All about gastric - What causes gastric & how to differentiate between having gastritis and a gastric ulcer?

A gastric ulcer can cause gastritis, but gastritis is not always caused by a gastric ulcer.

I am prone to bouts of ‘gastric’. Every time I don’t eat, I get a funny, acidic, and very ‘hot’ feeling in my stomach. My mother tells me that having ‘gastric’ is the same as having a ‘gastric ulcer’. Is this true?

Actually, gastritis means inflammation of the lining of your stomach (‘gastro’ means stomach, and ‘-itis’ means inflammation). It’s not a single disease, but rather, a condition that is contributed to by many causes.

A gastric ulcer is an actual hole, or sore, or break in the normal lining of your stomach. Having gastritis does not necessarily mean you have the ‘hole’.

In gastritis, you have pain or discomfort in the upper area of your abdomen, the one flanked by the ‘V’ of your ribcage. This pain is sometimes called dyspepsia.

What causes ‘gastric’?

The causes are very varied:

● Infections: Bacteria (Helicobacter pylori being the most common), viruses, fungi, parasites and worms can all cost gastritis, as well as tuberculosis and syphilis.

● Medicines: Aspirin, non-steroidal anti-inflammatory drugs, steroids, potassium supplements, iron tablets and chemotherapy.

● Alcohol

● Poisons: For example, acid, bleach and foreign bodies, like plastic toys.

● Stress, due to being injured or very ill. Plenty of patients who are ill in the hospital develop gastritis.

● Frequent vomiting

What is this Helicobacter pylori bacteria? I have heard so much about it and the fact that it is related to ‘gastric’.

Rightly so. The discovery of this bacteria has changed the entire landscape of gastritis and gastric/duodenal ulcer treatment over the last two decades.

This bacteria infects 50% of the world’s population! Eighty percent of those infected have no symptoms.

Helicobacter pylori causes a very chronic, low grade inflammation of our stomach and duodenal lining. (The duodenum is the first part of our small intestine, which is divided into three parts.)

Ten percent of all those infected develop an ulcer.

This bacteria can survive the highly acidic environment of our stomach, and is impervious to being destroyed by our digestive enzymes.

Helicobacter pylori also causes an increased chance of you developing stomach cancer or lymphoma.

It must be eradicated if you test positive for it.

How can I differentiate between having gastritis and a gastric ulcer?

For gastritis, pain or discomfort in your central upper abdomen is common.

Sometimes, this pain goes right through from your stomach to your back. The pain feels ‘burning’, or ‘aching’, or ‘sore’.

The pain may be accompanied by belching, bloating, a feeling of fullness, nausea and even vomiting.

In severe gastritis, your stomach lining can bleed. Then, you may even vomit blood, and feel faint or dizzy, be very pale and sweaty, or have dark stools (or faeces).

It can be very difficult to differentiate symptom-wise between gastritis and a gastric ulcer, especially since a gastric ulcer is almost always accompanied by gastritis.

An endoscopy performed by a gastroenterologist is the best way to see your stomach lining.

This procedure requires you to be sedated, then to have an endoscope (a thin, flexible probe with a tiny camera attached to it) passed through your mouth and into your stomach.

At the end of the procedure, you will receive a CD-ROM of your own stomach lining!

So, a gastric ulcer is a complication of what can happen to your stomach lining as a result of gastritis.

How can I treat my gastritis?

Your doctor will have to find out the exact cause of your gastritis.

Once you know what is causing it, you have to avoid the cause.

For example, if the cause of your gastritis is a certain type of medication like aspirin, your doctor can then switch you to a similar type of medication that does not irritate your stomach.

If the cause is alcohol, then you have to cut down on your alcohol intake.

Coffee (caffeine) also triggers gastritis, so you should avoid it if you are prone to getting gastritis after drinking it.

To alleviate your ‘burning’ pain symptoms, you can take antacids.

If these are not enough, you can take histamines (H² blockers), like cimetidine or ranitidine. These reduce the acid secretion of your stomach.

Then there are the newer medicines like proton pump inhibitors (for example, omeprazole). They also block your stomach’s acid secretion, but through another mechanism.

How will I know if I have Helicobacter pylori?

You can take a test.

You can submit a blood sample to test for Helicobacter pylori antibodies. Or a stool sample to look for the actual antigen.

A biopsy can also be taken from your stomach lining through an endoscope, and tested.

Helicobacter pylori is eradicated by a triple therapy consisting of two antibiotics (amoxicillin and clarithromycin) and a proton pump inhibitor, taken for 10 days.

■ Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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