Gastritis Symptoms - Acute And Chronic

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Gastritis Symptoms - Acute And Chronic
Gastritis Symptoms - Acute And Chronic
Video: Gastritis Symptoms - Acute And Chronic
Video: Acute Gastritis - Signs & Symptoms, Causes, Pathogenesis, Complications, Diagnosis & Treatment 2023, February
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gastritis

Gastritis is also known as inflammation of the stomach lining, as it is damage to the lining of the stomach caused by inflammation. Depending on the shape and form, this leads to superficial to deep changes in the glandular tissue of the stomach. Most gastritis is caused by certain bacteria (especially Helicobacter pylori) or drugs. A basic distinction is made between acute and chronic forms. It is important to differentiate between similar complaints that can originate from the intestines, pancreas, heart or biliary system.

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  • What are the symptoms?
  • How can you prevent gastritis?
  • How is the diagnosis made?
  • How is gastritis treated?
  • Whom can I ask?
  • How are the costs going to be covered?

The stomach lining protects the stomach wall from acids and pathogens. If the protective layer of the lining becomes irritated or damaged, it can become inflamed. A distinction is made between acute and chronic gastritis.

What are the symptoms?

Gastritis is basically a histological diagnosis. It can be symptom-free or accompanied by symptoms of dyspepsia, but also with bleeding.

Acute gastritis usually causes noticeable gastrointestinal complaints. Chronic gastritis can develop over a long period of time and also go unnoticed. Sometimes it is only discovered when stomach ulcers develop, which in turn cause discomfort.

Acute gastritis

Acute gastritis is provoked by harmful substances (noxae) such as drugs or alcohol, but also by bacterial infections. The symptoms usually set in quickly. The following symptoms can occur:

  • Stomach pain,
  • Bloating,
  • Heartburn,
  • Nausea, sometimes with vomiting,
  • Belching,
  • Loss of appetite,
  • bloated stomach.

Some of these symptoms can also occur with other digestive disorders.

Chronic gastritis

The physical problems associated with chronic gastritis are not always clear, because they can be associated with little or no discomfort. Possible symptoms are:

  • mild to severe upper abdominal pain,
  • Bloating,
  • Loss of appetite,
  • Feeling of pressure in the stomach,
  • Belching,
  • Nausea.

Depending on the intensity and progress, it can remain with chronic gastritis with superficial damage to the inner wall of the stomach. However, if the damage progresses, atrophic gastritis occurs, in which the inflammation in the tissue layers further expands. Ultimately, the gastric glands, the gastric mucosal atrophy, can be destroyed.

Chronic gastritides are classified according to the Sydney classification into type A (autoimmune), type B (bacterial), type C (chemical) and type D (other). The most common are types B and C, but mixed forms are also possible.

  • Gastritis type A: In this autoimmune form of gastritis, special antibodies (parietal cell antibodies) are directed against the acid-producing mucous membrane cells (parietal cells). In the long run, the gland cells in the stomach are destroyed. Gastritis type A is related to a reduced production of the intrinsic factor in the stomach, which is essential for the absorption of vitamin B12 and the deficiency of which leads to severe changes in the blood count (pernicious anemia). In addition, there is an increased level of gastrin in the blood (hypergastrinemia). Type A gastritis is very rare. It is often associated with other autoimmune diseases such as diabetes mellitus, Hashimoto's thyroiditis or vitiligo.
  • Gastritis type B: This form is related to the colonization of the stomach with the bacterium Helicobacter pylori. Around half of the people worldwide are infected with it (in Austria approx. 5-24%, people with a migration background approx. 36-86%). All of them develop chronic gastritis, which, however, often goes without symptoms and symptoms. The infection usually occurs in early childhood.
  • Gastritis type C: This is a chemically toxic form. Possible triggers are the backflow of bile from the duodenum into the stomach, which irritates the stomach lining, or certain anti-inflammatory pain medications, which reduce the production of factors that protect the mucous membrane. These drugs include, in particular, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, diclofenac, mefenamic acid, but also preparations with acetylsalicylic acid (eg “aspirin”).
  • Gastritis type D: These include diseases as diverse as Crohn's disease, sarcoid, infectious or allergic inflammation of the gastric mucosa, which require very specific treatment approaches.

How can you prevent gastritis?

In general, careful handling of drugs such as NSAIDs and acetylsalicylic acid ("aspirin") as well as alcohol is recommended to protect against irritation of the gastric mucosa. When taking long-term pain relievers such as NSAIDs, it is common in risk groups to take a proton pump inhibitor (PPI) at the same time.

Smoking also has a negative impact on conditions in the stomach, which is particularly important in the case of an irritable stomach.

How is the diagnosis made?

First and foremost, the doctor will conduct a detailed anamnesis interview. It will be discussed which complaints are present, when they occur and how long they have existed. The doctor will also ask whether and which medication is being taken, as this can be directly related to the symptoms. Lifestyle questions such as alcohol and cigarette consumption are also relevant. The doctor will also ask whether the symptoms have changed in connection with food intake. Questions about stress, anxiety and depression shed light on the psychosomatic aspects of dyspepsia / irritable stomach.

Gastroscopy

A detailed gastroscopy examination of the stomach may be required. An endoscope, which is equipped with a light-sensitive chip, is inserted through the throat into the esophagus and into the stomach. During gastroscopy, tissue samples can be taken from different parts of the stomach (biopsy). The clear evidence of gastritis is only possible histologically. On the basis of the biopsy, which is completely painless, a possible colonization of the stomach with H. pylori is determined. Gastroscopy also serves to rule out the typical rare complications of gastritis, ulcer and carcinoma of the stomach.

Further information is available under gastroscopy.

If autoimmune gastritis (type A) is suspected, a blood test can also be carried out. It provides information about antibodies (against intrinsic factor) and vitamin B12 status.

How is gastritis treated?

How is gastritis treated?

Acute forms of gastritis are mostly self-limiting, ie they heal spontaneously if the triggering substance (noxa) is omitted. In the event of infection with a pathogen, pathogen-specific therapy is carried out.

In chronic gastritis, the therapy depends on the form:

  • Type A gastritis: If there is a vitamin B12 deficiency, this vitamin is substituted. For more information, see Cobalamin (Vitamin B12).
  • Type B gastritis: If there is an infection with the H. pylori bacterium, antibiotic therapy may be useful - a so-called eradication therapy. It always takes place in combination with a proton pump inhibitor (PPI). The success of the therapy is then checked, usually with a breath test.
  • Type-C gastritis: In the case of chemically toxic gastritis, treatment consists primarily in - as far as possible - in omitting or avoiding the triggering substances (noxae) such as NSAID painkillers. In the case of biliary reflux, the peristalsis is supported by so-called prokinetics (e.g. metoclopramide, domperidone). Proton pump inhibitors (PPIs) are often used in this form of gastritis, although their benefit has not been clearly proven.

Dietological and psychotherapeutic measures can be used as support. In addition, herbal ingredients such as wormwood, centaury, fennel, anise, caraway and chamomile can improve the symptoms.

Whom can I ask?

If you suspect you have gastritis or an irritable stomach, you can contact the following offices for clarification:

  • General Practitioner,
  • Specialist in internal medicine (specializing in gastroenterology and hepatology).

How are the costs going to be covered?

How are the costs covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

  • Right to treatment
  • Visit to the doctor: costs and deductibles
  • What does the hospital stay cost?
  • Prescription fee: This is how drug costs are covered
  • Medical aids & aids
  • Health Professions AZ
  • and via the online guide to reimbursement of social insurance costs.

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