Gastritis is an inflammation of the gastric mucosa, a layer of cells that lines the stomach inside protecting it from the acidity of the gastric juices. Although it is not correct, it is common that the term gastritis is used as a synonym of dyspepsia (pain or discomfort in the upper abdomen, as well as symptoms of burning, pressure or fullness related many times, although not necessarily, with meals).
Gastritis can be produced by multiple causes: alcohol, tobacco, food, drugs (non-steroidal anti-inflammatory drugs), major surgeries, or infections (the bacteria Helicobacter pylori is related to some types of gastritis). Since the end of the 20th century, H. Pylori has been related to gastric pathology in one way or another. That is to say, the involvement of this bacterium in the gastroduodenal ulcer and as a precursor to some type of gastric cancer is undoubted, but it also plays an important role as a cause of gastritis. In fact, when its prevalence has been studied, more than half of the population presents data that confirm the presence of this germ in the stomach.
The symptoms are very variable, since each individual can experience them in a different way. The most frequent are discomfort or stomach pain, nausea, vomiting, belching, burning, or presence of blood in vomit or stool.
The diagnosis of gastritis is histological, that is, it is necessary to perform a gastroscopy and obtain a sample of the gastric mucosa by biopsy so that it can be analyzed. Therefore, the diagnosis of gastritis is not only clinical (not based only on symptoms) but it is necessary to perform invasive tests (gastroscopy and biopsy) to confirm its existence.
Generally, the treatment of gastritis includes antacids and other medications that help to reduce the acidity in the stomach, thus relieving the symptoms and favoring the healing of the irritation of your wall. If gastritis is related to a disease or an infection, that problem will also be treated.
Finally, patients are advised to make changes in their diet, avoiding certain types of food, beverages or drugs that may cause irritation of the stomach wall.
The classification of gastritis is complex, but by way of summary it can be said that they are divided into acute, chronic, and special forms of gastritis.
There are different options for the treatment of acute gastritis. Sometimes it is not necessary to treat them, since gastritis can resolve spontaneously. First of all it is important to avoid irritating foods (coffee, tea, alcohol, pepper, mustard, vinegar ...) or substances that can damage the gastric mucosa, such as anti-inflammatories. It is advisable to fractionate the meals in a smaller quantity avoiding fullness, as well as avoiding elaborate stews that invite a hyperproduction of gastric acid (cooked, fabada, etc.). Regarding anti-inflammatory drugs, in case it is essential to administer them, it will be done after meals (never fasting) and protected by omeprazole.
The drugs that can be used to prevent the onset of gastritis and treat it are antacids, H2 antagonists (which decrease the acid secretion of the stomach), or sucralfate. At present and for decades, the first line of treatment for dyspepsia are the inhibitors of the proton pump, highlighting omeprazole, pantoprazole, rabeprazole, lansoprazole and esomeprazole. These drugs manage to maintain a pH in the stomach that is not excessively acidic, thus decreasing the symptoms of gastritis and facilitating healing.
Occasionally, antacids can be combined with antiH2 (ranitidine) or antacids with proton pump inhibitors (omeprazole).
In the cases in which there is presence of H Pylori, the treatment of these acute gastritis should consist of triple therapy with omeprazole or some other proton pump inhibitor, plus two antibiotics (amoxicillin and clarithromycin in most cases).
Gastritis improves as the patient's situation improves, with the lesions disappearing approximately 48 hours after the attack.
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