From the Guidelines
Gastritis risk factors are primarily driven by Helicobacter pylori infection, which is a major cause of peptic ulcer and gastric cancer, as well as other factors such as regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), excessive alcohol consumption, smoking, and stress from severe illness, trauma, or burns. According to the study by 1, H. pylori infection is generally acquired in childhood, especially via transmission within families, and the lifetime risk of peptic ulcer is approximately 1 in 6 (∼17%) among those with H. pylori infection.
Key Risk Factors
- H. pylori infection, which is a major cause of peptic ulcer and gastric cancer, as supported by 1
- Regular use of NSAIDs, such as aspirin, ibuprofen, and naproxen, which can irritate the stomach lining
- Excessive alcohol consumption, which damages the stomach's protective mucous layer
- Smoking, which increases stomach acid production and impairs healing
- Stress from severe illness, trauma, or burns, which can lead to stress gastritis
- Age, with older adults at higher risk due to thinning stomach lining and increased medication use
- Autoimmune disorders, where the immune system attacks stomach cells
- Bile reflux from the small intestine into the stomach
- Certain viral or bacterial infections beyond H. pylori
Recent Guidelines
The study by 1 provides an update on the risk factors that should prompt consideration of a personalized approach to screening for gastric cancer in the United States. These risk factors include:
- Early-generation immigrants from moderate to high incidence GC regions
- Family history of GC in a first-degree relative
- Non-White racial and ethnic groups with established moderate to high incidence GC
- Personal history of chronic Helicobacter pylori infection and at least one of the following: history of regularly smoking tobacco, chronic consumption of high-salt diet, red meat, processed meats, and foods
- Individuals living under persistent poverty in the United States
- Certain hereditary GI polyposis syndromes and hereditary cancer syndromes
Recommendations
People with these risk factors should consider limiting NSAID use, moderating alcohol intake, quitting smoking, managing stress, and seeking medical attention for persistent symptoms like abdominal pain, nausea, or vomiting to prevent complications such as ulcers or bleeding, as supported by 1 and 1. A personalized approach to GC screening should be considered for individuals 45 years or older with multiple behavioral determinants, particularly those with current or former H pylori infection, as recommended by 1.
From the Research
Gastritis Risk Factors
- Helicobacter pylori infection is a major risk factor for gastritis and peptic ulcer disease 2, 3, 4, 5, 6
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are also a significant risk factor for gastritis and peptic ulcer disease 2, 3, 4, 5, 6
- The interaction between H. pylori infection and NSAID use is complex and may increase the risk of peptic ulcer disease, although the evidence is not conclusive 2, 4, 5, 6
- Low-dose aspirin use may also interact with H. pylori infection and NSAID use to increase the risk of peptic ulcer disease, particularly ulcer bleeding 5, 6
Key Factors in Gastritis Development
- Decrease in pH 2
- Imbalance between apoptosis and proliferation 2
- Reduction in mucosal blood flow 2
- Recruitment of polymorphonucleates in distinct compartments 2
Prevention and Treatment
- Eradication of H. pylori infection may reduce the risk of NSAID-induced gastritis and peptic ulcer disease 2, 4
- Proton-pump inhibitors (PPIs) may be effective in preventing and treating NSAID-induced gastritis and peptic ulcer disease 2, 3
- Omeprazole is a well-studied PPI that has been shown to be effective in preventing and treating NSAID-induced gastrointestinal damage 3