- Chronic gastritis is a long-standing inflammation of the stomach lining (gastric mucosa) that develops gradually over time. Unlike acute gastritis, which presents suddenly and may resolve quickly, chronic gastritis persists for months or years and often progresses silently without noticeable symptoms in its early stages. When symptoms do appear, they may include upper abdominal discomfort, bloating, nausea, a feeling of fullness after eating small amounts of food, and occasional vomiting. In some cases, chronic gastritis can lead to more serious complications, such as gastric atrophy, intestinal metaplasia, or even stomach cancer.
- The causes of chronic gastritis are multifactorial. One of the most common causes worldwide is infection with Helicobacter pylori, a spiral-shaped bacterium that colonizes the gastric mucosa and induces chronic inflammation. Over time, the persistent immune response and bacterial toxins damage the stomach lining, potentially leading to atrophic gastritis and increasing the risk of gastric cancer. Another important cause is autoimmune gastritis, in which the immune system attacks the stomach’s parietal cells, reducing acid and intrinsic factor production, leading to hypochlorhydria and vitamin B12 deficiency. This can result in pernicious anemia if left untreated.
- Other contributing factors to chronic gastritis include long-term use of NSAIDs, chronic alcohol consumption, smoking, and bile reflux. Prolonged exposure to these irritants can weaken the protective mucosal barrier of the stomach, allowing acid and digestive enzymes to cause ongoing damage. Additionally, chronic gastritis may be associated with other conditions, such as Crohn’s disease or certain infections, including viruses or parasites, though these are less common.
- Diagnosis of chronic gastritis typically involves endoscopy with biopsy to examine the gastric mucosa and assess the extent of inflammation or mucosal damage. Histological examination can reveal characteristic changes such as glandular atrophy, intestinal metaplasia, or lymphocytic infiltration. Testing for H. pylori (via urea breath test, stool antigen test, or biopsy-based methods) is crucial, given its significant role in chronic gastritis.
- Management of chronic gastritis focuses on treating the underlying cause, alleviating symptoms, and preventing complications. If H. pylori infection is identified, it should be eradicated with a combination of antibiotics and proton pump inhibitors. In autoimmune gastritis, monitoring for vitamin B12 deficiency and administering supplementation is essential. Lifestyle changes such as avoiding NSAIDs, limiting alcohol intake, quitting smoking, and adopting a balanced diet can also help reduce mucosal irritation and support healing.
- Though chronic gastritis may remain asymptomatic for years, its long-term effects on the gastric mucosa can be serious. Regular monitoring and appropriate medical care are vital to prevent progression to atrophic gastritis, peptic ulcers, or gastric neoplasia. With timely intervention, the inflammatory process can be controlled, and complications can often be avoided.
