It can occur both acutely and chronically, with both forms representing independent diseases. Acute gastritis often occurs in connection with other serious illnesses as an expression of the acute stress situation for the body (e.g.: serious injuries, burns, serious operations, sepsis). But also alcohol or medications that damage the mucous membranes such as: B. the so-called non-steroidal anti-inflammatory drugs (e.g. aspirin or ibuprofen), which are used in the treatment of rheumatic diseases and headaches, can cause acute gastritis. In rare cases, viruses can also trigger acute gastritis in immunocompromised patients.
Stomach acid plays a crucial role in the development of the usually acute mucosal lesions. Normally there is a balance in the stomach between gastric acid, which is aggressive to the mucous membrane, and natural protective mechanisms of the gastric mucosa, such as the mucous membrane barrier made of mucus and bicarbonate, intact blood flow to the stomach wall and cell regeneration. In the conditions described above, there is a breakdown of the mucous membrane barrier and a direct attack by stomach acid on the mucous membrane cells, with corresponding cell damage.
The first indication of acute gastritis is a diffuse feeling of pressure in the upper abdomen, often accompanied by nausea and the urge to vomit. However, the most serious symptom of acute gastritis is bleeding from the gastric mucosa, which in severe cases could be life-threatening and requires immediate treatment. The diagnosis is made using gastroscopy (gastroscopy). If there is evidence of acute gastric bleeding, this must be done as an emergency, i.e. immediately.
The therapy aims to reduce gastric acid production in order to counteract further damage to the gastric mucosa. Acid-neutralizing medications are also used. Damaging factors such as B. certain medications or alcohol should be avoided.
The overall prognosis of acute gastritis is very favorable; only the complication of bleeding can have an unfavorable effect on the patient.
Chronic gastritis, on the other hand, is an inflammation of the stomach lining that often lasts weeks or years. Depending on the cause, three forms can be distinguished.
Type A gastritis is very rare overall. It is an autoimmune disease in which the body’s immune system targets and destroys certain stomach lining cells (comparable to rheumatism, for example). As a result, there is a disruption in the regulatory mechanisms of acid production with an increased occurrence of so-called carcinoids, rare malignant gastrointestinal tumors. Furthermore, the absorption of vitamin B12 in the small intestine is disturbed, which results in a reduced production of red blood cells and anemia.
Type B gastritis is the most common form and is caused by the bacterium Helicobacter pylori in the stomach. Almost 60% of people over 60 in Western countries are infected with the pathogen, although not all infected people develop chronic gastritis.
Type C gastritis is caused by the effects of toxic substances on the gastric mucosa, primarily bile and small intestinal fluid flowing back, but ongoing alcohol abuse and certain medications are also possible. The symptoms of chronic gastritis are rather non-specific, such as loss of appetite, feeling of fullness, stomach pressure or belching. The diagnosis is made through a histological examination of a sample of the gastric mucosa that was taken during a gastroscopy. Detecting an infection with Helicobacter pylori is also possible using breathing tests or antibody tests.
Since chronic gastritis is often an incidental finding, therapy is only necessary if there are corresponding symptoms. If there is an accompanying/triggering infection with Helicobacter pylori, a targeted combined administration of antibiotics over 7 days can eradicate the bacterium. Otherwise, the same medications are used as for acute gastritis; stomach-damaging substances such as medications, alcohol or nicotine should be avoided, as should foods that are harmful to the stomach, such as coffee or fatty substances.
The overall prognosis for chronic gastritis is favorable. Patients with type A gastritis should seek regular medical check-ups because of the increased risk of cancer and the possible vitamin B12 deficiency. Patients after treatment for a Helicobacter pylori infection should also receive regular medical check-ups because of the risk of reinfection (= relapse ) should be examined at longer intervals or if symptoms recur.
Further topics on health and medicine