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Pangastritis: Causes, Symptoms, Diagnosis And Treatment

Gastritis is a condition of the digestive tract wherein there is an inflammation of the lining of the stomach [1] . It can be acute or chronic. There can be various reasons behind its occurrence, such as excessive alcohol use, use of certain medications and chronic vomiting. Acute gastritis is sudden with short-term inflammation whereas chronic gastritis is long-term inflammation [2] . If gastritis is left untreated, it can lead to severe blood loss and may also increase the risk of developing stomach cancer.

One of the most common types of chronic gastritis is pangastritis. Read on to know more about this condition, risk factors and treatment.

What Is Pangastritis?

Pangastritis affects the entire stomach lining. This condition irritates both the antral and oxyntic mucosa of the antrum (lower part of the stomach) and also the fundus (upper part of the stomach) [3] . This condition is different from regular gastritis. This is because the entire stomach region is involved here rather than just one area.

Symptoms Of Pangastritis

The symptoms are quite similar to regular gastritis and include the following [4] :

• Vomiting

• Abdominal pain

• Nausea

• Bloating

• Fullness after eating

• Appetite loss

It is important that you meet your healthcare expert once any of these symptoms start showing. This is so because the symptoms of pangastritis could be quite similar to other ailments as well. It is all the more important to get yourself checked if you are experiencing these symptoms quite often.

Causes Of Pangastritis

Several factors can damage the lining of your stomach, thereby increasing your risk of developing pangastritis.

1. Pain-relieving medications: Using pain-relieving medications, especially NSAIDs (nonsteroidal anti-inflammatory drugs), is one of the most common reasons why pangastritis can occur [5] . When you take NSAIDs quite often, it can cause injury to the mucosal lining and can affect gastric secretions. Such issues lead to inflammation.

[pangastritis medicine image]

2. Stomach infections: Bacterial infections of the digestive tract is another cause of pangastritis and stomach ulcers [6] . This form of an infection can also be linked to gastric cancer.

3. Autoimmune conditions: The progression of autoimmune gastritis [7] can cause pangastritis if the mucosa gets damaged to a great extent. Autoimmune gastritis occurs when the body attacks the parietal cells of the stomach.

4. Excessive alcohol use: Alcohol abuse can cause acute gastritis and in case of chronic drinkers, it can lead to pangastritis [8] .

5. Chronic stress: During stressful times, your body undergoes hormonal changes. There is an increase in the levels of histamine and acetylcholine [9] . This can lead to a change in gastric secretions causing stress-induced pangastritis.

Diagnosis Of Pangastritis

There are plenty of tests that your doctor can do to diagnose pangastritis. Some of them are as follows:

• Stool test: This is performed to check for gastric bleeding. Inflammatory stomach conditions such as pangastritis can lead to blood in the stool. Stool tests are also conducted to check for the presence of Helicobacter pylori [10] .

• Blood and breath test for infection: This is to look for the presence of Helicobacter pylori. The blood tests help in determining if you have had an infection [11] . The urea breath test can help indicate if one has an active infection.

• Blood test for anaemia: Pangastritis is a condition that can cause anaemia [12] . As the mucosa of the digestive tract becomes more damaged, it makes the absorption of nutrients from food quite difficult. This can lead to iron-deficiency anaemia.

• Endoscopy: An upper GI series is performed by a doctor to view the lining of the stomach using imaging equipment. A small camera-tipped tube is used to view the inside of the digestive tract to check for damages that might indicate pangastritis.

Treatment For Pangastritis

Your doctor would take any of the below-mentioned treatment approaches:

• Initial infection treatment: If the condition has been caused due to an infection with H.pylori, then it is essential that the infection is medically addressed first. For the treatment, your doctor may prescribe one or more medicines, which would ideally include the following[13] :

◦ Ranitidine bismuth citrate

◦ Proton pump inhibitor

◦ Antibiotics (tetracycline or amoxicillin)

• Restoring deficient nutrients: In case there have been any nutrient deficiencies due to the condition, then your doctor might want to restore your nutrient levels as quickly as possible. Deficiencies in iron and vitamin B12 can lead to anaemia. Hence for a patient with this condition, monitoring nutrient deficiencies is extremely important. Your doctor might prescribe supplements to overcome the deficiencies.

• Using medications to reduce stomach acid: Medications are generally prescribed to lower stomach acid levels. Your doctor may prescribe the following acid-lowering medications:

◦ Antacids: This is prescribed to neutralize stomach acid. The active ingredients present determine the different types of antacids. Antacids are categorized based on the presence of calcium, aluminium or magnesium [14] .

◦ Proton pump inhibitors [15] : These reduce the secretion of stomach acid. However, they take quite long to start showing results and hence are preferred as a long-term treatment option.

◦ H2 blockers [16] : They do not neutralize stomach acids, instead they prevent the cells present in the digestive tract from producing too much stomach acid. This prevents the occurrence of any form of damage to the sensitive mucosa.

Diet For People With Pangastritis

People with pangastritis need to make certain dietary changes[17] . This is essential to prevent further irritation to the lining of the stomach. For a person with pangastritis, his or her diet should include the following:

• Foods low in fat (such as lean protein)

• Foods high in fibre (such as vegetables and grains)

• Foods that do not raise stomach acid levels

• Drinks without caffeine or carbonation

• Garlic, ginger and turmeric (these can block the growth of bad bacteria in the stomach)

A person with pangastritis should avoid the following:

• Overly acidic foods

• Spicy foods

• Fatty or deep-fried foods

• Alcoholic drinks

Use Of Supplements

The intake of the following supplements have also been found to be beneficial for a person with pangastritis.

• Probiotics: Probiotic therapy [18] is considered very good for a person with gastritis. Studies reveal that probiotic usage can reduce gastric inflammation.

• Glutamine: This is an important amino acid. Research says that glutamine plays a protective role against mucosal damage [19] .

• Antioxidants: People who suffer from pangastritis need antioxidants as it can protect the body from DNA-damaging oxidative stress [20] . Antioxidants can help in reducing the inflammation of the mucosal lining that leads to oxidative stress in the cells of the stomach.

• Omega-3 fatty acids: Anti-inflammatory effects of polyunsaturated fatty acids make them worthy of being used in dietary therapy. Research reveals that such supplements can alleviate the inflammation and damage caused by gastritis.

Prevention Of Pangastritis

Healthy lifestyle habits can go a great way in preventing pangastritis. Ensure that you follow the below tips:

1. Avoid excessive alcohol consumption as this can irritate the lining of your stomach.

2. Wash your hands often to prevent the spread of H.pylori.

3. Limit the use of pain medications.

View Article References
  1. [1] Veldhuyzen, V. Z. S., & Sherman, P. M. (1994). Helicobacter pylori infection as a cause of gastritis, duodenal ulcer, gastric cancer and nonulcer dyspepsia: a systematic overview.CMAJ: Canadian Medical Association journal= journal de l'Association medicale canadienne,150(2), 177.
  2. [2] Chow, C. M., Leung, A. K., & Hon, K. L. (). Acute gastroenteritis: from guidelines to real life.Clinical and experimental gastroenterology,3, 97-112.
  3. [3] Sipponen, P., & Maaroos, H. I. (2015). Chronic gastritis.Scandinavian journal of gastroenterology,50(6), 657-667.
  4. [4] Warren, J. R., & Marshall, B. (1983). Unidentified curved bacilli on gastric epithelium in active chronic gastritis.The lancet,321(8336), 1273-1275.
  5. [5] Teck, V. O. S. PAINKILLERS.PHARMACYBULLETIN, 6.
  6. [6] Rodríguez, L. A. G., Ruigómez, A., & Panés, J. (2007). Use of acid-suppressing drugs and the risk of bacterial gastroenteritis.Clinical Gastroenterology and Hepatology,5(12), 1418-1423.
  7. [7] Kulnigg-Dabsch S. (2016). Autoimmune gastritis. Autoimmungastritis.Wiener medizinische Wochenschrift (1946),166(13-14), 424-430.
  8. [8] Roberts, D. M. (1972). Chronic gastritis, alcohol, and non-ulcer dyspepsia.Gut,13(10), 768-774.
  9. [9] Ock, C. Y., Hong, K. S., Choi, K. S., Chung, M. H., soo Kim, Y., Kim, J. H., & Hahm, K. B. (2011). A novel approach for stress-induced gastritis based on paradoxical anti-oxidative and anti-inflammatory action of exogenous 8-hydroxydeoxyguanosine.Biochemical pharmacology,81(1), 111-122.
  10. [10] Gatta, L., Vakil, N., Ricci, C., Osborn, J. F., Tampieri, A., Perna, F., ... & Vaira, D. (2004). Effect of proton pump inhibitors and antacid therapy on 13 C urea breath tests and stool test for Helicobacter pylori infection.The American journal of gastroenterology,99(5), 823.
  11. [11] Vaira, D., & Vakil, N. (2001). Blood, urine, stool, breath, money, andHelicobacter pylori.Gut,48(3), 287-289.
  12. [12] Nahon, S., Lahmek, P., Massard, J., Lesgourgues, B., De Serre, N. M., Traissac, L., ... & Delas, N. (2003). Helicobacter pylori‐associated chronic gastritis and unexplained iron deficiency anemia: a reliable association?.Helicobacter,8(6), 573-577.
  13. [13] Safavi, M., Sabourian, R., & Foroumadi, A. (2016). Treatment of Helicobacter pylori infection: Current and future insights.World journal of clinical cases,4(1), 5-19.
  14. [14] Kaehny, W. D., Hegg, A. P., & Alfrey, A. C. (1977). Gastrointestinal absorption of aluminum from aluminum-containing antacids.New England Journal of Medicine,296(24), 1389-1390.
  15. [15] Yang, Y. X., Lewis, J. D., Epstein, S., & Metz, D. C. (2006). Long-term proton pump inhibitor therapy and risk of hip fracture.Jama,296(24), 2947-2953.
  16. [16] Xue, S., Katz, P. O., Banerjee, P., Tutuian, R., & Castell, D. O. (2001). Bedtime H2 blockers improve nocturnal gastric acid control in GERD patients on proton pump inhibitors.Alimentary pharmacology & therapeutics,15(9), 1351-1356.
  17. [17] Fontham, E., Zavala, D., Correa, P., Rodriguez, E., Hunter, F., Haenszel, W., & Tannenbaum, S. R. (1986). Diet and chronic atrophic gastritis: a case-control study.JNCI: Journal of the National Cancer Institute,76(4), 621-627.
  18. [18] Land, M. H., Rouster-Stevens, K., Woods, C. R., Cannon, M. L., Cnota, J., & Shetty, A. K. (2005). Lactobacillus sepsis associated with probiotic therapy.Pediatrics,115(1), 178-181.
  19. [19] Rao, R., & Samak, G. (2012). Role of glutamine in protection of intestinal epithelial tight junctions.Journal of epithelial biology & pharmacology,5(Suppl 1-M7), 47.
  20. [20] Dennog, C., Hartmann, A., Frey, G., & Speit, G. (1996). Detection of DNA damage after hyperbaric oxygen (HBO) therapy.Mutagenesis,11(6), 605-609.

Story first published: Friday, May 24, 2019, 13:15 [IST]
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