Symptoms and Treatment of Gastritis

Symptoms

In the case of acute gastritis, sudden pain in the pit of the stomach, nausea, and vomiting occur. In such cases, there is often a history of having taken medicine, alcohol, or spoiled food before the symptoms started. Chronic gastritis does not have characteristic symptoms. Since many patients complain of upper gastrointestinal symptoms such as indigestion, it is often used interchangeably in clinical practice with functional dyspepsia. Symptoms of dyspepsia include upper abdominal pain or fullness in the epigastric area after meals, abdominal bloating, early satiety, and nausea.

Diagnosis

The appropriate cost-effective approach for patients with uncomplicated dyspepsia of unknown cause, who often visit the clinic saying they have gastritis, remains a subject of debate. There is ongoing controversy between the view that endoscopy should be performed early in all patients complaining of dyspeptic symptoms and the view that empirical drug treatment should be tried first, with endoscopy reserved for patients aged 45 or older who are at higher risk of malignancy, patients with warning signs (dysphagia, persistent vomiting, weight loss, evidence of gastrointestinal bleeding), and patients who do not respond to empirical drug treatment. However, in countries like Korea, where the fee for endoscopy is low, if symptoms persist even after short-term empirical drug treatment, it is better to undergo endoscopy first. Such early endoscopy can allow accurate diagnosis of diseases such as ulcers and appropriate treatment, reduce repeated hospital visits by reassuring the patient, and has the advantage of helping to differentiate cancer. In fact, when endoscopy is performed for dyspepsia, about two-thirds of cases show normal findings or no significant abnormalities, and in such cases a diagnosis of chronic gastritis or functional gastrointestinal disorder is usually made (the term “nervous gastritis” is often used).

Treatment

Whether gastritis should be treated is determined by the symptoms the patient reports rather than the results of endoscopy. Medications that reduce gastric acidity, gastrointestinal motility regulators, and mucosal protective agents are commonly used. Although there is no evidence that patients with chronic gastritis secrete excessive gastric acid compared with healthy individuals, medications that reduce gastric acidity are prescribed most often. These include antacids, H2 receptor antagonists, and proton pump inhibitors. If symptoms such as early satiety or postprandial fullness are present, gastrointestinal motility regulators are additionally used. In addition, mucosal protective agents that protect the gastric lining are often prescribed together.

Frequently Asked Questions

1. The endoscopy result said nervous gastritis. What does that mean?

When the upper endoscopy shows signs of gastritis and the symptoms do not improve even after continued treatment, the term “nervous gastritis” is commonly used because it is thought to be related to nerves, but the term nervous gastritis does not originally exist. Since the stomach’s motility and acid secretion are controlled by the autonomic nervous system and the brain, stress or emotional stimuli affect stomach physiology and cause symptoms such as indigestion. For example, when someone suddenly experiences sadness or worry, loss of appetite and indigestion are examples of this. In such cases, it is more appropriate to use the term “functional dyspepsia.”

2. The endoscopy says I have chronic gastritis. Is there no way to cure it completely?

As the term chronic gastritis suggests, chronic gastritis does not appear suddenly; it develops gradually over time. From birth, people eat a variety of foods such as spicy foods, salty foods, and burnt foods, and it can also be triggered by irregular eating habits and Helicobacter infection. In addition, as people age, the gastric mucosa also undergoes the aging process. Therefore, it is impossible to return a stomach in this chronic gastritis state to the normal condition it had at birth. It is like trying to restore the wrinkled skin of a 70-year-old grandmother to the firm skin of a 20-year-old, which is impossible. For reference, because the stomach is constantly irritated by various foods and stress, some degree of gastritis is always present. This is diagnosed as “physiological gastritis,” which is a normal finding.

3. If chronic gastritis lasts a long time, does it become stomach cancer?

Chronic gastritis can occur due to many different causes. According to what is currently known, chronic atrophic gastritis and intestinal metaplasia are suspected to be precursor processes for the development of stomach cancer, but not all of these patients develop stomach cancer, and the actual occurrence of stomach cancer is very rare. Therefore, there is no need to worry that chronic gastritis will become stomach cancer over time. It is sufficient to maintain a healthy daily lifestyle (no smoking, regular meals, and proper exercise) and undergo regular endoscopy (once every 1 to 2 years).

4. If digestion is poor, do I have to eat porridge?

Except in very special cases, there is no need to eat porridge for a long period of time. In general, when people say they have indigestion, it has become customary to tell them to eat porridge without exception. Telling someone to eat porridge without even setting a time limit for how long they should eat it is not a helpful prescription. For these patients, it is advised that they need “jogging for the stomach,” which of course does not mean actual running, but exercising the stomach. In cases of severe discomfort due to acute gastritis, it is fine to eat porridge for a few days, but once the condition improves, it is better to gradually increase the amount and return to a normal diet, slowly strengthening the stomach muscles. When you return to a normal diet, it may feel uncomfortable at first, but as the weakened stomach muscles gradually recover, digestive function will also improve.

So far, I have explained the symptoms and treatment of gastritis.

In the next part, we will look at food poisoning.

Source: Korea Disease Control and Prevention Agency National Health Information Portal