Gastritis

Gastritis is inflammation or irritation of the lining of the stomach. It can come on suddenly (acute) or persist (chronic), and it ranges from mild and symptomless to painful. The two most important causes are infection with the bacterium Helicobacter pylori — a very common, treatable stomach infection — and regular use of non-steroidal anti-inflammatory painkillers (such as ibuprofen and aspirin), which damage the protective lining. Alcohol, smoking, severe stress or illness, and, less commonly, an autoimmune process (which attacks the stomach cells and can cause vitamin B12 deficiency) also cause it. Symptoms, when present, include upper-tummy pain or burning, nausea, feeling full quickly, and indigestion. Gastritis matters because, untreated, the same processes can go on to cause stomach ulcers and bleeding, and long-standing H. pylori infection is linked to a small increased risk of stomach cancer. The good news is that the common causes are readily identified and treated.

• Helicobacter pylori testing — a breath, stool or blood test (or biopsy at endoscopy); central because it is common and curable.
• Full blood count and ferritin — check for iron-deficiency anaemia from slow bleeding.
• Vitamin B12 — can be low in autoimmune (atrophic) gastritis, which impairs its absorption.
• Endoscopy with biopsy — to look directly at the stomach lining when needed (persistent symptoms, alarm features, or over age 50). Blood tests are supporting; the cause is pinned down by H. pylori testing and, when indicated, endoscopy.

• Pain or a burning feeling in the upper abdomen
• Nausea, sometimes vomiting
• Feeling full quickly when eating; bloating
• Indigestion and belching
• Loss of appetite
• Sometimes no symptoms at all
• Warning signs: black or bloody stools, vomiting blood, weight loss, or difficulty swallowing — need prompt assessment