Erosive gastritis occurs when inflammation gradually damages the lining of the stomach, causing shallow cracks (called erosions) and ulcers.
People with erosive gastritis experience symptoms such as burning stomach pain, nausea, vomiting and loss of appetite. If erosions or ulcers bleed, symptoms may include black or tarry stools, fatigue, shortness of breath, and vomiting blood.
Treatment options for erosive gastritis are available. Medicines can help reduce stomach acid production, and procedures can stop internal bleeding if necessary.
There are two types of erosive gastritis: acute (short-term) and chronic (long-term). Healthcare professionals classify the types based on how quickly the condition develops and how long the inflammation lasts.
Acute erosive gastritis
Acute erosive gastritis develops suddenly when substances such as alcohol, non-steroidal anti-inflammatory drugs (NSAIDs) or cocaine irritate and damage the lining of the stomach. The length of the condition depends on when it is diagnosed and on the effectiveness of the treatment. Most people recover within a month.
Stress gastritis is a subform that develops when the physical stress of a critical illness or injury, such as severe burns or sepsis, reduces blood flow to the stomach, making it more vulnerable to damage from stomach acid.
Chronic erosive gastritis
Chronic erosive gastritis is a long-term form that develops gradually over time. In this type, the inflammation can last for months or years, damaging the lining of the stomach.
The most common causes are persistent use of non-steroidal anti-inflammatory drugs (NSAIDs) and continuous alcohol consumption. Viral infections (eg, cytomegalovirus), radiation exposure, and underlying digestive disorders such as Crohn’s disease can also lead to chronic erosive gastritis.
Symptoms of erosive gastritis vary depending on the severity of the damage to the stomach lining and whether ulcers or erosions are causing stomach bleeding. Mild erosive gastritis may not cause any symptoms.
As the condition progresses and symptoms develop, you may experience:
- Stomach pain or burning
- Nausea and vomiting
- Loss of appetite
- Feeling full too quickly when eating
- Bloating or feeling uncomfortably full after a meal
- Unintentional weight loss
When erosive gastritis wears away at the lining of the stomach and causes ulcers or erosions that bleed, symptoms can worsen and you may develop:
- Black, tarry stool
- Red or maroon blood in the stool
- Abdominal pain and cramps
- Fatigue
- Weakness
- Shortness of breath
- Haze
- Red blood in vomit or vomit that resembles coffee grounds
Erosive gastritis develops when inflammation damages the lining of the stomach, leading to ulcers (open sores) and shallow fissures (erosion). The most common causes of erosive gastritis are substances that irritate the protective lining of the stomach, including:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Alcohol
- cocaine
About 5% of people with critical illness or severe injuries also develop erosive gastritis.
In critical situations, the body prioritizes blood flow to essential organs such as the brain and heart, often reducing circulation to the stomach and digestive tract. Limited blood supply weakens the protective lining of the stomach, making it susceptible to damage from digestive acids and leading to ulcers and erosion.
Common causes of stress-related erosive gastritis include:
- Sepsis
- Severe burns
- Head injury or trauma
- Critical illness
- Use of mechanical ventilation (a machine that helps people breathe)
Risk factors
Certain factors can increase the likelihood of developing erosive gastritis, including:
- Age: Middle-aged and older people are more likely to develop erosive gastritis.
- Chronic use of NSAIDs: Long-term use of nonsteroidal anti-inflammatory drugs, such as Advil (ibuprofen), Aleve (naproxen), and Bayer (aspirin), increases the risk of stomach irritation and erosion.
- Heavy or prolonged alcohol consumption: Alcohol irritates and weakens the stomach lining over time.
- infections: Bacterial, viral and fungal infections affecting the gastrointestinal tract can increase the risk in people with weakened immune systems.
- Serious illness or injury: Critical conditions such as traumatic injury, sepsis, or surgery can reduce blood flow to the stomach, increasing the risk of erosive gastritis.
- Autoimmune conditions: Certain autoimmune disorders, including Crohn’s disease and sarcoidosis, can contribute to inflammation of the stomach lining.
- Cancer treatment: A history of radiation therapy or chemotherapy can weaken and damage the lining of the stomach.
During your examination, your health care provider may ask questions about your symptoms, when they developed, what medications you are taking, and how much alcohol you consume. Your health care provider may also order diagnostic tests to help detect inflammation, bleeding, and the extent of stomach damage.
These tests may include:
- Blood test: It identifies markers of infection and inflammation and checks for anemia
- Chair test: He takes a stool sample to check for blood in the stool, which is a sign of bleeding in the stomach
- Upper GI endoscopy: It uses a flexible tube with a small camera to view the abdomen and identify areas of erosion or ulceration
- biopsy: Removes a small sample of tissue from the lining of the stomach and looks at it under a microscope to check for inflammation and other abnormalities
Treatment for erosive gastritis focuses on reducing inflammation in the stomach lining to manage symptoms, promote healing, and prevent further erosion. Depending on the underlying cause and severity of erosive gastritis, your treatment plan may include lifestyle changes, medications, or medical procedures.
Lifestyle changes
Lifestyle changes can help manage the symptoms of erosive gastritis and help your stomach lining heal. Your healthcare provider may recommend:
- Make dietary adjustments: Avoid spicy, sweet, sour and fatty foods that can irritate the stomach lining and opt for foods that are gentle on the stomach, such as white bread, rice, oatmeal and cooked vegetables.
- Avoid or stop smoking and drinking alcohol: Tobacco and alcohol can irritate the lining of the stomach and prevent or slow down the healing of ulcers and erosions.
- Change your NSAID use: If you are taking NSAIDs, your healthcare provider may recommend switching to alternative pain relievers to avoid further damage to the stomach lining.
Medicines
Medicines that help control stomach acid levels are the main treatment for erosive gastritis. Your healthcare provider may prescribe:
- Proton pump inhibitors (PPIs): They protect the lining of the stomach and promote healing by reducing the production of stomach acid. PPIs include Prilosec (omeprazole), Nekium (esomeprazole), Prevacid (lansoprazole), and Protonic (pantoprazole).
- H2 blockers: These over-the-counter (OTC) medications such as Pepcid (famotidine), Acid (nizatidine), and Tagamet (cimetidine) reduce the production of stomach acid to control symptoms and promote healing.
- sucralfate: Carafate (sucralfate) is a drug that creates a protective barrier on damaged parts of the stomach lining. It acts as a shield against stomach acids, allowing the tissue to heal without further irritation.
Medical procedures
If erosive gastritis is causing stomach bleeding and severe blood loss, your healthcare provider may recommend a medical procedure to stop the bleeding.
- Endoscopic hemostasis: During this procedure, your healthcare provider will use an endoscope (a flexible tube with a camera) to locate the source of the bleeding and administer treatments to stop the bleeding. Depending on the severity of the bleeding, your doctor may use thermal coagulation (using heat to stop the bleeding), endoscopic clips (to close and seal the erosion), or injection therapy (injecting medicine into the bleeding area).
- Surgery: Although rare, surgery is sometimes needed when other treatments fail to stop bleeding in the stomach.
It is not always possible to prevent erosive gastritis, but certain lifestyle habits can help reduce the risk of developing this condition. You can try to:
- Limit the use of NSAIDs
- Stop or avoid smoking
- Avoid alcohol or drink in moderation
- Manage your stress levels with hobbies you enjoy, relaxation techniques and breathing exercises
- Eat smaller, more frequent meals throughout the day
- Reduce your intake of overly spicy, sweet or fatty foods
Untreated erosive gastritis can lead to other health problems, including:
- Gastrointestinal bleeding: Erosion of the stomach lining increases the risk of bleeding, which can appear as blood in vomit or stool and can lead to anemia.
- anemia: Chronic bleeding from erosive gastritis reduces the number of red blood cells, leading to anemia and symptoms such as fatigue, weakness, headache, irritability, loss of appetite, and shortness of breath during physical activity.
- Pyloric stenosis: Chronic inflammation and ulcers in the stomach can cause scar tissue to form in the stomach, narrowing the passage between the stomach and the small intestine, which can obstruct the passage of food and cause vomiting and abdominal pain.
- perforation: An untreated stomach ulcer can lead to holes in the lining of the stomach (known as perforation), which allows stomach contents to leak into the abdominal cavity. This can cause peritonitisa life-threatening infection that requires immediate treatment.
Erosive gastritis causes inflammation that damages the lining of the stomach, leading to ulcers and erosion. Long-term use of NSAIDs and excessive alcohol consumption are the most common causes of erosive gastritis.
If you develop this condition, common symptoms include stomach pain, nausea and loss of appetite. Treatments such as lifestyle changes, medications, and procedures can help heal the lining of the stomach and prevent complications.