Chronic gastritis is characterized by constant stomach pain, weakness, nausea, belching, and digestive disturbances. Once the doctor mentions “chronic,” it can feel like a verdict. However, there’s no need to despair. Gastritis manifests differently, with varying symptoms depending on the type, and even in ICD-10 it has different codes for its various forms. But the essence remains: gastritis is a highly unpleasant disease that requires treatment. In this article, we will explore how to live with chronic gastritis, its classification, and its degrees.
What is Chronic Gastritis?
Chronic gastritis is a long-lasting inflammation of the stomach lining, which can lead to mucosal degeneration, structural changes, and atrophy of the cells. As the disease progresses, the glands in the stomach cease functioning and are replaced by connective tissue. Early symptoms may include mild issues with stomach secretion and motility, but as the disease advances, these problems worsen. Chronic gastritis can be classified based on:
- Anatomical location (antral or fundal gastritis)
- Origin (bacterial, autoimmune, endogenous, iatrogenic, reflux gastritis)
- Histological changes (superficial, atrophic, hyperplastic)
- Secretory function (hypacid, hyperacid, or normal secretion)
The most common types are: Type A: Autoimmune gastritis; Type B: Bacterial gastritis (typically due to Helicobacter pylori); Type C: Reflux gastritis. There are also specific forms like radiation, allergic, lymphocytic, and granulomatous gastritis. The disease may be in either a remission or active stage.
Symptoms of Chronic Gastritis
Chronic gastritis can sometimes show no external symptoms, especially in the early stages. However, typical symptoms include:
- Pain in the epigastrium (1.5–2 hours after eating)
- Feeling of fullness and heaviness in the stomach after meals
- Belching (air, food taste, or sourness), heartburn, and a metallic taste in the mouth
- Poor appetite, nausea, bloating, and rumbling
- Stool disturbances (constipation or diarrhea)
As the disease progresses, the inflammatory process spreads, leading to atrophy of the stomach lining and secretory insufficiency. In advanced cases, weight loss, pallor, and signs of vitamin deficiencies may appear.
Chronic Gastritis in Remission
In its remission phase, chronic gastritis shows few or no symptoms, and the patient may feel completely well. However, ongoing prevention and medical monitoring are necessary to avoid flare-ups. The primary cause of gastritis flare-ups is Helicobacter pylori, a bacterium that exacerbates the condition. Patients are advised to avoid alcohol, smoking, and excessive use of certain medications, as these can increase acidity and worsen symptoms.
During remission, the stomach lining may thicken, and mild tissue changes may be visible. Inflammation may return after periods of stress, poor diet, or alcohol consumption. Symptoms of an exacerbation include: Heaviness after eating; Pain in the stomach area; Heartburn and belching
Dietary choices play a significant role in managing symptoms. For example, consuming fried or citrus-rich foods can trigger discomfort and heartburn.
Chronic Gastritis with Erosion and Other Complications
Chronic erosive gastritis occurs when there are disruptions in the stomach’s secretory processes, leading to ulceration and the formation of erosions. Common signs include mild stomach pain, heartburn, and persistent dyspeptic symptoms. Severe cases may lead to gastric bleeding, which signals the formation of erosions. Reflux gastritis, or bile reflux gastritis, results from the backflow of bile into the stomach. Symptoms include:
- Weight loss, nausea, and vomiting
- Bloating and discomfort after eating
- Heartburn and belching
- Diarrhea or constipation
This condition is usually caused by a malfunctioning pyloric valve, surgical resection, or medications like NSAIDs. The treatment includes proton pump inhibitors to reduce acid production and prokinetics to restore normal stomach function.
Chronic gastritis, especially with complications like erosion and reflux, requires thorough diagnosis and management to prevent long-term damage. Diagnosis typically involves gastroscopy, blood tests, and pH-metry to assess acidity and Helicobacter pylori infection.