Chronic gastritis is a slow-developing inflammation of the stomach lining that can last for months. In many cases, it causes no symptoms, but some people may experience abdominal discomfort, nausea, or loss of appetite.
Over time, chronic gastritis can lead to changes in the stomach lining. These changes may progress to more serious conditions, such as gastric ulcers, gastric atrophy, or intestinal metaplasia.
Treatment should always be guided by a gastroenterologist and depends on the underlying cause. It may involve medication and dietary changes, often with support from a nutritionist.
Main symptoms
The main symptoms of chronic gastritis include:
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Pain or burning in the upper abdomen
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Nausea
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Vomiting
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Feeling full after meals
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Loss of appetite
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Bloating or abdominal discomfort
In more severe cases, symptoms may include bleeding, persistent vomiting, and dizziness.
Most of the time, chronic gastritis does not cause very specific symptoms.
Possible causes
The main causes of chronic gastritis include:
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Long-term use of anti-inflammatory drugs, such as aspirin
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Viral or bacterial infections, especially Helicobacter pylori infection
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Chronic stress
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Autoimmune diseases, such as Hashimoto’s disease
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Diabetes or kidney disease
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Bile reflux
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Crohn’s disease
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Celiac disease
Chronic gastritis is more common in people who drink heavily, smoke, are older, or have weakened immune systems, such as those with HIV.
A high-fat diet may also increase the risk of developing chronic gastritis.
How to confirm a diagnosis
A gastroenterologist can diagnose chronic gastritis by reviewing a person’s medical history and symptoms, although many people do not have symptoms.
When discomfort is present, the doctor may order an upper endoscopy, a test that allows direct visualization of the stomach lining to check for inflammation. During the procedure, the doctor may also collect tissue samples to test for H. pylori infection.
Classification of chronic gastritis
Chronic gastritis can be classified by the stage of inflammation or by the part of the stomach affected:
1. Mild chronic gastritis
Occurs when inflammation affects only part of the stomach, usually the surface layer of the lining. This is considered the earliest stage of the disease.
2. Moderate chronic gastritis
At this stage, the stomach shows more significant damage, representing a more advanced form of the condition.
3. Severe chronic gastritis
Involves intense inflammation of the stomach lining, increasing the risk of tissue changes such as atrophy and metaplasia. Complications may include ulcers and, in some cases, stomach cancer.
4. Inactive chronic gastritis
Inflammation occurred in the past but shows no current activity. The stomach lining may still have changes caused by earlier inflammation, but there is no ongoing damage.
5. Antral chronic gastritis
Affects mainly the antrum, the lower part of the stomach that controls the passage of food into the intestine. This type is most often linked to H. pylori infection.
6. Chronic gastritis in the body of the stomach
Affects the middle part of the stomach, known as the gastric body. This form is often associated with autoimmune diseases, which can lead to mucosal atrophy and increase the risk of vitamin B12 deficiency and pernicious anemia.
Treatment options
Treatment for chronic gastritis depends on the cause and may include:
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Medications: common options include antacids with aluminum hydroxide, proton pump inhibitors such as omeprazole, and antibiotics if there is a bacterial infection.
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Soothing herbal teas: chamomile tea and ginger tea may help relieve discomfort and reduce inflammation.
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Easily digestible foods: meals should be grilled or steamed, seasoned with natural herbs, and low in fat.
It is important to avoid alcohol, soda, processed juices, fatty meats, full-fat dairy, yellow cheeses, pizza, frozen meals, and fast food.
Dietary changes are key to managing chronic gastritis. A nutritionist can provide a complete evaluation and create a personalized eating plan.
Can chronic gastritis be cured?
Chronic gastritis can often be controlled and, in some cases, cured, especially when the cause is identified and treated, such as H. pylori infection or long-term use of irritating medications.
When permanent damage to the stomach lining has already occurred, such as atrophy or metaplasia, treatment focuses on managing symptoms and preventing complications rather than reversing the condition.
Risk factors
The risk of developing chronic gastritis is higher in people who:
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Eat a diet high in fat or salt
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Smoke
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Drink excessive amounts of alcohol
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Use certain medications long term, especially anti-inflammatory drugs
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Live under intense stress
Autoimmune diseases may also increase the risk by weakening the stomach cells’ natural defenses against acid.