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What do you know about gastritis, commonly known as gastric in The Gambia?

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Causes, symptoms diagnose, treatments prevention

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By Dr Kehinde O Oduntan

What is gastritis (gastric)

Gastritis is the Inflammation of the lining of the stomach, which causes pain and discomfort. It is a common condition that affects many individuals in The Gambia, as well as in Africa and the entire World. In Africa, it is estimated that one out of every 10 people suffer from gastritis at some point in their life. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers or the regular use of certain pain relievers. Drinking too much alcohol also can contribute to gastritis.

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Gastritis may occur suddenly (acute gastritis) or appear slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn’t serious and improves quickly with treatment.

Check if you have gastritis

Symptoms of gastritis include: tummy pain, indigestion, feeling full and bloated, feeling sick (nausea), being sick (vomiting), not feeling as hungry as usual, burping and farting

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How do gastritis manifest

The signs and symptoms of gastritis: gastritis doesn’t always cause signs and symptoms., Burning sensation, ache, or pain in your upper abdomen that may become either worse or better with eating.  indigestion, Nausea, Vomiting, A feeling of fullness in your upper abdomen after eating, Heartburn

What causes gastritis

Gastritis is an inflammation of the stomach lining. Weaknesses or injury to the mucus-lined barrier that protects the stomach wall allows digestive juices to damage and inflame the stomach lining. Various diseases and conditions can increase the risk of gastritis, including inflammatory conditions, such as Crohn’s disease.

Risk factors

Factors that increase your risk of gastritis include:

Bacterial infection. Although infection with Helicobacter pylori is among the most common worldwide human infections, only some people with the infection develop gastritis or other upper gastrointestinal disorders. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and diet.

Regular use of pain relievers. Pain relievers commonly referred to as nonsteroidal anti-inflammatory drugs (NSAIDS) — such as ibuprofen, Diclofenac sodium and naproxen sodium can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach.

Older age

Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are.

Excessive alcohol use. Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis., Stress. Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis., Cancer treatment. Chemotherapy drugs or radiation treatment can increase your risk of gastritis., Autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This reaction can wear away at your stomach’s protective barrier., Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto’s disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency., Other diseases and conditions. Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn’s disease, celiac disease, sarcoidosis and parasitic infections.

Possible complications of gastritis

If left untreated, gastritis may lead to complications such as:

Stomach ulcers:  Characterized by formation of sore in the walls of the stomach, which can ultimately lead to perforation and peritonitis., Stomach bleeding: the inflammation of the inner lining of the stomach can lead to severe erosion, and bleeding. This can be manifested by vomiting blood, dark colour stool., Risk of stomach cancer, especially if you have extensive thinning of the stomach lining and changes in the lining’s cells., Tell your doctor if your signs and symptoms aren’t improving despite treatment for gastritis.

Anaemia due to malabsorption of nutrients and some vitamins.

How to diagnose gastritis

Although your doctor is likely to suspect gastritis after talking to you about your medical history and performing an exam, you may also have one or more of the following tests to pinpoint the exact cause.

H pylori test: Your doctor may recommend tests such as a blood, stool test or breath test to determine whether you have the bacterium H pylori. Which type of test you undergo depends on your situation.

For the breath test, you drink a small glass of clear, tasteless liquid that contains radioactive carbon. The H. pylori bacteria break down the test liquid in your stomach. Later, you blow into a bag, which is then sealed. If you’re infected with H. pylori, your breath sample will contain the radioactive carbon.

Endoscopy:  It is done by using a scope to examine your upper digestive tract. During endoscopy, your doctor passes a flexible tube equipped with a camera (endoscope) down your throat and into your oesophagus, stomach, and small intestine. Using the endoscope, your doctor looks for signs of inflammation, ulcer, cancer, and hiatal hernia. Depending on your age and medical history, your doctor may recommend this as a first test instead of testing for H. pylori., If a suspicious area is found, your doctor may remove small tissue samples (biopsy) for laboratory examination. A biopsy can identify the presence of H. pylori, inflammation and cancer in your stomach lining. Barium swallow: To make this test, you will swallow a white, metallic liquid (containing barium) that coats your digestive tract. This series of X-rays creates images of your oesophagus, stomach, and small intestine to look for anything unusual, such as inflammation, ulcer, and tumours.

How is gastritis treated

Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances.

Medications used to treat gastritis include: Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin XL) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for 7 to 14 days, along with medication to block acid production. Once treated, your doctor will retest you for H. pylori to be sure it has been destroyed.

Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Peracid), rabeprazole (Aciphex), pantoprazole (Protonix) and others.

Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist, and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk.

Medications that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhoea, depending on the main ingredients. These help with immediate symptom relief but are generally not used as a primary treatment. Proton pump inhibitors and acid blockers are more effective and have fewer side effects.

When to see a doctor

Nearly everyone has had a bit of indigestion and stomach irritation. Most cases of indigestion are short-lived and don’t require medical care. See your health care provider if you have signs and symptoms of gastritis for a week or longer.

Seek medical attention immediately if you have severe pain, if you have vomiting where you cannot hold any food down, or if you fee l light-headed or dizzy. Tell your doctor if your stomach discomfort occurs after taking prescription or over-the-counter drugs, especially aspirin or other pain relievers., If you are vomiting blood, have blood in your stools or have stools that appear black, see your doctor right away to determine the cause.

If gastritis is causing mild indigestion symptoms, there are things you can do to help reduce the number of drinks you have that contain caffeine, such as tea, coffee, cola and energy drinks lie on an extra pillow in bed so your head and shoulders are higher, to help stop stomach acid rising up your throat while you sleep lose weight if you’re overweight, talk to your doctor if you regularly take anti-inflammatory painkillers (such as ibuprofen) or aspirin do not eat 3 to 4 hours before going to bed, do not have food or drink that’s acidic (such as orange juice), fizzy, spicy or fatty, do not drink alcohol, do not smoke.

Author: Dr Kehinde O Oduntan, specialist in general surgery and obesity surgery, Medicare Clinic the Gambia.

Email: [email protected], [email protected]

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