Discomfort in the upper abdomen, nausea and fullness during or after a meal, and loss of appetite can be generally dismissed as dyspepsia (indigestion) and acidity. However, these symptoms could also collectively point toward a condition we often overlook — gastritis. Gastritis affects the lining of the stomach and causes its inflammation (swelling and reddening), according to the US government’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Infection by a bacteria called Helicobacter pylori (H. pylori) is the most common causes of gastritis,” according to NIDDK. “The bacteria can spread through contact with an infected person’s vomit, stool, saliva, or contaminated food and water.”
Causes of gastritis
“Irregular mealtimes, eating very spicy, fried and processed food, alcohol and smoking shoot up the acid concentration levels in the stomach, causing inflammation,” says Dr Ashok Goswami, registered medical officer at Anand Hospital, Surat.
Shilpa Joshi, a Mumbai-based registered dietitian and secretary of All India Association of Advancing Research in Obesity, says food that delays gastric emptying and overstuffs the stomach — for example, food that is high in fat, fibre, salt or sugar — can increase acid secretion and trigger gastritis.
As per NIDDK, the slowing down of the movement of food from the stomach to the small intestine — longer than one and a half hours to two hours — is called gastroparesis or delayed gastric emptying.
Dr Monica Matani, a homeopath from Mumbai, told Happiest Health that infection, prolonged medication, stress and intolerance to certain foods contribute to gastritis.
Alcohol, smoking and H. pylori
“Alcohol causes severe gastritis, even if diluted,” says Joshi. In many countries where alcohol consumption is a part of the meal, the intake is balanced with light food, she says.
A pooled analysis of three studies from southern Germany, published in the Epidemiology journal in 2001, said that alcoholic beverages have antimicrobial effects against H. pylori and moderate alcohol consumption may favour suppression and eventual elimination of H. pylori infection.
But with higher levels of alcohol consumption, the antimicrobial effects of alcoholic beverages may be opposed by adverse effects on the immune system.
Similarly, another study published in 2010 in the journal Alcohol and Alcoholism revealed that alcohol consumption facilitates H. pylori infection, presumably by damaging the gastric mucosa. The study indicated that the H. pylori positive rate was higher in smokers as compared to non-smokers, but the difference was not statistically significant.
Does gastritis need attention?
Up to 50.8 per cent of the population in developing countries suffer from gastritis.
But Dr Goswami says gastritis is not a very serious condition “unless it becomes chronic [when symptoms last for over a month]”.
Highlighting the difference between acute and chronic gastritis, Dr Matani says that the onset and intensity of symptoms (nausea, vomiting, stomachache and body ache with fever) are sudden in acute gastritis, whereas chronic gastritis has prolonged low-intensity symptoms with no fever.
For Dr MR Sathyanarayana, a consulting physician at Nanjappa Multi-Speciality Hospital, Shivamogga, Karnataka, the concern is more towards morbidity (suffering) in comparison with mortality (death) in gastritis. “Untreated gastritis damages the gastric mucous membrane (protective layer), exposing the gastric mucosa to the acid in the stomach,” says Dr Sathyanarayana. “This leads to complications like ulcer formation and hemorrhage.”
Most people confuse symptoms of gastritis with acid reflux and consequently delay treatment. Undiagnosed gastritis can cause stomach ulcers and in rare cases increase the risk of stomach cancers, says Dr Goswami.
Symptoms of gastritis
The diagnosis of gastritis is symptom-based. If the person doesn’t feel better within four or five days after symptomatic treatment, tests such as a uric acid test, erythrocyte sedimentation rate for detecting inflammation, and complete blood count for anemia are advised, says Dr Goswami. “Only if symptoms persist for over two months, despite the test investigations being normal, is endoscopy advised,” he says.
Medical history and physical examination form the basis of primary diagnosis, says Dr Sathyanarayana.
If symptoms persist, gastrointestinal endoscopy (to assess the severity of inflammation within the stomach), biopsy (to collect tissue samples for further testing), urea breath test, stool test, serology test and antigen test (to detect H. pylori infection) are done, he says.
Treatment for gastritis
The experts Happiest Health spoke to unanimously agreed that gastritis can be cured.
Dr Matani says homeopathy treatment has cured ulcers and shown excellent results even in acute ulcers.
The first step is to remove triggers that increase the acid levels in the stomach to manage the condition effectively, says Dr Goswami. It is important to consult a doctor if symptoms persist for more than four days, he says.
“Most people take antacids for a prolonged period, which could jeopardize their health in case of an undetected ulcer,” says Dr Goswami. “In some cases, it can lead to perforations in the stomach.”
Shilpa Joshi says dietary intervention is highly individualized and whatever increases acid levels must be avoided. “For 80 per cent of my clients, spicy and oily food, ready-made spices, Indian fermented foods (like dosa, idli), black lentils, yellow lentils (like tur dal), tea, coffee and non-vegetarian food are all gastritis triggers,” she says. Joshi also recommends soft-textured smaller meals, avoiding lying down within one hour of eating and taking any medication after meals (after doctor’s confirmation).
According to Dr Sathyanarayana, dietary changes, regular exercise, proper hydration, sufficient sleep and medications — antacids, antibiotics, proton pump inhibitors (PPI, medicines that shut down the proton pump, which is a membrane in the stomach that secretes gastric acid), H2 receptor blockers (medicines that restrict histamine, which stimulates gastric acid) — reduce acid levels in the stomach and go hand in hand with the treatment of gastritis.
Homeopathy and gastritis
Dr Matani says unlike allopathy, homeopathy goes beyond the foundational cause of an ailment and considers the entire physical and mental make-up of a person for treatment. Therefore, different people with the same condition receive different medicines in homeopathy. “People with acute gastritis have shown remarkable improvement with one to two doses, dispelling the myth that homeopathy works slowly,” she says.
For chronic gastritis, the focus is not on providing immediate symptomatic relief but on addressing the problem at the root level with constitutional treatment. The treatment continues even after the symptoms are relieved to remove the tendency of the condition from the body, says Dr Matani.
A 2021 case report of acute gastritis was published by Homeobook, an international platform for homeopathic students, teachers and professionals. It showcased how a 21-year-old man with seven days’ history of gastritis symptoms showed significant improvement within three days of homeopathic treatment as compared with antibiotics.
“Stress is one of the major contributors to gastritis causes,” says Joshi. “Although stress cannot be eliminated from one’s life, it can be managed effectively.”
Yoga and gastritis
Umme Iymen Zoeb, a Bengaluru-based yoga therapist, says that pranayama and asanas stimulate the endocrine gland (the hormone-producing gland) and hypothalamus (a region of the brain that controls sleep and emotional activity), which increase mood-enhancing chemicals like serotine and norepinephrine in the brain and reduce the secretion of the stress hormone cortisol.
Dr V Venugopal, assistant medical officer and lecturer, department of yoga, Government Yoga and Naturopathy Medical College, Chennai, says the holistic approach of yoga — including asanas, pranayama and meditation — has been well-documented to have anti-inflammatory properties that help in treating gastritis, which is the result of inflammation of the stomach lining.
A systematic review published in the Frontiers of Immunology journal in 2017 says that mind-body practices like meditation downregulate the activity of certain pro-inflammatory genes (NF-κB genes) that reverse the molecular damage caused by stress.
Dr Venugopal says yogic breathing exercises such as sheetali pranayama (a breathing practice that cools the body and the mind), sheetkari pranayama (breathing technique to cool the body), sadanta (the practice of controlled breath to calm the mind) and brahmari pranayama (breathing practice that soothes the nervous system) are useful in stimulating the parasympathetic nervous system. The parasympathetic nervous system slows down the heart rate, dilates blood vessels, decreases pupil size, increases digestive juices and relaxes muscles in the gastrointestinal tract, consequently reducing stress.