What is chronic gastritis?
Chronic gastritis refers to the long-term inflammation of the lining of the stomach. In our stomach, acid is produced to help break down food particles and protect our body from infection. As stomach acid is corrosive, mucus is produced by the stomach lining to protect itself from acid corrosion. When the mucus barrier breaks down, acid starts to corrode the stomach lining and causes chronic gastritis. Common symptoms of chronic gastritis include stomach pain, bloating, belching, nausea, vomiting and loss of appetite.
What causes chronic gastritis?
There are many risk factors which can be considered as chronic gastritis causes. The most common and most important cause of chronic gastritis is Helicobacter pylori infection. Helicobacter pylori or more commonly known as H. pylori is a type of bacteria which is transmitted from person to person via saliva or contaminated food or water. H. pylori causes chronic gastritis by secreting an enzyme which breaks down the mucus barrier of the stomach. The diminished mucus barrier will lead to acid corrosion and this will increase the risks of chronic gastritis, stomach ulcers and duodenal ulcers. Chronic H. pylori infection has also been shown to increase the risk of gastric cancers. H. pylori infection is one of the commonest infections in the world and it is especially prevalent in developing countries like Malaysia.
Other than H. pylori infection, another common cause of chronic gastritis is the long-term usage of certain types of medications such as aspirin or ibuprofen. These medications belong to a drug class known as NSAIDs, which are drugs that reduce inflammation and pain. As cardiovascular diseases become more prevalent across the world, many patients are on long term treatment with aspirin, which is an NSAID that prevents the formation of blood clots in the blood vessels. However, NSAIDs often causes a reduced production of the mucus that protects the stomach lining. Therefore, long-term treatment with NSAIDs will thin out the mucus barrier and lead to chronic gastritis. Nowadays, if a patient is started on long term treatment with NSAIDs, another medication such as omeprazole or lansoprazole will be given together to reduce stomach acid production and prevent chronic gastritis. Other than NSAIDs, other medications such as steroids can also cause chronic gastritis.
Smoking and excessive alcohol intake are also important factors which can lead to chronic gastritis. The chemical substances found in tobacco smoke often irritates the stomach lining and cause inflammation. Nicotine and certain substances in tobacco smoke has also been found to increase stomach acid production. Like smoking, excessive intake of alcohol causes chronic irritation and inflammation of the stomach lining. Alcohol thins out the mucus barrier and exposes the underlying stomach lining to acid corrosion. Alcoholics often experience symptoms of chronic gastritis such as stomach pain and bloating after a session of binge drinking.
Chronic diseases like liver failure, kidney failure, HIV infections and connective tissue disorders alters the balance of hormones in the body. Usually, hormones that increases stomach acid production are increased when the body is ill. This will increase the risk of acid corrosion and chronic gastritis. Other than these conditions, in a small number of patients, there are some abnormalities with their immune system. The immune system recognizes the cells and glands in the stomach lining as foreign and proceeds to destroy them. This results in a chronic inflammation of the stomach lining known as atrophic gastritis. Atrophic gastritis usually does not cause classic symptoms such as stomach ache or bloating. Instead, it causes anaemia secondary to reduced iron and vitamin B12 absorption in the stomach.