes known as curling ulcers. As stress levels increase, your body’s ability to repair damaged tissues is reduced. This lowered ability to heal, combined with the increased levels of stress hormones and gastric acid, can combine with a decrease of blood flow to the stomach to make for a very toxic combination primed for the formation of ulcers. 

People might list work or relational issues as stress, but there is more to the picture.  Intracranial trauma, ventilator dependency, and past emotional trauma are all forms of stress on the body that can make erosion of the stomach lining possible. Treating your gastritis if stress is a major cause may involve more than just taking antacids to calm your stomach or relieve indigestion. Seeking therapy or counseling to resolve emotional issues or changing work and lifestyle stresses may be necessary. 

The backflow of bile into your stomach can also contribute to gastritis. When you are healthy, bile and pancreatic juices move through the common bile duct into the intestines. If anything is obstructing this flow, bile may flow into the stomach instead of down into your intestines. This condition is known as bile reflux gastritis. A related condition further up the digestive tract is known as GERD or gastroesophageal reflux disease. GERD occurs when the bile excreted by the liver makes it all the way back through the stomach and into the esophagus. It can be difficult to distinguish between GERD and bile reflux gastritis, but greenish-yellow bile in your vomit is a good sign bile is entering the stomach and causing irritation. 

What Are the Symptoms of Gastritis?

Several types of gastrointestinal disorders share common symptoms, and gastritis is among them. Below is a list of the most common symptoms that may indicate you have gastritis:

  • indigestion
  • vomiting
  • nausea
  • bloating
  • loss of appetite 
  • abdominal pain

Other symptoms are more specific to gastritis. These include a burning or gnawing feeling in the stomach, especially at night or between meals. A more specific sign you may have gastritis is vomiting blood or a coffee ground-like substance. If you are seeing either of these in your vomit, seem medical treatment immediately. 

Lastly, you may experience black, tarry stools, which can help differentiate gastritis from other maladies. Gallbladder issues, for example, can leave the stools chalky and white. These distinctions are best made by your doctor, though. If you are experiencing any of the specific symptoms of gastritis, don’t attempt to diagnose or treat the disease yourself. Talk to your doctor or healthcare provider as soon as possible. 

What are the Complications of Chronic and Acute Gastritis?

Stomach ulcers, stomach bleeding, and ulcers in the upper portion of the small intestine are all common complications of gastritis. It is also possible, though rare, that chronic gastritis may lead to stomach cancer. This is particularly a concern if there is extensive damage to the stomach lining and underlying tissue layers.

How Is Gastritis Diagnosed?

Gastritis may be difficult to diagnose immediately. Many people suffering from acute gastritis do not even seek medical treatment, opting instead to treat their condition with antacids or other over-the-counter drugs. Since gastritis shares common symptoms with other gastrointestinal issues, it can be hard to pinpoint the source of your discomfort immediately. Even before a diagnosis is finalized, your healthcare provider may suggest beginning conservative treatment to begin relieving your symptoms.

Your doctor will ask a series of questions about your lifestyle, other known medical conditions, and family history to get as clear a picture as possible of your current condition. He or she will then suggest more specific tests to begin closing in on what might be causing your gastritis. Testing for H. pylori is a common starting point if gastritis is suspected. The H. pylori bacteria can be found in a stool sample, blood test, or even a breath test. 

An X-ray may also be ordered if your doctor suspects you have gastritis. After drinking a solution containing barium, images will be taken of your small intestines, stomach, and esophagus. These images can help your doctor see the location and nature of some forms of damage to your gastrointestinal tract. 

Even after X-rays and other tests, your doctor will likely want to take a look inside your stomach to see what is going on. If you have gastritis, an upper endoscopy is the best way to ensure an accurate diagnosis. During an upper endoscopy, a thin, flexible tube called an endoscope is inserted into your mouth and down your esophagus to your stomach. This tube contains a light, a tiny camera and sometimes the tools to extract a tissue sample from your stomach. By looking at the images of your stomach through the endoscope, your doctor can check for signs of inflammation and possibly retrieve tissue samples of your stomach lining to perform a biopsy. This can help confirm the presence and severity of H. pylori bacterial infections. 

How is Gastritis Treated?

Regardless of the cause, gastritis boils down to the same problem—too much acid in your stomach. Treating your gastritis will focus on managing or eliminating the source of stress or irritation that is prompting the increased levels of digestive juices in your stomach. Regardless of how you manage your gastritis, allowing the stomach to heal by taking antacids will most likely be a part of the picture.

If an H. pylori infection is confirmed, you may have to go on antibiotics in an attempt to eliminate the bacteria. Two common drugs used to eradicate H.pylori are amoxicillin and clarithromycin. Your doctor will likely prescribe either a seven or 14-day course of antibiotics depending on the severity of your infection.

Another key component of treatment for gastritis are drugs called proton pump inhibitors (PPIs). These medications work by binding to the cells that secrete gastric juices into the stomach. Proton pump inhibitors work to reduce the amount of gastric acid in your stomach and are useful in fighting H. pylori gastritis or in cases where the cause of your gastritis is not immediately obvious. Your healthcare provider will evaluate the cause of your gastritis carefully, as PPIs are not effective against all forms of gastritis. Additionally, long-term use of PPIs can have unwelcome side effects. 

Before agreeing to take any medication to treat your gastritis, talk to your doctor about what other options are available. It is important that your treatment plan is tailored to the particular gastritis you are suffering from. Proton pump inhibitors, for example, are not ideal for treating chronic gastritis. When taken at higher doses, long-term use of PPIs should only be done under a doctor’s supervision. 

Taking medications that are aggravating the lining of your stomach, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can cause problems as well as solving them. Long-term use of NSAIDs is not recommended, as over-the-counter versions can cause damage if used for long periods of time. Always be sure to talk to your doctor about your pain management program, as there may be other options available that may be easier on your stomach. 

Diet and lifestyle changes will be a part of managing your gastritis in nearly all cases. Lowering or eliminating your alcohol consumption will almost certainly be a part of the answer if your chronic gastritis has been caused by excessive alcohol consumption. Similarly, if stress has been the main source of your gastritis, changing living situations, jobs, or pursuing mental health treatments to address past trauma will be a priority. 

When Should I Talk to My Doctor About Gastritis?

Anytime you find blood or coffee ground-like material in your vomit, you should talk to your doctor. This is also true if you are repeatedly finding blood in your feces, or if you are experiencing black, tarry stools. Consistent nausea, unexplained loss of appetite or ongoing abdominal pain are all good reasons to talk to your doctor or healthcare professional, as many conditions share the same symptoms.  One day of an upset stomach may not be a reason to go to the hospital, but if you are suffering from ongoing or chronic abdominal pain, upset stomach or vomiting, don’t wait. At GI Associates and Endoscopy Center, our experienced team can help you find the reason for your discomfort and get you back on the road to health. 

If you are suffering from the symptoms of gastritis, request an appointment today. We can diagnose the source of your pain and discomfort, as well as ensure you have a treatment plan that can help you heal from your gastritis as quickly as possible.

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