Gastritis Pain Characteristics
None of the listed options (A-D) are typical of gastritis. Gastritis typically presents with epigastric pain or discomfort that worsens after eating, not with the specific patterns described in these answer choices 1, 2.
Why Each Option is Incorrect
Option A: Pain worse on drinking warm milk
- This is atypical for gastritis. Gastritis pain characteristically worsens after eating, but warm milk specifically is not a recognized aggravating factor 1.
- In fact, gastritis often presents with nonspecific dyspeptic symptoms rather than food-specific triggers 2, 3.
Option B: Pain which wakes the child from sleep
- This pattern is more characteristic of peptic ulcer disease, not gastritis. Nocturnal pain awakening patients from sleep suggests duodenal ulcer rather than gastritis 1.
- Gastritis is typically asymptomatic or presents with daytime postprandial discomfort 4, 2.
Option C: Pain worse first thing in the morning and relieved by eating
- This classic pattern describes duodenal ulcer, not gastritis. The "hunger pain" relieved by food intake is the hallmark of duodenal ulcer disease 1.
- Gastritis pain typically worsens after eating, not improves 1, 2.
Option D: Pain going through to the back
- This radiating back pain suggests pancreatic pathology or posterior penetrating peptic ulcer, not gastritis. Gastritis pain remains localized to the epigastrium 1.
- Back radiation is a red flag for more serious pathology requiring urgent evaluation 1.
Actual Typical Features of Gastritis
The characteristic presentation includes:
- Epigastric pain or discomfort that worsens after eating 1, 2
- Early satiety and postprandial fullness 1, 2
- Nausea and vomiting 1
- Bloating and abdominal distension 1
- Heartburn or acid reflux symptoms 1
- Frequently asymptomatic, especially in early stages 4, 2, 3
Critical Clinical Pitfall
The most important caveat: Gastritis often causes no symptoms at all and is frequently an incidental finding 4, 2, 3. Studies demonstrate no reliable correlation between upper abdominal dyspepsia, endoscopic findings, and histological gastritis 3. When symptoms do occur, they are nonspecific and overlap significantly with functional dyspepsia 1, 2.