Gastritis, duodenitis and ulcers

 

Gastritis refers to an inflammation of the stomach. This can be due to an infection or excessive acid exposure in the stomach.

Duodenitis is an inflammation of the duodenum, a short segment of the small intestine which is connected directly to the stomach. Food enters the duodenum from the stomach and then makes its way along the small intestines.

Inflammation of the duodenum and stomach may be either mild or severe. Mild cases are simply a redness of the lining of the stomach and duodenum, while severe cases may present as erosions with bleeding and ulceration.

 

Symptoms

Gastritis and duodenitis may present with the following symptoms:

  • Upper abdominal pain – often located in the centre to the left upper area.
  • Pain which is related to meals (either better or worse with food)
  • Pain which is better with gastric medicine and antacids
  • Belching and bloating
  • Indigestion when taking a meal
  • Loss of appetite and weight loss

Ulcers in the stomach and duodenum may present as bleeding and anaemia (low red blood count). Rarely, ulcers may create a hole in the stomach or duodenum (perforation) leading to severe abdominal pain and fever. This is a life-threatening complication, which requires urgent surgery and antibiotics.

 

Diagnosis

The only way to check the stomach is to perform an endoscopy. This procedure is known as a gastroscopy or oesophagogastroduodenoscopy (OGD). Scans are unable to visualise the stomach and will miss both polyps and ulcers.

A gastroscopy (OGD) is a procedure in which a flexible tube with a video camera at its end is used to examine the stomach and duodenum. This device is inserted into the mouth and down the throat. Sedation is routinely given so that patients can remain relaxed and asleep.

The stomach and duodenum are inspected for inflammation and ulcers. Inflammation is observed as an area of redness in the digestive tract. A biopsy is taken to check for Helicobacter pylori, a common bacterial infection.

Sometimes, other organs such as the colon, pancreas, liver and gallbladder need to be examined too. This involves performing tests such as a colonoscopy, an ultrasound scan or a CT scan of the abdomen.

 

Treatment

Gastric problems are treated with three types of medicines:

  • Medicines to suppress gastric acid (e.g. proton pump inhibitors)
  • Medicines to neutralise gastric acid (antacids)
  • Medicines to relief the sensation of bloating (prokinetics e.g. domperidone)

If H. pylori, a bacterial infection of the stomach is present, then antibiotics are given. The eradication of H. pylori requires 2 antibiotics and a gastric tablet. Usually, all of these are taken twice daily for 7 to 14 days.

Modifying one’s lifestyle and diet can improve the symptoms of gastric pain. If bloating is a problem, then consuming smaller, more frequent meals is preferred to eating three large meals in a day. Smoking and alcohol are detrimental to the stomach and should be avoided. Chilli and spicy foods can lead to gastric pain. These should also be avoided.

At Nobel Gastroenterology Centre, we treat many individuals with gastritis, duodenitis and ulcer related diseases. Many of our patients are cured with medicines. Rarely, we may detect a stomach cancer instead. If you have any of the symptoms mentioned above, then you should consider an evaluation, especially if your symptoms are persistent.

 

Dr Eric Wee,

Consultant Gastroenterologist and Hepatologist,

Nobel Gastroenterology Centre

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