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Gastritis and Gastrointestinal Reflux Diseases

Gastritis, esophagitis, GERD, Barret’s esophagus

Stomach fluids can affect the tissue lining in the stomach. Acid flow to esophagus due to acid reflux (backflow or upward movement of acidic fluids) can lead to irritation and soreness in the lining of esophagus also. Inflammation, soreness and erosion of the inner lining of the digestive system due to stomach acids are grouped as gastritis and gastrointestinal reflux diseases.

What is gastritis?

An inflammation, soreness or erosion of the inner lining of the stomach is called gastritis. This inflammation can occur for short-term (acute) or long-term (chronic). Based on the location and nature of gastritis, it is of 4 types:-

Pangastritis – Gastritis affecting entire stomach

Antral gastritis – Gastritis of antrum, lower portion the of stomach

Erosive gastritis – Over extended exposure to stomach acids, irritation can progress to damage and erosion of inner lining. Based on the extent of erosion, acute gastritis may either be superficial erosive gastritis or deep erosive gastritis.

Hemorrhagic gastritis – In extreme cases, erosion may be accompanied with bleeding and thus called as acute hemorrhagic gastritis.

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    What is heartburn or GERD?

    Heartburn, medically known as gastroesophageal reflux disease (GERD) is a medical condition which occurs due to backflow of stomach acids into the tube connecting the mouth and stomach (esophagus). This acid reflux causes irritation and inflammation of the esophagus, which is medically called as esophagitis.

    What are the causes of gastritis and GERD?

    The irritation of the inner lining of the digestive system occurs due to several factors:

    • Imbalance in the protective chemicals and aggressive acids of the digestive system.
    • Movement of bile from the gallbladder into stomach and backflow of stomach juices into the esophagus.
    • Stress
    • Repetitive or longstanding vomiting
    • Excessive alcohol intake
    • Frequent use of medications such as aspirin or other painkillers
    • Long-standing presence of a bacteria, Helicobacter pylori (H. pylori) in the stomach,
    • Rarely, ischemia of stomach

    What are the symptoms of gastritis and GERD?

    Symptoms vary from person to person. Sometimes, there may not be any symptoms at all. Common symptoms include:

    • Bloating of stomach
    • Burning sensation in stomach region between meals or at night
    • Reduced hunger
    • Frequent stomach upset
    • Hiccups
    • Indigestion and burping
    • Pain in abdomen and back pain
    • Vomiting
    • Ulcers, erosion and bleeding

    The acid reflux irritates the lining of the esophagus, resulting in one or more of the following symptoms of GERD:

    • Chest pain
    • Difficulty in swallowing
    • Heartburn or a burning sensation in the chest after meals, sometimes increased at night
    • Reflux of a sour liquid in the mouth
    • Food coming into the esophagus

    What are the risk factors for gastritis and GERD?

    Some conditions that increase the risk of GERD include:

    • Certain medical conditions like a hiatal hernia and scleroderma
    • Increased intake of alcohol or coffee
    • Certain foods like fatty or fried foods
    • Consuming large heavy meals especially at night
    • Delay in stomach emptying
    • Medications, such as aspirin, NSAIDs (painkillers)
    • Overweight/obesity
    • Pregnancy
    • Smoking

    How are gastritis and GERD diagnosed?

    Your doctor or gastroenterologist can diagnose gastritis and GERD by:

    • A detailed medical history
    • Physical examination
    • Tests for gastritis
      • Blood tests – red blood cell count and hemoglobin for anemia, screening for Helicobacter pylori infection
      • Stool test/ fecal occult blood test
      • Endoscopy
    • Tests for GERD
      • Ambulatory acid (pH) probe test
      • Esophageal manometry
      • Upper endoscopy
      • X-ray of your upper digestive system or the barium swallow test

    What are the complications of gastritis and GERD?

    Gastritis spontaneously heals in general. However, untreated gastritis can lead to further complications:

    • Obstruction to flow of stomach contents into intestine.
    • Bleeding from gastric erosion and ulcers
    • Excessive vomiting resulting in dehydration and renal insufficiency

    If left untreated, long-standing inflammation in the esophagus in GERD can result in:

    • Scarring, narrowing and tightening in the esophagus (esophageal stricture)
    • Ulceration in the esophagus
    • Barrett’s esophagus or further increased risk of developing cancer

    When to consult a doctor?

    In either case, if you have been taking over-the-counter medicines for gastric symptoms for more than 2 weeks, talk to your doctor.

    Gastritis: Any symptoms of gastritis should be addressed immediately. Even after diagnosis, chances are that symptoms may worsen, new symptoms may appear or medications may not help. In either case, consult your doctor immediately.

    GERD: While chest pain is a common symptom of GERD, you should seek immediate medical attention, especially if the chest pain is accompanied with shortness of breath, or pain radiating to the jaw or arm. You should also consult your doctor in case you experience the symptoms of GERD frequently and have to take medicines to treat heartburn twice a week.

    What is the treatment for gastritis and GERD? Can gastritis be prevented?

    Depending upon the cause, your physician or gastroenterologist will prescribe medicines to treat gastritis.

    Medicines for gastritis protect the tissues exposed to stomach acids, reduce the stomach acid release and promote healing.

    Medicines for GERD reduce the backflow/reflux of stomach juices and acid into the esophagus, prevent damage to the tissue, and prevent complications and recurrence of GERD.

    GERD that is prolonged and not responsive to treatment may lead to complications such as Barrett’s esophagus. In case of worsening of symptoms or appearance of complications your doctor may suggest an upper intestinal endoscopy with or without surgery.

    Certain lifestyle modifications can help ease symptoms and heal faster. Conventional treatment and prevention of gastritis and GERD include:

    • Enjoy plain food such as ripe bananas and clear soup until symptoms have cleared.
    • Avoid spicy and oily food
    • Avoid late night meals
    • Have small, frequent meals
    • Limit tea and coffee
    • Avoid alcohol
    • Exercise regularly
    • Control your weight
    • Quit smoking
    • Reduce stress – Engage in stress relieving activities like meditation, yoga, etc.
    • Use a pillow to prop your head while sleeping

    To know more about gastritis and GERD and its management, you can request a callback and our gastritis specialists will call you and answer all your queries.

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    References

    Mayo Clinic. Gastroesophageal reflux disease (GERD). Available at: https://www.mayoclinic.org/diseases-conditions/gerd/diagnosis-treatment/drc-20361959.Accessed on 21st Dec 2017
    Mayo Clinic. Gastritis. Available at: https://www.mayoclinic.org/diseases-.conditions/gastritis/symptoms-causes/syc-20355807. .Accessed on 21st Dec 2017
    National Institute of Diabetes and Digestive and Kidney Diseases. Gastritis. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastritis. . Accessed on 21st Dec 2017
    National Institute of Diabetes and Digestive and Kidney Diseases. Acid Reflux (GER & GERD) in Adults. Available at:https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults.. Accessed on 21st Dec 2017

    Disclaimer: The content of this publication has been developed by a third party content provider who is clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.

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