Gastritis and Gastric Ulcer

First you should understand what causes gastritis and gastric and duodenal ulcer.

Before anything else, we must define what gastritis and ulcer are, affecting either the stomach or duodenum. Gastritis is an inflammation of the epithelium of stomach, i.e., the tissue layer overlying it. This acts as a mucosal lining consisting of a fabric resistant to intense acidity, which makes sense since the material contained in the stomach has extremely low pH. Ulcer, as its name implies, is an ulcer (or erosion) in the epithelium, like a big cold sore. Ulcer is called gastric when it affects the stomach, duodenum and when it presents the duodenum (the first portion of small intestine).



Gastritis is not a single disease. It is, in fact, the final result of various types of injury to the stomach. Causes of gastritisare as follows:
Gastritis is manifested by symptoms such as heartburn, pain in the "pit of the stomach," nausea, oversaturation and belching (burping).

Gastric ulcer
Gastric ulcer
These symptoms are framed in a picture called dyspepsia. Importantly, the severity of the symptoms does not necessarily correlate with the severity of gastritis or the presence of an ulcer. You may not even have dyspepsia and endoscopy may have no signs of gastritis, but you canhave an ulcer and hardly feel uncomfortable.

When there are no symptoms and no visible lesions in the stomach / duodenum, i.e. no gastritis, it is called functional dyspepsia, it is clinical gastritis / ulcer without these lesions. The functional dyspepsia is responsible for the situation which is wrongly called nervous gastritis.
There is nervous gastritis. Unlike physical stress, emotional stress alone is not a cause of lesions in the stomach or duodenum. Stressful situations can trigger symptoms of dyspepsia; they may also delay the healing of existing lesions, but individually cannot cause gastritis or ulcer.

Gastritis can be acute, when it develops quickly, or chronic, when the inflammation settles slowly and persists for several months. The first is usually caused by alcohol, drugs and food poisoning. The second tends to be caused by the H. pylori.

The gastritis left untreated can progress to erosions of the stomach mucosa, leading to formation of ulcers.

Peptic ulcer

Peptic ulcers are those caused by the action of gastric juice in the wall of the duodenum, stomach or esophagus. The two main causes are inflammatory and abuse of H. pylori infection.

The new anti-inflammatory drugs called COX-2 inhibitors are less harmful to the stomach / duodenum, however, are not 100% safe. Although they can cause ulcers-less effectively, the use of COX-2 prevents wound healing from those ulcers that are already present.

Duodenal ulcers are more common than gastric and affect mainly individuals between 30 and 50 years of age. Gastric ulcers are more common for people over 60 years.

Ulcers can complicate causing perforations or bleeding. Peptic ulcers do not cause cancer, but some cancers can cause something similar to an ulcer. The lesser curvature of gastric ulcers is the most worthy of attention because it is at this point where the tumors tend to arise.

A little symptomatic ulcer is often responsible for anemia without an apparent cause. The bleeding can be small and not noticeable to the naked eye, but an ulcer may cause a hemorrhage, being sufficient to have loss of fresh blood through the mouth or faeces.

Diagnosis of gastritis and peptic ulcer

The diagnosis is made by endoscopy. Once detected, you should always biopsy ulcer, even if that does not display characteristics of cancer. Do not rule out neoplasia is safe only by the appearance of the lesion.

The research of H. pylori should be made only in the presence of ulcers. Despite this statement, many doctors still do research the bacteria even when there are only signs of gastritis. One should not search because there is no indication of H. pylori without ulcer.

The reports of endoscopies often cause some degree of confusion. First it is important to know the anatomy of the stomach.

Some common questions:
  • When you say antral gastritis or den, that means inflammation of the final portion of the stomach (see diagram above).
  • The term enanthematous means a mucosa injury. So enanthematousantral gastritis is an inflammation of the mucosal lesion in the antrum region.
  • Pangastritis means a diffuse inflammation, affecting most of the stomach.

Treatment of gastritis and peptic ulcer

Treatment today is done with suppression of gastric acidity. There are two classes of drugs for this purpose:
  • H2 receptor antagonist - Ranitidine
  • Proton pump inhibitors (PPIs) - omeprazole, pantoprazole, lansoprazole etc.

Preference is given to the proton pump inhibitor as it tends to be more effective. To help to cure the disease one should cut tobacco and booze. As already mentioned, the treatment of H. pylori is only indicated if there is ulcer. There is no evidence that H. pylori eradication in gastritis alone bring any benefit. The treatment is done for at least 4 weeks.

General keywords

User discussion

06 April 2012
chronic constipation I am 56. Because of the main diseaseI take antidepressants (according to the scheme). I am suffering from a chronic constipation for 9 years. How can I improve the performance of the intestine, by which scheme?
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06 April 2012
Can I have a stomach ache from emotional stress? And then in such cases is it better to take analgesic, or sedative?
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07 April 2012
Can I use the sports nutrition (weight gainer, protein) after removal of the gall bladder? For example, after six months of compliance with all diets? And another question, how long after surgery should I keep out of training in the gym and the martial arts section. Can I go to the swimming pool and run around in the evenings?
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08 April 2012
Many parents believe that a child who has attained the age of three, does not need a special menu - (s)he can have the same thing as his parents, but, of course, in other quantities. Is it true or not? Can I give seafood to my child?
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07 May 2012
Good morning! I am 17 years old, I am always I tormented by flatulence. And the sounds are so loud that they could be heard by those who are near me. I do not know what because I feel uncomfortable. Can you advise me please, how to deal with it. Thank you very much.
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