10349 Gastritis

Overview

Gastritis is inflammation (swelling and irritation) of the inner lining of the stomach. This lining protects the stomach from the strong acid it uses to digest food. When it becomes inflamed, it can cause pain, discomfort, and other digestive issues.

Gastritis is a common problem. Many people have it at some point in their lives, and it accounts for a large number of visits to general practitioners.

Gastritis can affect people of all ages, but it is more common in older adults. It is also more likely in people who regularly use non-steroidal anti-inflammatory drugs (NSAIDs), drink a lot of alcohol, or are infected with a bacterium called Helicobacter pylori (H. pylori).

Symptoms

Common symptoms

• A burning or gnawing pain in the upper part of the belly (abdomen)
• Nausea or an upset stomach
• Bloating and feeling uncomfortably full after eating
• Indigestion or burping
• Loss of appetite
• Feeling sick, and sometimes being sick (vomiting)

Symptoms in children

• The same tummy pain or burning feeling as adults
• Being unusually fussy or crying after meals
• Feeling full very quickly or eating less than usual
• Vomiting, sometimes with a small amount of blood
• Foul-smelling stools

Symptoms in older adults

• Some older adults have no symptoms at all
• Unexplained weight loss or loss of appetite
• Feeling tired or weak due to low iron (anaemia), which can come from slow stomach bleeding
• Black or tarry stools, or vomit that looks like coffee grounds

Causes

Main causes

• Infection with Helicobacter pylori (H. pylori), a type of bacteria that lives in the stomach lining
• Regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin
• Drinking too much alcohol
• Severe physical stress, such as from major surgery, injury, or burns
• Autoimmune conditions, where the body's immune system mistakenly attacks the stomach lining

Risk factors

• Being older, as the stomach lining thin naturally with age
• Taking pain relievers often or in high doses
• Drinking alcohol heavily or regularly
• Smoking, which can irritate the stomach lining
• Having a family history of gastritis or stomach ulcers
• Having other health conditions, like Crohn's disease or kidney failure

When to see a doctor

See a doctor urgently if:

• If you have vomiting blood or black, tarry stools, get medical help immediately — this could be a sign of serious bleeding
• If you have severe pain that does not go away, seek urgent care
• If you feel faint, dizzy, or unusually weak, especially along with stomach symptoms

Book a routine appointment if:

• If you have stomach pain, nausea, or bloating that lasts more than a few days
• If you are frequently getting indigestion or heartburn
• If you are losing weight without trying, or have a poor appetite that will not improve
• If you are taking NSAIDs regularly and have stomach discomfort

Diagnosis

To diagnose gastritis, a doctor will start by asking about your symptoms, health history, and any medicines you take. They will also press gently on your tummy to check for pain. If your symptoms are simple and you are otherwise healthy, the doctor may recommend a trial of care first. If not, they may arrange tests.

Tests that may be done

• A stool test to check for blood or signs of H. pylori infection
• A breath test to detect H. pylori — you drink a special solution and breathe into a tube
• A blood test to check for anaemia or antibodies to H. pylori
• An upper endoscopy — a thin, flexible tube with a camera is passed into the stomach to look at the lining and take a small tissue sample (biopsy) if needed

What to expect at your appointment

Most tests for gastritis are quick and painless. An endoscopy is usually done with you relaxed or asleep, and you can go home the same day. The doctor or specialist will explain your results and discuss what treatment might be best. You do not need to do anything unusual to prepare — just follow any instructions given to you before the test.

Treatment

Treatment for gastritis depends on the cause. If an H. pylori infection is found, a combination of antibiotics and an acid-reducing medicine can clear it. If medications or alcohol are the cause, the doctor will usually advise cutting back or stopping them. The main goal is to reduce stomach acid and protect the stomach lining while it heals.

Self-care at home

• Eat smaller, more frequent meals instead of huge portions
• Avoid foods and drinks that irritate your stomach, like spicy foods, citrus, caffeine, and alcohol
• If you smoke, ask your doctor or pharmacy about ways to quit
• Try to reduce stress through activities like walking, breathing exercises, or talking to a friend
• Do not take NSAIDs unless a doctor has told you they are safe for you
• Sleep with your head slightly raised if night-time symptoms bother you

Medical treatments

Doctors may recommend medicines that reduce or neutralise stomach acid. Some are available over the counter, and others require a prescription. If H. pylori is found, you will be given a course of two or more antibiotics together with an acid-reducer, usually for one to two weeks. Always take medicines exactly as prescribed — even if you feel better, finish the entire course of antibiotics.

When is surgery considered?

Surgery is rarely needed for gastritis. It may only be considered if you have a severe complication, such as a bleeding ulcer that cannot be controlled with medicines, or if there are signs of a tear (perforation) in the stomach wall.

Living with this condition

Living with gastritis usually means being kind to your stomach. Pay attention to what makes your symptoms worse and try to avoid those triggers. Keep a simple food diary if that helps. Stay in touch with your doctor, especially if your symptoms change or do not improve within a few weeks of treatment.

Lifestyle tips

• Eat regular meals and avoid grazing all day
• Limit alcohol and avoid binge drinking
• Move your body regularly — even a short walk can help digestion
• Find healthy ways to manage stress, such as listening to music, gardening, or talking with friends
• If you use pain relief often, talk to your doctor about safer options

Diet and exercise

There is no strict diet for gastritis, but most people do well with plain, non-irritating foods like rice, bread, oatmeal, bananas, and well-cooked vegetables. Try to avoid very spicy, fried, or acidic foods for a while. Gentle exercise like walking, swimming, or yoga is usually fine and can help reduce stress. If you find that certain foods bother you, eat less of them and see if your symptoms improve.

Mental health and emotional wellbeing

Living with a chronic stomach problem can be frustrating and stressful. You might worry about some foods, or feel embarrassed about symptoms. It is normal to feel this way. Talking about it with your doctor or someone you trust can make a difference. If you feel your mood is low or anxiety is high, do not hesitate to ask for support — many people feel the same way.

Prevention

You cannot always prevent gastritis, but you can lower your chances. Limit alcohol, avoid using NSAIDs too often, quit smoking, and manage stress. If you know you have a stomach condition, avoid known irritants and keep regular follow-ups with your doctor.

Vaccines

There is no vaccine to prevent gastritis. However, a vaccine against H. pylori is not yet available, and prevention mainly relies on good hygiene, clean water, and safe food handling.

Screening programmes

There is no routine screening for gastritis in the general public. If you have risk factors such as long-term NSAID use or ongoing symptoms, your doctor may check for H. pylori or other causes as part of your care.

Complications

If left untreated

• Stomach ulcers (open sores in the stomach lining)
• Bleeding in the stomach, which can lead to anaemia or blood loss
• A hole (perforation) in the stomach wall, which is a medical emergency
• In some cases, chronic gastritis can increase the risk of stomach cancer, though this is uncommon

Long-term outlook

The outlook for gastritis is generally very good. Most people recover fully with treatment and simple lifestyle changes. If the cause is H. pylori, a short course of medicines often clears it for good. Even when gastritis is chronic, it can usually be managed so that symptoms are mild or hardly noticeable. Staying in touch with your doctor and following your treatment plan greatly improves your chances of feeling better.

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