Gastritis: symptoms and treatment by video in Puerto Rico

In gastritis, the stomach lining (the mucosa) is inflamed. When the lining is damaged but has little or no inflammation, doctors call it gastropathy; the two look alike and are managed in similar ways.

The most common causes are infection with Helicobacter pylori (H. pylori) bacteria, the most common cause of gastritis; nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen and aspirin; and alcohol. Other causes include bile flowing back from the intestine, an autoimmune reaction and the stress of a severe illness.

Many people with gastritis feel nothing at all. If your main problem is heartburn rising into your chest, see acid reflux; if you are not sure where the pain comes from, read stomach pain.

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Gastritis is handled in a doctor visit, the same price for every age, with no membership. You pay by card when you request the visit, and you get a full refund if the clinic can’t see you. A doctor’s note is included. We do not bill insurance; the lab and the pharmacy charge separately. See all prices. The service is run by The Health Initiative, a nonprofit.

When gastritis causes symptoms, they are usually those of indigestion:

• Pain or discomfort in the upper belly
• Nausea or vomiting
• Feeling full too soon while eating
• Feeling full for too long after eating
• Poor appetite
• Weight loss

If H. pylori is the cause: treatment combines two or more antibiotics with a medicine that lowers stomach acid (a proton pump inhibitor). Take every dose: stopping early lets the bacteria survive and become resistant. The test is repeated at least 4 weeks after you finish, to confirm the bacteria are gone. If you are already our patient, we review that result with you in a follow-up visit.

If anti-inflammatory painkillers are the cause: the doctor helps you cut down, stop or switch to another pain reliever, and may prescribe a medicine that protects the stomach. Do not stop an aspirin prescribed for your heart without talking to your doctor.

For symptom relief: antacids, H2 blockers and proton pump inhibitors are options. The doctor tells you which fits your case. According to the NIDDK, diet does not cause most gastritis, but cutting down on alcohol helps.

The doctor orders an H. pylori test when your symptoms point to gastritis or an ulcer, especially if they are not improving. If there are signs of bleeding, anemia or weight loss, we give you a lab order and refer you for an endoscopy.

On what to eat: no diet or food has been proven to cure gastritis. According to the NIDDK, what you eat does not play a major role in causing or preventing most gastritis, so a gastritis diet is more about avoiding what irritates your stomach and replacing what you are low on than about a list of miracle foods. What the evidence does support:

• Cut down on alcohol. Drinking a large amount of alcohol can cause acute erosive gastropathy (NIDDK), and MedlinePlus advises against long-term alcohol use.
• Avoid anti-inflammatory painkillers if they caused your gastritis. MedlinePlus advises against long-term use of aspirin, ibuprofen, naproxen and other anti-inflammatories. The doctor helps you cut down, stop or switch to another pain reliever. Do not stop an aspirin prescribed for your heart without talking to your doctor.
• If a food gives you an allergic reaction, avoid it. The NIDDK lists food allergies as one cause of gastritis.
• Ask before you take supplements. In rare cases, iron supplements can cause gastritis; the NIDDK advises talking with your doctor before taking vitamins or supplements.
• If gastritis has lowered your iron or B12. According to the NIDDK, gastritis caused by H. pylori or autoimmune gastritis can keep you from absorbing iron and vitamin B12 and lead to anemia; the doctor can order lab tests and recommend iron, folic acid or B12 supplements.

These signs can mean bleeding in the stomach. For your safety, go to the emergency room or call 911. See when to go to the ER.

• Vomiting red blood or something that looks like coffee grounds
• Black, tarry stool, or red or maroon blood in the stool
• Dizziness, shortness of breath or extreme tiredness with stomach pain
• Sudden, severe stomach pain, or a hard belly that is tender to the touch