Gastritis is an inflammation, irritation or erosion of the stomach mucosa. Gastritis is not one disease but a group of conditions, which are characterized by inflammation of the lining of the stomach. Gastritis can broadly be divided into acute gastritis and chronic gastritis.
Causes include medications, alcohol, eating or drinking corrosive substances, extreme physiological stress, and infections. Acute gastritis is often associated with a severe, acute illness, or trauma. The risk factors include nonsteroidal anti-inflammatory drug use (NSAIDs), recent heavy alcohol use, and physiological stress such major surgery, head trauma, renal failure, liver failure, or respiratory failure.
Chronic gastritis is an inflammation of the lining of the stomach that occurs gradually and persists for a prolonged time. Chronic gastritis may be caused by prolonged irritation from the use of nonsteroidal anti-inflammatory drugs (NSAIDs), infection with the bacteria Helicobacter pylori, pernicious anemia (an autoimmune disorder), degeneration of the lining of the stomach from age, or chronic bile reflux.
WHAT ARE THE CAUSES OF GASTRITIS?
Helicobacter pylori (H. pylori) that live deep in the mucosal layer, which coats the lining of the stomach. Although it’s not entirely clear how the bacteria are transmitted, it’s likely they spread from person to person through the oral-fecal route or are ingested in contaminated food or water. H. pylori infection frequently occurs in childhood and can last throughout life if untreated. It’s now known to be the primary cause of stomach ulcers and is a leading cause of gastritis. Long-term infection with the bacteria causes a widespread inflammatory response that leads to changes in the stomach lining. One of these changes is atrophic gastritis, a condition in which the acid-producing glands are slowly destroyed.
Bile reflux disease:
Bile helps in digestion of fat. The liver secrets bile and stores it in the gall bladder. After releasing from the gallbladder, the bile goes into the small intestine through biliary ducts; the pyloric valve prevents bile from flowing back into stomach from the small intestine. Dysfunction of the valve gives rise to back flow of bile into the stomach, leading to inflammation of the gastric mucosa.
Permicious anemia can result in atrophic gastritis. People with pernicious anemia may have gastric polyps and get gastric cancer and gastric carcinoid tumors twice as often than the normal population.
The immune system makes antibodies and other proteins that fight off infection and keep the body healthy. In some disorders, the body mistakenly targets one of its own organs as a foreign protein or infection. It makes antibodies against it and can severely damage or even destroy the organ. The stomach lining also may be attacked by the immune system leading to loss of the stomach cells. This causes acute and chronic inflammation which can result in a condition called pernicious anemia. The anemia occurs because the body no longer can absorb vitamin B12 due to a lack of a key stomach factor, destroyed by the chronic inflammation. A form of anemia that occurs when the stomach lacks a naturally occurring substance needed to properly absorb and digest vitamin B12. A lack of vitamin B12 may change the surface of the tongue and shrink or thin the stomach lining.
Regular use of pain relievers:
Non-steroidal anti-inflammatory drugs (NSAIDs) reduce prostaglandin which preserves the stomach mucosa thereby cause inflammation of stomach lining.
Severe stress due to major surgery, traumatic injury, burns or severe infections can cause gastritis as well as ulcers and stomach bleeding.
It can irritate and erode the gastric mucosa.
Cocaine damages the stomach lining and may lead to hemorrhage.
Radiation and chemotherapy:
Chemotherapy and radiation given for cancer can cause irreversible erosions of the stomach lining and destruction of acid-producing glands.
Gastritis may be associated with other medical conditions, including HIV/AIDS, parasitic infections, some connective tissue disorders, and liver or kidney failure.
WHAT ARE THE SIGNS AND SYMPTOMS OF GASTRITIS?
The signs and symptoms of gastritis include:
- A gnawing or burning ache or pain in the upper abdomen that may become either worse or better after eating.
- Loss of appetite.
- Bloating: A feeling of fullness in upper abdomen after eating
- Weight loss.
- Belching: Belching either does not relieve the pain or relieves it only briefly.
- Nausea and vomiting: The vomit may be clear, green or yellow, blood-streaked, or completely bloody, depending on the severity of the stomach inflammation.
In more severe gastritis, bleeding may occur inside the stomach. Any of the following symptoms can be seen as well as those already mentioned.
- Pallor, sweating, and rapid (or “racing”) heart beat.
- Feeling faint or short of breath
- Chest pain or severe stomach pain
- Vomiting large amounts of blood
- Bloody bowel movements or dark, sticky, very foul-smelling bowel movements
How Gastritis is Diagnosed?
Gastritis is diagnosed on the basis of medical history and physical examinations of the patient and the following tests:
§ Blood tests. Blood test to detect presence of H. pylori antibodies. A positive test shows that you’ve come in contact with the bacteria at some time in your life, but it doesn’t necessarily indicate current infection. Blood tests can also check for anemia, which may result from stomach bleeding associated with gastritis.
§ Stool tests. To check H. pylori presence in a sample of stool. A positive result shows current infection. Test for the presence of blood in stool, a sign of gastric bleeding.
§ Upper gastrointestinal X-ray. After swallowing barium liquid which coats the lining of digestive tract, it is easier to check signs of gastritis and other digestive problem.
§ Upper gastrointestinal endoscopy. On taking X–ray if gastritis is still doubtful then we will go for endoscopy. This procedure allows seeing abnormalities in the upper gastrointestinal (GI) tract that may not be visible on X-rays. If any tissue in your upper intestinal tract looks suspicious, your doctor can remove a small sample (biopsy) using instruments inserted through the endoscope. The sample is then sent to a lab for examination by a pathologist. Risks of the procedure are rare and include bleeding and perforation of the stomach lining. The most common complication is a slight sore throat from swallowing the endoscope.
WHAT IS THE TREATMENT OF GASTRITIS?
Treatment depends upon the cause of gastritis. It may include lifestyle changes, medication or rarely surgery. Medication includes, Antacids, H2 blockers, Proton pump inhibitor, Antibiotics, antidiarrheal agents etc. In some patients the side effects of these drugs may seen:
§ Antacids: Antacids containing Aluminum and Magnesium are given but contraindicated in documented hypersensitivity, it can’t be safely used in pregnancy as it decreases effect of amprenavir, chloroquine, corticosteroids, diflunisal, digoxin, ethambutol, iron salt, H2 antagonists, isoniazid, penicillamine, phenothiazines, tetracycline, thyroid hormones & ticlopidine; increases effect of benzodiazepines & amphetamine; may cause Aluminum toxicity with ascorbic acid.
Magnesium containing antacids may cause diarrhea and may lead to dehydration.
Patient having history of gastrointestinal bleeding can not take Aluminum and Magnesium containing antacids.
§ H2 Blockers: Cimetidine [Tagmet] is commonly given to the patient, it may lead to confusional states; may cause impotence and gynaecomastia in young males.
§ Proton Pump Inhibiters: Omeperozol [Prilosec] drug given to patients may increase toxicity of warfarin, digoxin and phenytoin.
§ Antibiotics: Amoxicillin [Amoxil, Trimox], is contraindicated in hepatic dysfunction. It reduces efficacy of oral contraceptives. Tetracycline used during teeth development can cause permanent discoloration of teeth.
§ Antidiarrheal Agents: They are used along with antibiotics and proton pump inhibitors/H2 Receptor Antagonists to eradicate H.Pylori. Administration along with anticoagulants may increase risk of bleeding. It may cause darkening of tongue and black stool which is temporary.
HOMEOPATHIC TREATMENT OF GASTRITIS
Nux Vom: Heartburn with flatulence. Nausea and vomiting in the morning. He feels “If I could only vomit I would be so much better”. Alternating constipation and diarrhea. Eructations sour, bitter; nausea and vomiting every morning with depression of spirits, after eating. Heartburn. Drinking milk seems to cause acidity. Hunger, but if he eats ever so little, he is satisfied and feels quite full. Repeated, violent vomiting of sour mucus with headache or with blood. Nux vomica is mostly indicated in case of chronic gastritis which is caused by tobacco, alcoholic stimulants, aromatic or patent medicines, sedentary habits, highly spiced food. Contractive, squeezing stomachache.
Lycopodium: It has pain in the pit of stomach when the hypochondria are pressed and pain in hypochondria when the pit of stomach is pressed. There is fullness even after a light meal, with no intestinal irritation. Offensive discharges. Eructation ameliorates gastric troubles. Bitter taste in mouth at night, sour vomiting. A grand characteristic of Lycopodium is, “The patient goes to meals with a vigorous appetite, but after eating a small quantity of food he feels so full and bloated that he has to force himself to swallow another mouthful; and he leaves the table with his hunger, only momentarily satisfied.”
Veratrum Album: White hellebore or Veratrum album is common in Europe. It bears a yellowish-white flower and is highly poisonous. Veratrum album is a natural treatment for gastritis and it can relieve most symptoms of gastritis such as hiccups after consuming hot drinks, belching, belching after eating, mucus ejection when burping, vomiting, terrible hunger and great thirst.
Pulsatilla: Pasque flower, a dried herb, is used to make Pulsatilla. This remedy is ideal for those whose symptoms keep varying a lot. Heartburn and bloating are two common symptoms that can be effectively treated by Pulsatilla. It also relieves other symptoms including depression, loss of appetite, diarrhea, white coating on tongue and greasy taste in the mouth.
WHAT HOMEOPATHY COSTS?
Your first consultation with a private homeopath will usually cost between INR 500 to INR 10,000. Further appointments usually cost less – about INR 500 to INR 5000 depending on the location of the place and experience of homeopath. It will also depend on the skill level of his staff or assistants who usually take the first case and prepare it for the main consultant.
Your remedy will usually be included in the consultation price, but do check this first. Homeopathic tablets or other products usually cost around INR 100 to INR500 if you need to buy them separately in India.
Imperial clinics Mumbai
Dr. Shreepad A. Khedekar, BHMS, MD (homeopathy), a specialist for over 17 years, he has used homeopathy in his Switzerland, Belgrade and Mumbai practice for the last 17 years. He lectures in homeopathy at Switzerland, Croatia and at the Serbian Doctors Association (SLD) Teaching Centre in Belgrade and has a busy private practice in Dadar, Mumbai and at Shushrusha Citizens co-operative hospital, Mumbai and is the only Homeopath in their 60 year history.
Dr. Shreepad Khedekar is the Clinical Director, Imperial clinics Mumbai and Imperial clinics Belgrade, Consultant at Shushrusha Citizens Co-op Hospital Mumbai and Physician to several international stars and celebrities.
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