Trust Your Gut

Upset stomach? It could be the questionable leftovers you had for lunch, or it could be gastritis.

Gastritis refers to inflammation of the lining of the stomach and can be caused by a variety of things from infections to medications to certain foods you consume. Most commonly it presents as a gnawing or burning pain in the upper belly, bloating, or feeling full after eating a small amount of food. Gastritis can also be associated with nausea or vomiting (with or without blood), decreased appetite, and black-colored stools. Often gastritis may not cause any signs or symptoms at all. If left untreated, gastritis can lead to ulcers or stomach cancer.

The most common cause of gastritis is an infection with Helicobacter pylori, also known as H. pylori. H. pylori is a bacterium that is present in almost half of the world’s population; however, the vast majority of people will not develop any symptoms and will not be affected at all. For the small percentage of people who do develop symptoms, it is most often due to the development of ulcers in the stomach or the beginning of the small intestine (the duodenum). There are a variety of ways to test for H. pylori infection, most of which are non-invasive. Treatment of H. pylori gastritis typically involves taking 3-4 medications for 2 weeks. This regimen is comprised of antibiotics and medicines that reduce the acidity in the stomach to help existing ulcers heal. After completion of treatment, follow-up tests may be required to ensure the infection is completely eradicated.

Gastritis can also be caused by regular use of certain medications. The most common culprit is class of pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDS). Included in this class of drugs are ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin. Supplements like iron and potassium can also irritate the stomach and exacerbate gastritis symptoms. Other causes of gastritis include alcohol, coffee/caffeine, and tobacco use. Even some herbal and holistic supplements can contribute to gastritis including, but not limited to ginger, gingko, saw palmetto, feverfew, chaste tree berry, and white willow bark. In the case of substance-induced gastritis, it is recommended to avoid the triggers mentioned above as well as some dietary and lifestyle modifications. This includes spacing meals out and reducing meal size, as well as avoiding spicy, acidic, or high-fat foods. Your doctor may also recommend medicine to help reduce stomach acid.

Some less common causes of gastritis include systemic diseases like Crohn’s disease and vasculitis, or certain autoimmune disorders in which the body’s immune system mistakenly attacks the stomach lining.

Diagnosing gastritis depends on the suspected cause and may be a clinical diagnosis and not require any tests or procedures. If diagnostic testing is required, it is often non-invasive; however, there are certain red flags that may make more thorough testing necessary. If you are older than 60 years old, have a family history of gastrointestinal cancers, experiencing unintentional weight loss, and signs of gastrointestinal bleeding, your doctor may want to order an upper endoscopy. During this procedure, a thin flexible tube with a camera at the end is inserted through the mouth to visualize the lining of the

esophagus, stomach, and duodenum. A biopsy may also be taken during the procedure in which they take a small sample of the lining and inspect it under a microscope for any abnormalities.

It is not uncommon to have some episodes of upset stomach and irritation throughout your lifetime. However, these episodes often resolve on their own and only last for a short time. If you have symptoms for more than a week, talk to your primary care provider to discuss potential causes and treatment options that are best suited for you.

Dr. Liu is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.