Inflammation of the stomach lining

Synonyms in a broader sense

Medical: gastritis, gastroenteritis, inflammation of the mucous membranes

Definition of gastric mucosal inflammation

Gastritis (Inflammation of the stomach lining) is an inflammation of the Gastric mucosa where one:

  • a acute gastric mucosal inflammation and
  • a chronic inflammation of the gastric mucosa

differs.

Figure gastric mucosal inflammation / Gastritis: A gastric opening with gastric wall and B forms of gastritis

Type A - autoimmune disease
Type B - bacterial infection
Type C - Chemically Induced
gastritis

  1. Inflammation of the stomach lining
    gastritis
  2. Mucous membrane -
    Tunica mucosa
  3. Dimples in the stomach
  4. Gastric gland -
    Glandula gastrica propria
  5. Surface covering fabric
  6. Esophagus - Esophagus
  7. Stomach body -
    Corpus gastricum
  8. M.gatekeeper - Pylorus
  9. Zduodenum -
    Duodenum
  10. Immune cells
  11. Helicobacter pylori (HP)
  12. NSAIDs (drugs)

You can find an overview of all Dr-Gumpert images at: medical illustrations

So not all layers of the stomach are affected, only the inner layer of the mucous membrane.
The mucous membrane layer has the task of protecting the stomach from the aggressive substances in the stomach, i.e. the substances contained in gastric acid. The stomach produces gastric acid to break down the food and to absorb some of it. The substances that cannot be absorbed continue to migrate into the intestine, where they are broken down and absorbed. If this protective layer of mucous membrane is damaged, inflammation and pain in the stomach occur.

Anatomy stomach

Anatomy of the stomach
  1. Esophagus (esophagus)
  2. Cardia
  3. Body
  4. small curvature
  5. Fundus
  6. great curvature
  7. Duodenum (Duodenum)
  8. Pylorus
  9. Antrum

Gastric mucosa with peptic ulcer
  1. Mucosa (mucous membrane)
  2. Gastric ulcer
  3. Submucosa (connective tissue)
  4. Blood vessels

    If the mucous membrane is damaged, it extends into the connective tissue underneath, which can lead to gastric bleeding.

Types

There are basically three different types of chronic gastric mucosal inflammation:

  • Type A gastritis
  • Type B gastritis
  • Type C gastritis

root cause

An inflammation of the stomach lining can various causes to have. A precise clarification of the cause, especially in the case of chronic courses, is often only possible through one Gastroscopy possible. Here will be rehearse taken from the gastric mucosa and then im Laboratory examined.
Common causes of a acute Inflammation is excessive Alcohol consumption or consumption spoiled food. In the chronic There are several clinical types (A-D) of the course of gastric mucosal inflammation, with one being the most common cause bacterial or viral infection represents.

Depending on the cause, gastric mucosal inflammation can be divided into different classes:

  • Type A gastritis:
    The type A gastritis is caused by a Autoimmune disease triggered, which is based on the fact that the immune system recognizes the body's own structures as foreign and begins to fight them similar to pathogens, resulting in a inflammation and Cell destruction leads. Why the immune cells attack the stomach in type A gastritis has not yet been clarified. Through the Destruction of the so-called parietal cells, which produce stomach acid, a chain reaction is triggered that ends in cell proliferation.
    In the worst case scenario, imagination Stomach cancer. Another consequence of type A gastritis can be a Vitamin B12 deficiency be, which turn into a anemia can pass. This type of gastric mucosal inflammation comes with it less than 10% of cases rarely before.

  • Type B gastritis:
    The type B gastritis is that most common form inflammation of the gastric mucosa over 80% of the cases. It is triggered by bacteria, above all Helicobacter pylori. An infection with this germ is one of the most common worldwide. Helicobacter pylori is found in that extremely low pH of our stomach very well and spreads over the stomach wall, which leads to irritation and inflammation of this.
    These bacteria are mostly means fecal-oral Ingestion transmitted, which means that they can be passed on through poor hygiene. Helicobacter pylori can too Stomach ulcers and heartburn cause. However, the bacterium can easily pass through a Breath test or by a Gastroscopy be proven and good by a Antibiotics-Acid blockers-Triple combination (Triple therapy).
    The two scientists who were able to prove Helicobacter pylori to be the cause of gastric mucosal inflammation received the 2005 Nobel Prize in Medicine and Physiology for their discovery.

  • Type C gastritis:
    Further 10% of those affected with gastric mucosal inflammation have type C gastric mucosal inflammation, which chemically triggered. With chemical almost any substance can be meant, whereby the type C gastritis mostly through Medication is caused. Certain drugs, especially those NSAIDs (Non-steroidal anti-inflammatory drugs), such as Diclofenac or Ibuprofen inhibit protective mucus production and favor by shifting the balance between aggressive and protective gastric juices in favor of aggressive gastric acid the development of gastric mucosal inflammation. Also other pain relievers, like Paracetamol can have a promoting effect on the development of inflammation. Also a high nicotine or alcohol consumption and acidic foods can lead to inflammation of the stomach lining. Another well-known representative of the harmful substances are the Corticosteroids, known colloquially as "cortisone". Food poisoning are also among these chemical causes of gastric mucosal inflammation. Evil doers can also be their own Bile acids be that coming from the duodenum backwards enter the stomach (retrograde).

  • Type D gastritis:
    Under the rare Type D gastritis is grouped together with various other causes, such as inflammation due to inflammatory bowel disease, how Crohn's disease or an illness due to others rarer bacteria.

  • Type R gastritis:
    The type R gastritis is very rare and comes through a long-term heartburn conditions.

All forms of gastritis can cause stress and mental illness be aggravated.

Symptoms

This is one of the most frequently mentioned symptoms Feeling of pressure in the stomach, as well as the diffuse, stabbing abdominal pain in the epigastric region, the better after a meal will return afterwards. Sometimes the stomach pain is not felt in the epigastric region, but is projected further up.
The "wrong" perception of the pain in the chest area can lead to inflammation of the stomach lining also confused with heart problems become. It is therefore important to pay close attention to when the pain starts and what is improving it.
It can also cause inflammation of the stomach lining Loss of appetite, nausea, Vomit, Bad breath, Bloating, bad taste in the mouth and heartburn come.
In the case of a long-standing inflammation of the stomach lining, it can also Bleeding in the stomach come. This is expressed in Tarry stool and Breaking coffee grounds.
Tarry stool is a term for pitch black stool and breaking coffee grounds means that Vomiting of dark stomach contents. The color comes through that Mixing of stomach acid and blood conditions. However, these two symptoms do not necessarily have to occur with bleeding. The bleeding can also only occur in one Anemia, called anemia in technical terms. The signs of anemia are Difficulty concentrating, dizziness and pale skin.

Read a lot more information on this topic at: Symptoms of inflammation of the stomach lining

Inflammation of the stomach lining and diarrhea

In some cases it can be part of an inflammation of the stomach lining diarrhea occur.
At a acute gastritis can in addition to the typical burning Pain also Loss of appetite, nausea and diarrhea occur. This can also lead to so-called “hunger pains”. Despite feeling very hungry, those affected can only eat a few bites until a feeling of fullness and pressure sets in in the upper abdomen. This symptom also goes with Digestive problems and diarrhea hand in hand.

Diarrhea is very common in the chronic form of gastric mucosal inflammation on. The causes of diarrhea can be different.
At severe inflammation It comes to Damage to the mucous membrane, what to Bleeding in the stomach leads. At a acute bleeding the blood is excreted undigested as diarrhea. The color is accordingly dark, as most of the blood has clotted. Even with one Ulcer, which can result from an inflammation of the stomach lining, blood is often passed in the stool.
The inflammation the Cells of the stomach lining so affectthat important digestive enzymes no more be distributed. Above all, this means that fatty foods are not broken down and excreted as fatty diarrhea. The smell is unusually strong. Also already at the Color and consistency of the stool can you increased fat excretion detect.

diagnosis

If you have stomach problems, your doctor will be one first exact anamnese carry out. He will make you exactly yours Symptoms question, because usually one can diagnose an inflammation of the gastric mucous membranes simply by questioning them.

According to the anamnesis, the Belly looked at and up Redness or Swelling respected.
Can also be a Ultrasound examination or Blood tests to be ordered. However, in order to be sure of a gastric mucosal inflammation, a Gastroscopy be made.

Only for type B gastritis caused by the HP bacterium is sufficient Breath test out. The gastroscopy can precisely determine how terrible the inflammation is and where exactly the stomach is inflamed. A gastroscopy can also have a Sample of gastric mucosa can be taken, one suspicious area in the stomach also examined for cancer or pathogens become.

Is gastric mucosal inflammation contagious?

The most guys inflammation of the stomach lining not infectious.
Only type B gastric mucosal inflammation caused by the Helicobacter pylori bacterium is considered contagious. In Germany alone it can be found in the stomach of many millions of people. For most of them, it will find its way there in the childhood, if that Immune system not yet performing well enough is to fight the germ. It populated the whole Gastric mucosa and can multiply there unnoticed for decades.
complaints makes it only at about 10% the infected people and one even smaller part it dissolves by irritating the mucous membrane cells Inflammation of the stomach lining out. It is transmitted through the Feces affected people. It is sufficient that the hands have not been washed sufficiently after using the toilet and that the Germ on the hands and as a result gets into the digestive tract of other people through contact with food or direct mouth contact.

What to do in case of an inflammation of the gastric mucosa

A healthy diet can prevent this

Does the Suspicion If you suffer from an inflammation of the stomach lining, you should always have one doctor ask for advice. If the suspicion is confirmed, it is not uncommon Gastroscopy (Gastroscopy) performed to explain the exact cause and differentiate the different types. Of the proof of the bacteria Helicobacter pylori as the cause can be in a simple test in the Exhaled air respectively. Already during this time of the diagnosis search, the person affected can positively influence their complaints through correct behavior. General measures are also very valuable during therapy and to prevent renewed gastric mucosal inflammation.

All behavior changes should include a balanced lifestyle Avoidance of stress as a risk factor for a increased stomach acid production underlie. In addition to causing heart attacks, stress is also a predictor of gastric mucosal inflammation. If stress reduction is not possible, it can Learning different relaxation techniques be helpful. Also in terms of nutrition it is important to adhere to the instructions listed below. Once the gastric mucosal inflammation has healed and the symptoms have subsided, it is advisable to stick to the lifestyle, otherwise the inflammation can very easily occur again.

Duration of gastric mucosal inflammation

A acute Gastritis can occur within Days subside again, sometimes without treatment. If one adheres to certain rules of behavior, everyone affected can accelerate the healing process and influence it positively; First and foremost here is the lifestyle change: Stress reduction, as well as a balanced nutrition, Avoidance from nicotine, alcohol and other the gastric mucosa in addition harmful substances promotes the healing process.
More difficult and longer therapy is more permanent than with acute gastric mucosal inflammation chronic gastric mucosal inflammation be. Since chronic gastric mucosal inflammation can have various causes, the inflammation can also drag on over a different period of time.
Is the cause a Autoimmune disease, so an inflammation of the stomach lining from Type a, the body no longer recognizes certain cells of the gastric mucous membrane as its own and begins to fight them like a pathogen. In this case there is one lifelong therapy necessary because the body's immune system will repeatedly turn against the cells. A final one cure is here not possible.

The most common form is gastric mucosal inflammation Type B. Here are bacteria the cause of the inflammation of the stomach lining. The best known and most important representative is the bacterium Helicobacter pylori. Here the therapy lasts up to several weekswhich one cure can achieve and the person affected will be symptom-free again. However, since the Helicobacter pylori bacterium is very widespread and can very easily get back into the stomach via infected food, this type of gastric mucosal inflammation can recur.

The gastric mucosal inflammation is also common Type c. She is going through chemical poisons or substances to which our stomach lining is exposed. Poisons can be affected by Medication, Cigarette smoke up to alcohol many chemical substances. Here is the Avoidance of these poisons, i.e. stopping medication, smoking cessation or avoiding alcohol, the therapy that can cure those affected and that determines the duration of the illness. So if you only looked too deeply into the glass once or "ate something wrong", the gastric mucosal inflammation may have disappeared after a day when the poison, in this case alcohol, or the spoiled food, has disappeared from the stomach again (see also: Abdominal pain from alcohol). However, if you drink alcohol permanently, regeneration will take some time and the gastric mucosal inflammation can become chronic, i.e. long-lasting. First after shunning The substances can re-enter the stomach lining regenerate completely and the symptoms can subside or disappear within a short time. The duration of therapy can thus from a few days to down to months or years and maximum for life be.

Common to all forms is the rule of thumb that the therapy As a rule, until the symptoms subside longer lasts, ever longer the complaints have passed and all the more difficult and more pronounced the gastric mucosal inflammation was.
In addition, the healing process can be controlled by a stress free lifestyle and through a healthy and balanced diet for gastritis be positively influenced. This means that alcohol, fatty or acidic foods should be avoided in order to accelerate recovery.

therapy

Depending on the cause, the gastric mucosal inflammation can develop without medication regress on their own and heal within a few days. Here is a Avoid the following foods helpful:

  • coffee
  • chocolate
  • alcohol

Also helpful are:

  • Avoiding stress
  • No nicotine
  • Relaxation exercises

At severe nausea and heartburn can for this time, however Medicines for the ailments be prescribed. In general, almost every type of chronic gastric mucosal inflammation will be one drug prescribed that the Gastric mucosa before the very acidic one consisting of hydrochloric acid Protects stomach acid.
The excessive gastric acid production is common to all types and expresses itself with Heartburn as an external sign of damage to the mucous membrane.
For milder complaints, so-called Antacids (German: "against acid") help. you are less effective than those described below Proton pump inhibitors and thus only the means of choice if treatment with proton pump inhibitors is not possible. Proton pump inhibitors To block a special structure in the stomach lining cell called the Proton pumpthat for the Gastric acid production is essential is. This re-establishes the balance of aggressive acid and protective gastric juices caused by excessive gastric acid production and allows the stomach to recover from the damage and inflammation.

Is the sufferer besides the heartburn from severe stomach cramps and nausea plagued so there is the possibility to take a drug additive that the Promotes movements of the stomach (prokinetics) and so the food is transported faster. If the inflammation lasts for a long time, this can also be important for blood formation Vitamin B12 can no longer be absorbed by the body and has to go through a syringe given (substitution).

If the symptoms do not get better depending on the type of gastric mucosal inflammation specific medication to be started.
There are different approaches depending on the cause:

  • Type A gastritis:
    In type A gastritis, drugs are prescribed to prevent the Reduce acidity in the stomach. These drugs are either Antacids (Rennie), Proton pump inhibitors (-prazole / Pantozol®) or H2 blockers (Ranitidine). In addition, there is usually a Vitamin B12 intake required. Due to the constant attack of the body's own defense system, in severe cases a anti-inflammatory drug used to protect the stomach from serious damage by the body's own immune cells. Type A gastritis should regularly checked are around Rule out gastric cancer.

  • Type B gastritis:
    Here comes the so-called Eradication therapy for use.
    This means that the bacterium is using two Antibiotics and stomach acid with one Gastric acid agents (usually proton pump inhibitors) is being treated. This therapy is also called the Triple therapybecause it consists of three drugs.
    The following drugs are usually used: Clarithromizine, Amoxicilin and a Prazole. Amoxicilin can also go through Metronidazole be replaced.
    This therapy takes about seven to ten daysSince the bacterium can no longer be killed by many of the common antibiotics, it is often necessary to try several combinations of antibiotics and the Duration of therapy can thus up to six to eight weeks drag out: it will be repeated if necessary if the breath test continues to be positive. Therapy is only then considered to be successfully if in a renewed Gastroscopy after several weeks no bacteria more can be proven.

  • Type C gastritis:
    In type C gastritis, it is important to find out which substance or which drug the gastric mucosal inflammation triggers and this to avoid. If this is not possible, for example because painkillers have to be taken, type C gastritis can also be dealt with Acid blockers for example, treat pantoprazole.

If an inflammation of the stomach lining occurs suddenly your doctor can advise you nothing to eat for 24-36 hours and to drink only tea or water.
Again, acid blockers are prescribed as medication. After the symptoms have subsided, nicotine, coffee, alcohol and chocolate should be avoided for the time being.

Read more on the subject at: Medicines for gastrointestinal diseases and Heartburn medication

Medicines for inflammation of the stomach lining

One is enough Change of lifestyle and eating habits not off, the gastric mucosal inflammation must with the help of medication be treated.
In the case of advanced inflammation or an already existing ulcer, symptomatic therapy of the Acidity levels in the stomach are reduced. Several means are available for this.

So-called Antacids are substances with a high pH. You can remove the acid using simple chemical reactions bind and neutralizewhich relieves pain within minutes. If the acid level is permanently too high, antacids can be used between meals to protect the mucous membrane.

Means that are often used are so-called Proton pump inhibitors. she To block in certain stomach cells enzyme, which is significantly involved in acid formation. Applied over several days, it can die Lower acid load and give the stomach lining time to regenerate. You are that for stomach protection First choice means.
They are also common in the hospital Administered provisionally when taking pain medication.
To reduce acidity can also Antihistamines be used. she block certain receptors in the stomachthrough which the stomach receives the signal to produce acid. These agents, as well as so-called prokinetics, are used rather of secondary importance as they are in contrast to proton pump inhibitors stronger side effects cause.

Is colonization by the bacterium Helicobacter pylori the cause of the gastric mucosal inflammation, antibiotic therapy must also be carried out for several weeks in order to be able to completely eliminate the pathogen.

Influence of eating on gastric mucosal inflammation

There eat the greatest stimulus for gastric acid production represents, optimal nutrition can have a major influence on the course of gastric mucosal inflammation.

For the first painful days a gastric mucosal inflammation is recommended either complete Fast or a very easily digestible, low-fat whole food. Oatmeal, bananas, rusks and vegetable juices are very suitable for these days.
A gentle diet should be used during the entire course of therapy to be continued. Difficult to digest and high fat foods lie significantly longer in the stomach and lead to more gastric acid production than light products that can be quickly digested in the rest of the digestive tract.

On the list of foods that not consumed sour citrus fruits (which are produced by the Fruit acid reduces the harmful pH the stomach acid), cheese, cream, fatty sauces, deep-fried foods, cream, but also sweets. Flatulent foods such as lentils or cabbage should also be avoided as the Stomach stretching due to the gases being formed is another stimulus to gastric acid production. With vegetables, wholesome varieties such as carrots, zucchini or lettuce should be chosen instead of legumes. Before cooked vegetables is additionally more digestible. Likewise, when it comes to fruit, bananas, apples, pears and apricots should be given preference over acidic oranges or lemons.

Meals should be on several small instead of a few large meals to reduce the stretch as a stimulus to gastric acid production. If the inflammation persists, this diet should be maintained.

Also different beverages can increase gastric acid production and should therefore be avoided. First and foremost are the drinks that have already been mentioned several times Alcohol and coffee.

Similar to the bloating cabbage should also Carbonated drinks not be drunk as the gas stimulates gastric acid production by stretching the stomach.
Strongly acidic fruit juices, like orange juice, humiliates the PH value in addition to stomach acid and should therefore Be avoided.

In principle can eaten everything be what no complaints power. According to this simple principle, the diet can later be set up towards normal diet.

Complications

Rare A simple inflammation of the gastric mucosa creates complications. Depending on the type of gastric mucosal inflammation, a long illness can lead to stomach cancer, anemia, ulcer, vomiting of blood and blood in the stool.

forecast

The prognosis varies depending on the type of gastric mucosal inflammation. A Type A gastritis is more difficult to cure than type B gastritis, but also much rarer in occurrence. Usually the gastric mucosal inflammation heals within a few weeks to months without permanent damage out.

Acute gastritis

Acute (sudden) inflammation of the gastric mucosa begins quickly and is often related to the ingestion of substances that irritate the mucous membranes.

The mucous membrane of the Stomach has a safe protective film that protects you from aggressive Stomach acid (Hydrochloric acid) and the enzymes (food-digesting proteins) of the stomach. This protective layer can be attacked by various factors, so that the gastric mucosa can be attacked.

You can find detailed information on the causes, symptoms and therapy of acute gastric mucosal inflammation under our topic: Acute gastric mucosal inflammation

Chronic gastritis

In general, one can say that an existing discrepancy between factors that damage the mucous membrane (e.g. stomach acid) and factors that protect the mucous membrane (mucous layer) lead to a chronic gastritis can lead.

The chronic inflammation of the gastric mucosa is divided into 3 types:

  • Type A gastric mucosal inflammation: Autoimmune gastritis: Here antibodies (proteins of the immune defense) are directed against the body's own stomach structures (stomach).
  • Type B gastric mucosal inflammation: BAkterielle gastritis: This causes inflammation with the bacterium Helicobacter pylori Erosion (superficial damage) on the mucous membrane.
  • Type C gastric mucosal inflammation: CHemically caused gastritis: In this form of the disease, pain medication like Voltaren (Drug group NSAIDs), but also a number of other drugs and chemical substances, such as alcohol or the reflux of bile acids (reflux) (Heartburn / reflux disease) responsible for the inflammation of the stomach lining.