Wait you think I just have gas?  This definitely feels like more than that.”

Patty, my thirty-something patient was expressing a common confusion.  After hearing her symptoms and examining her, I had told her that I thought she likely had gastritis. But only the “gas” part of that diagnosis had jumped out to her.

So what is this common entity that definitely is a good bit more than just gas? Gastritis is a condition where the lining of the stomach is inflamed.  If someone was to look at the stomach lining with an endoscope, instead of looking a normal shiny greyish, it would look red and irritated.  The “gas” part of the name just comes from the fact that “gastro” is the word for stomach (and “itis” is the term for inflammation).

Acute gastritis usually only lasts a couple of days.  More often we are dealing with chronic gastritis that can drag on for weeks, months, or years.  The symptoms include a lack of appetite, meal intolerance (a feeling of fullness or sickness soon after beginning to eat), nausea, upper abdominal pain or discomfort, and, yes, gas.  It is estimated that at least one third of Americans will suffer from gastritis at some time.

So what causes this common, nagging problem?  The causes are many.  Common contributors include:

  • smoking, excessive alcohol, and caffeine
  • regular use of aspirin and anti-inflammitant drugs (including over-the-counter ibuprofen and naproxen)
  • stress
  • infections including viruses, bacteria, fungi (such as yeast) and parasites
  • auto-immune conditions which can end up resulting in vitamin B-12 deficiency anemia
  • allergic responses to food allergies
  • the most common cause of chronic gastritis is a little cork-screw shaped bacteria called Helicobacter pylori, or H. pylori for short.

It is estimated that over 20% of young adults and close to half of older adults harbor H. pylori.  Sometimes this causes definite problems such as symptomatic gastritis or ulcers, and sometimes it remains asymptomatic. Certain forms of chronic gastritis even bring with them a higher incidence of gastric cancer.

The bottom line is that if you are dealing with ongoing gastrointestinal symptoms such as the ones we have mentioned, get it checked out.  Besides getting a full description of your symptoms and examining you, your doctor will likely check the blood for anemia, B-12 levels, and perhaps H. pylori antibodies among other things.

Often a trial treatment is then given.  This may include avoidance of offending agents (aspirin, excess alcohol, NSAID’s such as ibuprofen and naproxen), and taking acid-blocking meds such as omeprazole or one of several similar meds.  If H. pylori appears to be the cause then a strong triple medicine combination may be used to eradicate it.

Finally, if the trial treatment does not resolve the symptoms then further testing, such as an ultrasound of the abdomen to look for other abnormalities like gallbladder disease, may be needed.  Likewise, a referral to a gastroenterologist may be appropriate at that point to consider an upper endoscopy where the lining of the stomach can be directly visualized through a fiberoptic camera.

So if gastritis is gnawing at your stomach, get it checked out and treated; it’s definitely more than just gas.