What Causes Gastritis? How to Protect Your Gut

by Tim Gower Health Writer

If you have persistent stomach discomfort or distress, don’t take it lightly: The problem could be gastritis, a condition that occurs when the stomach lining becomes inflamed and damaged.

The risk for gastritis rises with age, but fortunately, effective treatments can ease any symptoms and limit your risk for complications. Better yet, some healthy habits can lower your risk for developing gastritis in the first place.

Fire in the belly

The stomach lining, called the gastricmucosa, is coated with a thick layer of mucus, which protects the lining from being dissolved by stomach acid and digestive enzymes. Gastritis occurs when the gastric mucosa becomes inflamed. Gastritis can appear suddenly and last for a few days (acute) or develop gradually and last for months or years (chronic).

Many people don’t experience signs or symptoms of gastritis, but discomfort is more common in acute gastritis. Chronic gastritis symptoms may not appear until damage to the stomach lining causes peptic ulcers (deep sores on the lining) or other complications. When symptoms do occur, they typically include:

  • Nausea or indigestion

  • Bloating or pain and discomfort in the upper abdomen

  • Vomiting

  • Loss of appetite

  • Fatigue

If you have any symptoms of gastritis that last longer than a week, see your doctor. Most acute bouts of gastritis aren’t serious and can be treated easily. However, untreated peptic ulcers brought on by chronic gastritis may bleed or weaken the stomach wall so severely that it perforates, or ruptures, and causes peritonitis — an infection that can cause serious complications, and if not treated quickly, death.

Other possible complications of gastritis include anemia from bleeding ulcers. Advanced gastritis can cause severe symptoms that may be related to overt or covert bleeding, so contact your doctor or go to an emergency room immediately if you:

  • Become short of breath for no obvious reason

  • Feel dizzy or faint

  • Vomit blood, which can sometimes look like coffee grounds

  • Have blood in your stools, or your stools are black and tarlike

  • Lose weight without trying

  • Feel weak or turn pale

What’s behind gastritis

Doctors and patients alike sometimes mistakenly use the term gastritis to refer to any stomach ailment. Notably, gastritis shouldn’t be confused with gastroesophageal reflux disease, or GERD, which is the medical name for chronic heartburn.

There are two general types of gastritis:

  • Non-erosive gastritis, which produces inflammation in the stomach lining but doesn’t promote formation of ulcers

  • Erosive gastritis, which causes peptic ulcers or erosions (shallow breaks) that can wear away the stomach lining.

You can develop gastritis for several reasons, but the most common causes include:

  • An infection. About 30 to 40 percent of Americans are infected in their stomach with a type of bacteria called Helicobacter pylori (H. pylori). Some people never develop symptoms of gastritis, but the infection can irritate and inflame the stomach lining, leading to under- or overproduction of gastric acid. This inflammation increases the risk of developing a peptic ulcer, although most infected people never get ulcers. In rare cases, long-term H. pylori infection increases the risk of stomach cancer, since it can cause precancerous changes to the stomach lining.

  • Pain relievers. Regular or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and aspirin, can damage stomach lining, resulting in inflammation. NSAIDs increase your risk for peptic ulcers and gastrointestinal bleeding, especially if you’re 70 or older; female; take two or more types of NSAIDs (including aspirin); have a history of peptic ulcers; consume alcohol; smoke; have two or more other medical conditions; or take certain drugs such as corticosteroids, the osteoporosis drugs alendronate (Fosamax) and risedronate (Actonel), anticoagulants, and antidepressants in the selective serotonin reuptake inhibitor class. NSAIDs are the most common cause of erosive gastritis.

  • Advancing age. Older people appear to be at greater risk for developing gastritis and peptic ulcers for several reasons. Aging slows down mucus production, which minimizes the stomach lining’s protective shield. Plus, older adults are often heavy users of NSAIDs for managing painful conditions such as arthritis, and many take a low-dose daily aspirin to lower heart attack risk.

  • An autoimmune disease. Your immune system normally defends your body from germs and other intruders. However, it can go awry and mistakenly attack healthy tissue, including the stomach lining. This condition is called autoimmune gastritis; it’s typically non-erosive.

  • Alcohol. Excessive drinking can irritate your stomach lining and cause acute gastritis.

Less common causes of gastritis include physical stress, such as surgical procedures, acute illness, and traumatic injury; some medical disorders, such as Crohn’s disease or sarcoidosis, a form of chronic inflammation; and food allergies, such as those to milk or soy.

Gastritis tests and treatments

If your doctor suspects gastritis, he or she will perform a physical exam and one or more of the following tests:

  • Upper gastrointestinal endoscopy. The doctor slides a thin tube with a tiny video camera on the end down your esophagus and into the stomach, which provides a view of the stomach lining. He or she may also use the endoscope to obtain a sample of tissue, or biopsy, to study under a microscope.

  • H. pylori test. A common test for the presence of H. pylori involves swallowing a liquid or other substance containing the compound urea, waiting a few minutes, and then breathing into a container. If you’re infected with H. pylori, the urea will convert to carbon dioxide that can be detected in your breath.

  • Blood and stool samples. These tests can detect evidence of anemia due to bleeding from the stomach and the presence of H. pylori.

If you’re diagnosed with gastritis, your doctor may prescribe medication to reduce the amount of acid in your stomach and help heal an inflamed stomach lining:

  • Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, and Riopan.

  • H2 blockers, such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac).

  • Proton pump inhibitors (PPIs), such as omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), dexlansoprazole (Dexilant), pantoprazole (Protoni x), rabeprazole (AcipHex), and esomeprazole (Nexium).

If an underlying ailment is causing your gastritis, your doctor may recommend additional treatment. For example, if you test positive for H. pylori, your doctor will prescribe antibiotics to eradicate the bug.

Protecting your gut

The following measures can help you reduce the risk of stomach inflammation:

  • Be careful with NSAIDs. If you must take aspirin, ibuprofen, or another NSAID regularly, use the smallest possible dose and always take it with food.

  • Consider diet changes. Researchers haven’t established that certain diets or foods can protect against gastritis, but if specific foods irritate your stomach, try to avoid them or consume them in moderation. Common offenders include caffeine containing foods and beverages such as tea, coffee, and hot chocolate; acidic foods and beverages like tomatoes and fruit juice; spicy foods such as those made with hot peppers or chili powder; fatty foods such as red meat; trans fat-containing foods like baked goods and French fries; foods prepared with seasonings like onions, garlic, cinnamon, or cloves; and refined foods such as white bread, white pasta, or sugar.

  • Go easy on the milk. Some people used to think that drinking milk could cure an ulcer. While it’s true that milk can neutralize stomach acid and make you feel better temporarily, it also stimulates acid levels in your stomach. This acid rebound can end up making you feel worse.

  • Drink only in moderation. Drink alcohol moderately (no more than two drinks a day for men and one a day for women) and never on an empty stomach.

  • If you smoke, quit. Cigarettes can negatively affect the stomach lining and duodenum (the first part of the small intestine).

  • Practice good hygiene. Wash your hands often and ensure that foods have been washed and cooked properly to reduce the risk of H. pylori infection.

Tim Gower
Meet Our Writer
Tim Gower

Timothy Gower is an award-winning journalist who writes about health and medicine. His work has appeared in more than two dozen major magazines and newspapers, including Prevention, Reader’s Digest, and the Los Angeles Times.