Acute gastritis

Gastritis, or inflammation of the gastric mucosa, is inflammation-related damage to the gastric mucosa(lat. tunica mucosa gastrica), whereby, depending on the variation, superficial to deeper changes can occur in the mucosal tissue. In principle, a distinction is made between acute and chronic gastritis, with the course of the disease being the decisive factor.

The triggers of acute gastritis are manifold. Harmful substances or other factors that cause an excess of gastric acid can be the causes. These include:

• Excessive consumption of alcohol and/or nicotine.
• Excessive, frequent consumption of stomach-irritating stimulants such as coffee or hot spices
• Excessive intake of certain medications such as painkillers and anti-inflammatories
• Mental and physical stress
• Bacteria-induced food poisoning e.g. by staphylococci or salmonellae
• Irritation of the gastric mucosa by foreign bodies such as a feeding tube
• Acids or alkalis
• After surgical interventions
• Burns
• "Runner's stomach": hyperacidity of the stomach caused by running, diet and hormones

In the context of bacteria-induced gastritis, bacterial metabolites are primarily responsible for destruction of the gastric mucosa. In these cases, gastritis may be contagious due to transmission of the causative bacteria. Attention must be paid to adequate toilet hygiene, as the bacteria are usually excreted in the stool.

The main symptoms of both acute and chronic gastritis are the same and differ only in their timing. The symptoms of acute gastritis occur rapidly, whereas in a chronic form they develop over a longer time frame. Inflammation of the gastric mucosa is characterized by a variety of symptoms, but in many cases it can also proceed without symptoms. Possible symptoms are:

• pain in the upper abdomen (epigastric pain)
• unpleasant feeling of fullness
• bloated abdomen
• nausea and vomiting
• loss of appetite
• frequent belching
• flatulence
• heartburn
• bad breath
• unpleasant taste in the mouth

1. Medical history
   For stomach problems, the primary care physician should be consulted first. If necessary, the patient should be referred to a gastroenterologist. The suspected diagnosis of acute gastritis can already be made with the help of the anamnesis (questioning about the medical history and symptoms).
2. Physical examination
   Subsequently, the abdominal region is examined. Initially, the exact location of the pain is determined. By palpating the abdomen, this can be determined more precisely and is also an important indication of other possible causative diseases. During palpation, including the liver and spleen, indurations can also be detected. In addition, the doctor listens to the bowel sounds with a stethoscope (auscultation). By tapping the abdomen, accumulations of air or fluids can be registered.
3. Endoscopy
   To clearly detect acute gastritis, a gastroscopy (endoscopy of the stomach) can be performed. For this purpose, a tube with a camera is inserted into the stomach via the mouth and the mucous membrane is viewed. In acute gastritis, this shows typical inflammatory changes such as redness and swelling. In the course of a biopsy, tissue samples can also be taken with a small forceps. This often makes it possible to find the definite cause of the gastritis and to exclude more dangerous clinical pictures such as stomach cancer or stomach ulcers.

Mild courses of acute gastritis heal spontaneously in most cases. The use of medications can promote healing. More severe courses must be investigated and treated with more specific methods.

Mild cases of acute gastritis usually heal spontaneously within a few days without drug therapy. More severe cases usually require drug therapy, but are generally also easily treatable.

Prophylaxis is especially important in cases of acute gastritis that has already been experienced, in order to prevent a recurrence.

• Ensure a healthy and balanced diet
  This includes reducing the amount of fat in the diet and taking in enough fiber. Strong seasoning, citrus fruits, coffee, alcohol and nicotine should be avoided as much as possible. When taking meals, care should be taken to eat them slowly.
• Avoid medications that damage the stomach
  Medications that irritate the mucous membrane should be avoided. These include specifically anti-inflammatory and analgesic drugs, such as acetylsalicylic acid, ibuprofen or naproxen. If there is a medical indication for such therapy, concomitant anti-acid therapy should be considered.
• Ensure sufficient relaxation and rest
  Stress and strain affect the health of the stomach. Opportunities and times for relaxation and rest should be found. Exercise can also help with this.

In high-risk patients, recurrent gastritis illnesses and special pre-existing conditions, permanent prophylaxis using acid-inhibiting drugs may be useful.