Acute gastritis refers to sudden inflammation of the mucosal lining of the stomach.  This inflammation weakens the mucosal lining, causing the stomach acid to irritate the tissue underneath the mucosa. This often results in sudden severe pain which usually lasts for a short time. The pain, peppery in nature, is felt at the upper middle portion of the abdomen.  

What are the causes of acute gastritis?

Acute gastritis can be caused by any factor or agent that can lead to erosion or weakness of the mucosal lining of the stomach. These include: 

1. Drugs categorised as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, diclofenac, piroxicam etc; corticosteroids such as predinisolone, dexamethasone etc.
2. Excessive alcohol intake.
3. Use of hard drugs such as cocaine.
4. Bacterial infection such as Helicobacter pylori.
5. Autoimmune disorder, resulting in the immune system attacking the lining of the stomach and destroying it.
6. Physical or psychological stress.
7. Bile reflux.
8. Ingestion of poisonous / corrosive substance such as acid.
9. Some viral infections.
10. Major surgery.
11. Kidney failure.
12. Liver failure.

How does acute gastritis manifest (symptoms)?

Sometimes, acute gastritis may not manifest with any symptom. When it does, you may feel any of the following or a combination of the symptoms. 

1. Pain at the upper central part of the abdomen.
2. Nausea.
3. Vomiting, which may contain blood.
4. Loss of appetite.
5. Constipation

What investigations are done for acute gastritis?

The following investigations may be requested either to know the cause of the disease or the extent to which you have been affected.

1. Stool test – to check for blood in your faeces.
2. Endoscopy – to look at the lining of your stomach using an instrument with light and camera at the tip.
3. Biopsy – taking small tissue from the lining of the stomach during endoscopy which is sent for laboratory (histology) studies rule out cancer.
4. X-ray – to look at the intestine in order to be sure there no any structural problem.
5. Helicobacter pylori test using breath, saliva or blood – to test for the presence of the bacteria as a cause of acute gastritis.
6. Complete blood count – to check for anaemia, especially if you have vomited blood or passed blood in your faeces.

How is acute gastritis treated? 

The treatment of acute gastritis depends on the cause. In some cases, specific treatment may not be necessary. Removal of the causative agent may be all that is needed.

1. Cases resulting from medication like non-steroidal anti-inflammatory drugs, or corticosteroids may subside after withdrawing the offending drugs.
2. Reduction in alcohol intake or its cessation may help in reducing or eliminating the symptoms of acute gastritis.
3. Diet modification – Foods low in natural acid, fat and fibre may be helpful. Fried or spicy food, which can provoke stomach acid production, should be avoided.
4. Eating more frequently, small meal at a time will make food available in the stomach at all time so that the stomach acid does not attack the stomach lining.
5. Acute gastritis following H. pylori infection will require appropriate antibiotics such as: amoxicillin, metronidazole and clarithromycin.

Other drugs in the treatment of acute gastritis are aimed at reduction of acid production or to neutralise stomach acid. These include:

1. Antacids such as gascol, gestid etc. These work by neutralising the stomach acid.
2. Histamine 2 (H2) receptor antagonists such as ranitidine, cimetidine – these work by reducing stomach acid production.
3. Proton pump inhibitors such as omeprazole, lansoprazole etc – these also work by reducing stomach acid production.

How can acute gastritis be prevented?

1. Avoid drugs that can erode the protective lining of the stomach such as non-steroidal anti-inflammatory drugs and corticosteroids, if possible. When necessary, non-steroidal anti-inflammatory drugs should be taken with food or immediately after food and for limited period.
2. Practice proper hand-washing before handling food. This can help reduce the risk of H. pylori infection.
3. Proper cooking of food to kill all germs (infective microorganisms like bacteria and viruses) and reduce the risk of infection.
4. Reduce alcohol consumption or avoid alcohol intake completely.
5. Reduce physical and psychological stress.