What Causes Gastritis and How to Treat It

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Gastritis symptoms can include upper abdominal pain, and sometimes nausea, vomiting, and/or a feeling of fullness soon after eating. The condition is characterized by inflammation of the stomach lining. This inflammation can be erosive, causing sores in the stomach lining, or non-erosive, which doesn't wear away the lining.

There are many causes of gastritis, with the bacterial infection Helicobacter pylori (H. pylori) among the most common. Excessive use of nonsteroidal anti-inflammatory medication (NSAIDs) or alcohol are additional common causes of gastritis.

This article discusses gastritis symptoms, potential causes of gastritis, and how the condition is diagnosed and treated with gastritis medication and other interventions.

what is gastritis

 Illustration by Gary Ferster for Verywell Health

Gastritis Symptoms

The most common gastritis symptom is upper abdominal upset or pain. The pain is often described as an uncomfortable burning or gnawing sensation.

Besides pain, other potential symptoms of gastritis include:

Blood in your vomit or dark or tar-colored stools may be a sign of bleeding in the stomach, as gastritis can promote ulcers (sores within the lining of the stomach).

Additional signs and symptoms of bleeding in the stomach (all of which stem from related iron deficiency anemia) include:

If you experience any signs or symptoms of bleeding in your stomach, seek immediate medical attention. Severe or worsening abdominal pain is another reason to seek attention right away.

Types of Gastritis

Gastritis symptoms can come on suddenly and last for a short time. This is called acute gastritis. Chronic gastritis means symptoms persist for months or even years. Chronic gastritis is much more likely to lead to complications like ulcer formation and iron deficiency anemia from bleeding. Some people with chronic gastritis go on to develop gastric cancer, but this is rare.

Gastritis can also be categorized as erosive or non-erosive based on how severely injured the mucosal lining of the stomach is.

  • Erosive gastritis is more severe than non-erosive gastritis, as it wears away the stomach lining, leading to the formation of sores called erosions. If left untreated, these sores can penetrate deeper into the stomach mucosa and form painful ulcers.
  • With non-erosive gastritis, the stomach lining is changed as a result of the underlying inflammation; however, there is no wearing away of the lining, so no erosions or ulcers develop.

Both gastritis conditions are common. One study found erosive gastritis was the most frequent diagnosis (16%), followed by non-erosive gastritis (14%), in 911 people who received a diagnostic endoscopy to investigate their gastrointestinal symptoms.

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What Causes Gastritis?

There are multiple possible causes of gastritis. One of the most common causes is an infection with the bacterium H. pylori, which can result from poor handwashing habits and other causes.

Other potential causes include:

  • Drinking too much alcohol
  • Smoking
  • Extreme stress
  • Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Infection with another bacteria, a virus, or fungus

In addition, gastritis may develop after major surgery, traumatic injury, burns, radiation, or a severe illness. Certain diseases and even treatments can also cause gastritis, such as:

Sometimes, the precise cause of a person's gastritis remains unknown.

Diagnosis

While your primary care practitioner may run some tests and diagnose you with gastritis, they may also refer you to a gastroenterologist. This is a medical professional who specializes in diseases of the esophagus, stomach, and intestines. A referral is particularly likely if your diagnosis is not certain, or if your gastritis is severe or persistent.

Your healthcare provider will take a careful medical history and do a physical examination. If gastritis is suspected, you may need blood tests and, potentially, a set of X-rays called an upper gastrointestinal (GI) series. Additional testing, such as an upper endoscopy, may also be needed.

For persistent symptoms of gastritis, upper endoscopy has now replaced the upper GI series as the primary diagnostic test.

Blood Tests

Your healthcare provider will order the following blood tests to check for iron deficiency anemia from potential stomach bleeding:

Your healthcare provider may also check your vitamin B12 level to help diagnose pernicious anemia. With this condition, the immune system misguidedly attacks a vitamin B-12 binding protein made by stomach cells.

Sometimes, a person's immune system attacks the stomach cells themselves. This causes impaired vitamin B-12 absorption and low blood levels. Another blood test used to diagnose pernicious anemia is autoantibodies to intrinsic factor (IF).

Lastly, a blood antibody test may be used to evaluate for H. pylori infection, although other tests (see below) are more sensitive and specific.

Upper GI Series

For this test, you first drink barium, a chalky white substance mixed with water. The barium coats your esophagus, stomach, and the first part of the small intestines. A series of X-rays lets a healthcare provider visualize the digestive tract.

Various gastritis-related abnormalities can be seen with an upper gastrointestinal series, including ulcers and inflammation.

Upper Endoscopy

If the diagnosis of gastritis remains unclear, and/or if your symptoms are severe or persistent, an upper endoscopy may be performed.

During an upper endoscopy, a gastroenterologist eases an endoscope, a thin tube containing a tiny camera, through your mouth (or occasionally nose) and into your stomach. With the camera, they will check for inflammation and may remove a tiny sample of tissue for testing. This is called a stomach biopsy.

Other Tests

Besides these, other tests may be performed to support or confirm a diagnosis of gastritis:

  • A breath test may be recommended to test for H. pylori. With this test, you drink a special liquid and your exhaled breath is then examined to see if breakdown products of the bacterium are present in the stomach.
  • A stool antigen test may also be recommended to test for H. pylori. A stool sample is checked for an antigen that is normally located on the surface of the bacteria.
  • A fecal occult blood test looks for blood in a stool sample; a positive test (meaning blood is present) suggests there is some sort of bleeding within the digestive tract.

Differential Diagnoses

Many other health conditions can cause symptoms similar to those found with gastritis, including:

In addition, non-gastrointestinal conditions can be mistaken for acute gastritis, such as:

Acute coronary syndrome, such as unstable angina or an acute myocardial infarction (heart attack), is a gastritis mimicker that requires immediate diagnosis and treatment. An electrocardiogram (ECG) and cardiac enzymes (a blood test) are required to distinguish perceived stomach pain from heart-related pain.

This is why a comprehensive evaluation with the above tests is often needed to confirm your diagnosis.

How Gastritis Is Treated

Treatment of gastritis first involves addressing the underlying cause. For example, if alcohol or NSAIDs are causing your gastritis, then stopping them is essential.

If H. pylori infection is the cause, your healthcare provider will prescribe you a two-week medication regimen that usually consists of two antibiotics and a proton pump inhibitor (PPI).

Stomach acid irritates the inflamed tissue in the stomach. PPIs such as Prilosec (omeprazole) and Nexium (esomeprazole) work by reducing stomach acid, thereby easing gastritis symptoms and promoting tissue healing.

Once the underlying gastritis culprit disappears, your pain and other symptoms should subside. See your practitioner before stopping any medicine or starting any gastritis treatment on your own.

After identifying and eliminating the underlying cause (if known), an acid-reducing medication may be recommended.

Besides a proton pump inhibitor, histamine blockers like Pepcid (famotidine) and Zantac 360 (famotidine) may be recommended. Sometimes, an antacid is included in your treatment plan for rapid relief.

Keep in mind, these acid-reducing medications are generally only recommended for a short time. This is especially true for the proton pump inhibitors, as they have been linked to adverse health effects with long-term use.

In 2020, the Food and Drug Administration (FDA) announced the recall of all medications containing the ingredient ranitidine, known by the brand name Zantac. The FDA also advised against taking OTC forms of ranitidine, and for patients taking prescription ranitidine to speak with their healthcare provider about other treatment options before stopping medication. The active ingredient in all Zantac products (now with the brand name Zantac 360) is the histamine blocker famotidine.

Prevention

Besides avoiding or minimizing the potential causes of gastritis (like smoking, regular NSAID use, and excessive alcohol intake), researchers have looked into whether preventing H. pylori infection is possible. According to a study published in 2014, improvements in hygiene reduced rates of infection in children.

Since infection with H. pylori is often acquired during early childhood and can spread from person to person through the fecal-oral or oral-oral route, teaching parents and their children to practice good hygiene habits may help prevent gastritis.

Besides washing your (and your child's) hands regularly with soap and water, other hygiene habits include:

  • Ensuring your water comes from a safe, clean source
  • Eating food that is properly washed and cooked
  • Not sharing utensils, toothbrushes, glasses, or cups
  • For mothers of infants, avoid putting your mouth on your child's pacifier or bottle, or tasting their food

Summary

Gastritis is an inflammation of the stomach lining, which causes upper abdominal pain and other possible symptoms like nausea and vomiting. It can have a number of potential causes, including infection with H. pylori, excessive use of NSAIDs, and alcohol use. 

The cause of gastritis can usually be identified with a series of blood tests and/or visual tests like an upper endoscopy. Treatment depends on the underlying cause. Sometimes repeat tests are needed to ensure effective treatment.

If a habit like alcohol use contributed to your case, remember that it's best to continue any lifestyle changes that improve your gastritis so you can keep the condition at bay.

A Word From Verywell

If you are struggling with upper abdominal pain, heartburn, nausea and/or vomiting, or other upper digestive symptoms, it's important to see a healthcare provider to evaluate for gastritis as a cause of your symptoms. There are a number of effective treatments that can provide durable and long-lasting relief.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Sharon Gillson
 Sharon Gillson is a writer living with and covering GERD and other digestive issues.