Acid Reflux / GERD GastroIntestinal / Gastroenterology

What are the causes and symptoms of chronic gastritis?

Gastritis is when the lining of the stomach becomes inflamed or swollen. This usually happens after the stomach lining has been damaged. Gastritis that is long-lasting or recurring is known as chronic gastritis.

Chronic gastritis is one of the most common chronic conditions and can last for years or even a lifetime if left untreated. A wide range of different conditions and factors are known to cause or contribute to the development of chronic gastritis.

Resolving mild cases of gastritis can often be through the use of medication and lifestyle changes. However, for some people with severe chronic gastritis, a cure may not be possible, and the focus of treatment will be on managing the symptoms.

In this article, we look at the symptoms, causes, risk factors, and possible complications of chronic gastritis. We also cover when to see a doctor, diagnosis, treatment, and lifestyle and dietary changes.

Symptoms

Woman holding stomach due to chronic gastritis
Indigestion, nausea, bloating, and a burning feeling in the stomach can be symptoms of chronic gastritis.

People with minor cases of gastritis that are caused by the bacterium Helicobacter pylori may not always notice any symptoms.

However, most people with chronic gastritis experience a variety of symptoms, including:

  • indigestion
  • a burning or gnawing feeling in the stomach
  • the sensation of being full after eating a small amount
  • nausea and vomiting
  • belching
  • unintentional weight loss
  • bloating
  • loss of appetite
  • upper abdominal pain or discomfort
  • bleeding, usually only in erosive gastritis
  • Gastritis is termed “erosive” if the stomach lining has been worn away, exposing the tissue to stomach acids.


Causes

Chronic gastritis refers to a group of conditions that cause chronic inflammation of the mucosal lining of the stomach.

There are many different causes of chronic gastritis, but most cases are related to one of the following:

H. pylori bacterial infection

H. pylori bacterial infection is the most common cause of gastritis worldwide. Many people first become infected during childhood, but not everyone experiences symptoms.

While H. pylori infection can cause both acute and chronic gastritis, it is not often associated with erosive gastritis.

Researchers think H. pylori spreads through infected food, water, salvia and other bodily fluids.

Damage to the stomach lining

Damage to the stomach lining can lead to chronic inflammation. Causes of this include:

  • overuse or long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen
  • excessive alcohol consumption
  • chronic stress
  • injuries and impact
  • exposure to radiation
  • recurring bile reflux from the small intestine
  • cocaine use

Autoimmune conditions

In people with autoimmune gastritis, their immune system attacks the stomach lining for no apparent reason. Autoimmune gastritis is usually chronic but non-erosive.

In some people, autoimmune gastritis may be linked to chronic or severe H. pylori infection.

Other causes

Less common causes of chronic gastritis include:


Risk factors

Trans fats may cause chronic gastritis
Risk factors for chronic gastritis include diets high in fat, oil, salt, and preservatives.

Possible risk factors for chronic gastritis include:

  • diets high in salt or preservatives
  • diets high in fat and oil, especially saturated and trans fats
  • smoking
  • long-term consumption of alcohol
  • conditions that weaken the immune system
  • cocaine use
  • long-term use of NSAIDs and some other medications
  • long-term use of medications for acid reflux and indigestion


Possible complications

If properly treated, acute cases of gastritis are rarely associated with complications. However, people may experience serious health complications if they have severe or untreated chronic gastritis.

Erosive gastritis can cause peptic ulcers. Once an ulcer has formed, they can progressively degrade the surrounding tissues, widening and enlarging themselves. Severe ulcers may eventually cause internal bleeding, which can be life-threatening if left untreated.

Other possible complications of chronic gastritis include:

  • anemia caused by iron deficiency
  • anemia caused by internal bleeding
  • vitamin B-12 deficiency
  • abnormal stomach growths, such as polyps and tumors

When to see a doctor

People with symptoms of gastritis should see a doctor if the symptoms:

  • are severe
  • last for more than a week
  • do not respond to treatment or lifestyle adjustments

Internal bleeding requires immediate medical attention. Signs of internal bleeding can include:

  • dizziness
  • unexplained weakness
  • paleness
  • black, tarry stools
  • red, fresh-looking blood in the stool
  • red blood in vomit or vomiting blood
  • unexplained drowsiness
  • difficulty breathing or swallowing
  • confusion
  • passing out


Diagnosis

Doctors use a wide range of tests and tools to diagnose chronic gastritis, including:

  • medical history
  • physical exam
  • stool tests to check for both H. pylori and signs of bleeding
  • endoscopy when a camera on a tube is put down the throat into the stomach
  • blood tests
  • X-rays
  • urea breath test to check for H. pylori infections

Treatment

Treatment depends on the type, cause, and severity of gastritis.

Gastritis caused by H. pylori infections is usually treated with a combination of antacids and antibiotics, even if the infection is not causing any symptoms.

People will often need to take supplements or make dietary adjustments to prevent complications if their chronic gastritis is causing nutritional deficiencies.

Most gastritis medications focus on reducing the amount of acid in the stomach.

Common acid-reducing medications include:

  • Antacids. Antacids typically contain magnesium, calcium, sodium, or aluminum salts that can help neutralize stomach acids. Antacids can sometimes cause constipation or diarrhea and other side effects.
  • Proton-pump inhibitors (PPIs). These reduce the amount of acid the stomach produces. People can buy low-strength versions of lansoprazole and omeprazole over the counter, but most PPIs are only available on prescription.
  • H2 blockers. H2 blockers are antihistamines that can help reduce stomach acid production. Most types of H2 blockers are available in both over-the-counter and prescription strengths.


Lifestyle and dietary changes

colorful fruits and vegetables
Gastritis may be prevented or treated by eating a diet rich in whole fruits and vegetables.

Regardless of the cause or severity of symptoms, making dietary and lifestyle adjustments may help treat gastritis or prevent it occurring.

Common dietary suggestions for people with chronic gastritis include:

  • avoiding or reducing alcohol consumption
  • avoiding spicy foods
  • avoiding rich, oily, or fried foods
  • avoiding acidic foods, especially citrus fruits and juices
  • eating smaller meals but more frequently
  • reducing salt consumption
  • eating less red meat

Eating a healthy, balanced diet rich in antioxidants, fiber, and probiotics may also help. You find these substances in foods such as:

  • whole fruits and vegetables
  • whole-grain breads, cereals, rice, and pasta
  • fermented products, including yogurt, kefir, sourdough bread, sauerkraut, and kimchi
  • lean proteins, including chicken, fish, beans, legumes, nuts, and seeds

Some people with chronic gastritis may also find benefit from eating foods with anti-bacterial properties, such as:

  • garlic
  • cumin
  • ginger
  • turmeric
  • cranberries
  • peppers
  • mild curries

Common lifestyle changes recommended for people with chronic gastritis include:

  • quitting smoking
  • avoiding or reducing the use of NSAIDs, sometimes by talking to a doctor about other medications
  • practicing good food and personal hygiene, including washing the hands frequently
  • exercising regularly
  • drinking plenty of water to stay hydrated
  • managing stress and pain with relaxation techniques and practices, such as meditation, yoga, controlled breathing, and acupuncture

Outlook

Chronic gastritis can cause pain and discomfort and lead to serious complications if left untreated. People should see their doctor if they have symptoms of chronic gastritis.

Management of chronic gastritis involves treating any underlying conditions, taking medications to counteract stomach acid, and making lifestyle and dietary changes.

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