Chronic gastritis is a long-lasting condition where the mucus lining of the stomach is persistently inflamed or irritated. There are three main types of chronic gastritis depending on its cause, namely autoimmune gastritis, infection with the bacteria Helicobacter pylori, and due to prolonged use of alcohol or NSAIDs. Chronic gastritis affects your lives in a slightly different way compared to acute gastritis by having a more gradual onset. In an acute case of gastritis, symptoms are usually very apparent and brief, and treatment can be sought immediately to prevent complications. A person experiencing chronic gastritis will have gradual dull but long-lasting symptoms which are usually brushed off and never treated. This causes diagnosis of chronic gastritis to be much later and usually after complications have developed, unless incidentally found. The fortunate thing is that chronic gastritis often improves fast once treatment has been initiated.
Chronic gastritis can lead to other conditions if not treated adequately. One complication is that it can develop into atrophic gastritis. This condition is where the protective mucus layer of the stomach is damaged, which leads to loss of gastric glandular cells. This loss is compensated by cells of the intestines. Eventually, the glandular cells are replaced by intestinal and fibrous tissue, which is known as intestinal metaplasia of the stomach. This increases risk of gastric cancer compared to the general population. Treating the cause of the gastritis will prevent further intestinal metaplasia, however little evidence is available if the metaplasia can be reversed and reduce the risk of cancer. A person with atrophic gastritis does not experience any symptoms and again is diagnosed incidentally.
Untreated gastritis also causes stomach ulcers due to prolonged exposure to gastric acid. This condition is more common in chronic gastritis caused by H.pylori infection and prolonged use of NSAIDs. Symptoms of stomach ulcers are more apparent than the gastritis itself, and are the reason most patients to seek treatment. The symptoms are burning pain in stomach, nausea and retching, vomiting, bloating, belching, heartburn, changes in appetite, unplanned weight loss. Symptoms usually appear on an empty stomach and can last for minutes or hours. Symptoms are also intermittent. Patients with stomach ulcers are usually dependent on antacids for temporary relief of the symptoms. If the ulcer perforates, one may experience difficulty in breathing, feeling faint, vomiting blood and bloody stools, as well as stools that appear black and tarry. This is a medical emergency and warrants immediate emergency management.
Another complication of chronic gastritis is formation of gastric polyps. Again, they usually present no symptoms and are found incidentally. Rarely if they do, symptoms include anemia due to bleeding polyp and tender stomach when pressed. Most stomach polyps are benign but some can develop into gastric cancers. If gastritis is caused by H. pylori infection, they increase the risk of a specific form of cancer known as gastric mucosa-associated lymphoid tissue (MALT) lymphoma.
Depending on the cause, a person diagnosed with chronic gastritis can prevent complications of the condition by adopting a few simple lifestyle modifications. If H. pylori is the cause of your gastritis, ridding your body of the bacteria will cure the gastritis. If your gastritis is caused by excessive use of NSAIDs or alcohol, you should stop taking them completely. Currently there is no treatment for curing autoimmune chronic gastritis. However you can adapt some non-specific lifestyle changes to prevent progression, such as eating smaller and more frequent meals. Try to avoid overly spicy, acidic or fried foods, and opt for milder and more nutritious foods instead. Take NSAIDs only when absolutely necessary and preferably with a doctor’s prescription.
