From the Guidelines
Acute gastritis is primarily caused by Helicobacter pylori infection, as well as other factors such as excessive alcohol consumption and regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). The most recent and highest quality study, published in 2022 1, highlights the importance of H. pylori infection in the development of acute gastritis, peptic ulcer disease, and gastric cancer. According to this study, H. pylori infection is the primary cause of atrophic gastritis, which is tightly linked to gastric cancer.
Causes of Acute Gastritis
- Infection with Helicobacter pylori bacteria
- Excessive alcohol consumption
- Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve)
- Severe stress from major surgery, trauma, burns, or severe infections
- Bile reflux from the small intestine into the stomach
- Certain bacterial or viral infections
- Autoimmune disorders that cause the immune system to attack healthy stomach cells
- Less common causes include cocaine use, ingestion of corrosive substances like strong acids or alkalis, and radiation therapy
Treatment and Prevention
Treatment of acute gastritis depends on the specific cause, but may include acid-reducing medications like proton pump inhibitors (omeprazole 20mg daily) or H2 blockers (ranitidine 150mg twice daily), as well as antibiotics for H. pylori infection (typically a 14-day regimen of amoxicillin, clarithromycin, and a proton pump inhibitor) 1. Avoiding triggers like alcohol, NSAIDs, and spicy foods is essential for recovery and prevention of recurrence.
Importance of H. pylori Eradication
The study published in 2022 1 emphasizes the importance of H. pylori eradication in preventing gastric cancer and reducing the incidence of peptic ulcer disease. Countries with a high prevalence of gastric cancer, such as Japan, Korea, Taiwan, and China, have introduced or are planning to introduce population-wide H. pylori eradication programs. Eradicating H. pylori infection is crucial in preventing the development of gastric cancer and reducing the risk of peptic ulcer disease.
From the Research
Causes of Acute Gastritis
- Helicobacter pylori infection is a major cause of chronic gastritis, but its role in acute gastritis is less clear 2, 3, 4, 5
- Non-steroidal anti-inflammatory drugs (NSAIDs) can cause gastroduodenal ulcers and ulcer complications, and may also contribute to acute gastritis 3
- Other factors, such as acid suppression by antacids and H2 receptor antagonists, may not increase the incidence of atrophic gastritis in patients with or without H. pylori gastritis 6
Helicobacter pylori Infection
- H. pylori infection is a class I carcinogen according to the WHO and is the main cause of relevant diseases such as atrophic gastritis, peptic ulcer disease, and gastric cancer 2
- Eradication of H. pylori before NSAID treatment decreases the occurrence of ulcers 3
- H. pylori eradication therapy should be given to all H. pylori-infected patients with peptic ulcers, irrespective of whether or not they have used NSAIDs 3
NSAIDs and Acute Gastritis
- NSAIDs can cause gastroduodenal ulcers and ulcer complications, and may also contribute to acute gastritis 3
- The use of NSAIDs can interact with H. pylori infection to increase the risk of ulcers and ulcer complications 3
- Proton pump inhibitors are superior to placebo for the prevention of ulcer recurrence, but are inferior to full-dose misoprostol for the prevention of ulcers among those with NSAID ulcers and no H. pylori infection 3