Gastritis is an extremely common inflammatory condition. While there are several causes, the most common cause is H. Pylori infection, which affects 50 to 75% of the world's population. In the long run, it is worth understanding one's gut health, including gastritis status, as it can have negative long-term implications, even if symptoms are barely noticeable.
This article will discuss gastritis, its causes, how to test for the root causes, and a functional approach to this condition.
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What is Gastritis?
Gastritis is an inflammation of the mucosal lining of the stomach. It is most often the result of an infection or autoimmune process. The most common infection associated with gastritis is H. Pylori, but other bacteria and viruses can also contribute.
Other irritating factors can certainly cause gastritis as well. Some of these are alcohol, NSAIDS, and stress. Additionally, a situation where there is bile reflux to the stomach from the small intestine can quickly cause irritation. Physical, emotional, and mental stress can also contribute to gastritis. Gastritis may be acute, occurring for a short period, or chronic, lasting longer.
There are two main types of gastritis, both of which involve inflammation. But only one type can also lead to the erosion of the stomach lining with time. If this remains untreated, it can gradually result in the loss of gastrin and acid-producing cells in the stomach, affecting digestion. Over time, it also increases the risk of developing stomach cancer. Gastritis with ulcerations may also cause hidden blood loss.
What are the Symptoms of Gastritis?
Gastritis, especially when acute, may not cause significant symptoms or may present as an upset stomach. This case is often identified incidentally during an upper endoscopy for a different condition.
When symptoms of gastritis are experienced, the most common include:
- Frequent upset stomach or pain
- Nausea, vomiting
- Upper abdominal pain
- Indigestion
- Abdominal bloating, sense of fullness or burning
- Loss of appetite
- Hiccoughs and belching
- Vomiting blood or black material resembling coffee grounds
- Black tarry stools (from bleeding)
Causes of Gastritis
Gastritis is caused when something irritates the lining of the stomach, weakening it. By far, the most common cause of gastritis worldwide is infection with the bacteria Helicobacter pylori (H. Pylori).
Some lifestyle factors can be irritating to the stomach and cause gastritis. A few of these are alcohol abuse and ongoing use of Non-Steroidal Anti Inflammatory (NSAID) medications or corticosteroids to manage pain. Smoking also appears to contribute to an elevated risk of both acute and chronic gastritis.
Some medical conditions can damage the stomach lining. These include autoimmune conditions that create an immune attack against the stomach lining, and bile reflux, which happens when bile moves backward up the GI tract from the small intestine to the stomach, which can cause a great deal of irritation.
Sudden onset of significant stress, including illness or injury, can lead to gastritis. This is not uncommon with severe burns and brain injuries.
Certain genetic variants also increase the risk of gastritis through different mechanisms. Genetic variants of the Human Leukocyte Antigen (HLA) genes, specifically HLA-DRB1*4 and DQB1*3 variants, may predispose people to autoimmune gastritis. For atrophic gastritis (AG), a precancerous condition, several genetic variants or single nucleotide polymorphisms (SNPs) related to immune response are related to increased risk. These include: TLR1 rs4833095, IL-10 rs1800871, IL-8 rs4073 and PSCA rs2294008. TLR4 rs11536878 may decrease susceptibility to atrophic gastritis, while DQA1*0102 may protect against H. Pylori infection, atrophic gastritis, and gastric cancer.
Functional Medicine Labs to Test for Root Cause of Gastritis
In addition to conventional testing, functional medicine testing for gastritis may include further tests to evaluate potential causes. These tests may include the following:
H.Pylori Testing
Stool antigen testing has high sensitivity and specificity to detect active H. Pylori infection. This is the most common cause of gastritis, so ruling in or out H.Pylori is imperative.
Food Allergy Panel
As consuming foods that one is allergic or sensitive to can worsen irritation and inflammation, evaluating for food allergies or sensitivities in the presence of gastritis is often a priority.
Autoimmune Testing
If there is evidence on endoscopy of cell changes suggesting autoimmune disease, antibodies to intrinsic factor, a protein required for your intestines to absorb vitamin B12, can be tested. The presence of these antibodies indicates autoimmune gastritis.
Stress Hormone Testing
Significant stress can cause changes in the production of cortisol, our body's major stress hormone. A salivary cortisol curve can show the daily pattern, helping to highlight whether shifts in cortisol production have occurred.
Micronutrients Testing
In addition, testing to evaluate nutritional status, particularly in relation to vitamin B12, iron, calcium, magnesium, and zinc, would make sense in cases of chronic gastritis, as the damage in severe gastritis may impair the absorption of these nutrients.
Additional Labs to Check
Conventional diagnostics for gastritis or complications may also be helpful. For example, an upper endoscopy, a breath test for H. Pylori infection, or antibodies to H. Pylori can help to further identify H. Pylori, the most common cause of gastritis.
Certain blood tests, such as a Complete Blood Count (CBC), can screen for anemia, including pernicious anemia, resulting from poor Vitamin B12 absorption. An occult blood stool test can also detect blood loss, a possible consequence of gastritis.
Bile Reflux Testing
If bile reflux is suspected, further evaluation may involve an upper endoscopy exam to physically look at the stomach lining and scintigraphy, a scanning test that tracks bile flow from the liver to the small intestine.
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Conventional Treatment for Gastritis
Conventional treatments for gastritis include antibiotics if a bacterial infection is found as well as antacids, such as Tums, to minimize irritation from stomach acid, histamine (H2) blockers like cimetidine (Tagamet), and proton pump inhibitors, such as omeprazole (Prilosec), to decrease the production of stomach acid.
Functional Medicine Treatment for Gastritis
The functional medicine approach to gastritis will mirror the root causes. This may include herbs, supplements to help heal the stomach mucosa and reduce inflammation, and antimicrobials or antibiotics if an infection is a component. Lifestyle factors and alternative pain management to NSAIDS/corticosteroids may also be a component of the treatment.
Diet for Gastritis
Moderating lifestyle factors, such as smoking and drinking alcohol, which are known to worsen gastritis, is generally helpful, especially during a healing period. Generally, a diet should focus on whole, plant-based foods, such as a Mediterranean diet, and avoid known food allergens.
Supplements and Herbs for Gastritis
There are several supplements and herbs that integrative practitioners use to heal the mucosal lining of the stomach. A few also show efficacy similar to antibiotics for H. Pylori infection, which may be especially useful in antibiotic-resistant infections. Here are several of the most common:
Anti-Inflammatory Herbs
The traditional Chinese herbal formula Zuojinwan has been used for centuries in the treatment of gastritis. Modern studies show a positive effect that may be related to anti-inflammatory pathways.
Anti-Microbial Herbs
For H.Pylori Infection, eradication of the infection is a key component of healing. The seeds of the black cumin plant (Nigella sativa) have shown efficacy similar to standard antibiotic therapy, thus, may present a useful alternative to antibiotics in some circumstances.
Pain Reduction Supplements to Reduce Reliance on NSAIDS
Finding alternative means of pain management that reduce or eliminate reliance on NSAIDs and corticosteroids will reduce exposure to these gastric irritants, which can worsen gastritis. Some commonly used herbs for inflammation and musculoskeletal pain are curcumin and Boswellia. For many kinds of pain, cannabis, especially high CBD strains, is often useful when legally available.
Stress Reducing Supplements
To the degree stress may be playing a role in gastritis, relaxing herbs or adaptogens that help to adapt to stress may be a helpful component of a treatment plan. Popular adaptogens include ashwagandha, ginseng, and rhodiola. Popular relaxing herbs include lavender, chamomile, tulsi, and lemon balm. Magnesium supplementation can also be helpful since lower magnesium levels are associated with increased susceptibility to stress.
How to Relieve Gastritis Naturally
A 2010 paper describes a yogic technique of "drinking" air, followed by a few minutes of inversion posture daily, as a very simple, low-cost, low-risk possible intervention for H. Pylori infection. H. Pylori is an anaerobic bacteria, meaning it does not thrive in the presence of oxygen.
In general, lifestyle factors reducing stress reactions will reduce that contribution to gastritis.
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Summary
Gastritis and H. Pylori infections are extremely common and can impact acute and long-term well-being. Integrative medicine has numerous things to offer in terms of getting a more specific understanding of what is leading to gastritis and how to cure it.
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