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Gastritis is an inflammation of the lining of the stomach, and has many possible causes.[1] The main acute causes are excessive alcohol consumption or prolonged use of nonsteroidal anti-inflammatory drugs (also known as NSAIDs) such as aspirin or ibuprofen. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract. Chronic causes are infection with bacteria, primarily Helicobacter pylori. Certain diseases, such as pernicious anemia, chronic bile reflux, stress and certain autoimmune disorders can cause gastritis as well. The most common symptom is abdominal upset or pain. Other symptoms are indigestion, abdominal bloating, nausea, and vomiting. Some may have a feeling of fullness or burning in the upper abdomen.[2][3] A gastroscopy, blood test, complete blood count test, or a stool test may be used to diagnose gastritis.[4] Treatment includes taking antacids or other medicines, such as proton pump inhibitors or antibiotics, and avoiding hot or spicy foods. For those with pernicious anemia, B12 injections are given.

Acute Gastritis

Erosive gastritis is gastric mucosal erosion caused by damage to mucosal defenses.[2] Alcohol consumption does not cause chronic gastritis. It does, however, erode the mucosal lining of the stomach; low doses of alcohol stimulatehydrochloric acid secretion. High doses of alcohol do not stimulate secretion of acid.[6] NSAIDs inhibit cyclooxygenase-1, or COX-1, an enzyme responsible for the biosynthesis of eicosanoids in the stomach, which increases the possibility of peptic ulcers forming.[7] Also, NSAIDs, such as aspirin, reduce a substance that protects the stomach called prostaglandin. These drugs used in a short period of time are not typically dangerous. However, regular use can lead to gastritis.[8]

Chronic Gastritis

If the esophageal sphincter fails to do its job properly, some stomach acid can escape up the esophagus. This causes very painful “heartburn” or “gastritis” in the chest as the esophageal walls are eroded by the hydrochloric acid. Chronic gastritis refers to a wide range of problems of the gastric tissues that are the result of H. pylori infection.[2] The immune system makes proteins and antibodies that fight infections in the body to maintain a homeostatic condition. In some disorders the body targets the stomach as if it were a foreign protein or pathogen; it makes antibodies against, severely damages, and may even destroy the stomach or its lining.[8] In some cases bile, normally used to aid digestion in the small intestine, will enter through the pyloric valve of the stomach if it has been removed during surgery or does not work properly, also leading to gastritis. Gastritis may also be caused by other medical conditions, including HIV/AIDS, Crohn’s disease, certain connective tissue disorders, and liver or kidney failure.

Severe gastritis is possible when the stomach is viewed without symptoms being present and may be present despite only minor changes in the stomach lining. Seniors have a higher likelihood of developing painless stomach damage. They may have no symptoms at all, such as an absence of vomiting or pain, until they are suddenly taken ill with internal bleeding. Pain in the upper abdomen is the most common symptom. The pain is usually in the upper central portion of the abdomen, the “pit” of the stomach. Gastritis pain can occur in the left upper portion of the abdomen and in the back. The pain seems to travel from the belly to the back. The pain is typically vague, but can be a sharp pain. Belching either doesn’t relieve pain or only relieves it for a moment. The vomit is either clear, green or yellow, has a bloody streak in it, or is completely bloody, depending on the severity of inflammation. Bloating and a feeling of fullness or burning in the upper abdomen are also signs of moderate gastritis. Severe gastritis presents pallor, sweating, rapid heart beat, feeling faint or short of breath, severe chest or stomach pain, vomiting large amounts of blood, or bloody or dark, sticky, foul-smelling bowel movements.