GASTRITIS

Gastritis is an inflammation, irritation, or erosion of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic). It may occur as a short episode or may be of a long duration.
Gastritis is a condition in which the stomach lining—known as the mucosa—is inflamed, or swollen. The stomach lining contains glands that produce stomach acid and an enzyme called pepsin. The stomach acid breaks down food and pepsin digests protein. A thick layer of mucus coats the stomach lining and helps prevent the acidic digestive juice from dissolving the stomach tissue. When the stomach lining is inflamed, it produces less acid and fewer enzymes. However, the stomach lining also produces less mucus and other substances that normally protect the stomach lining from acidic digestive juice.
Gastritis is believed to affect about half of people. As people get older the disease becomes more common. When the same inflamation or irritation happens, along with similar condition in the first part of the intestines known as duodenitis
Causes
Is associated with various conditions like, medications, medical and surgical conditions, physical stresses, social habits, chemicals, and infections. Some of the more common causes of are :
Medications (only the most common medications are listed)
• Aspirin (more than 300 drug products contain some form of aspirin)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or painkillers such as ibuprofen, diclofenac, naproxen etc
• Prescription steroids for example prednisolone etc
• Potassium supplements
• Iron tablets
• Cancer chemotherapy medications
Swallowing chemicals or objects
• Corrosives (acid or lye)
• Swallowed foreign bodies (paper clips or pins)
Medical and surgical conditions
• People who are critically ill or injured can develop.
• After medical procedures (such as endoscopy, in which a specialist looks into the stomach with a small lighted tube)
• After an operation to remove a part of the stomach
• After radiation treatment for cancer
• Autoimmune diseases like SLE, sarcoidosis etc
• Chronic vomiting
Infections
• Tuberculosis
• Syphilis
• Bacterial infections (H pylori infection is the most common, A bacteria that lives in the mucous lining of the stomach; without treatment, the infection can lead to ulcers, and in some people, stomach cancer). Helicobacter pylori colonizes the stomachs of more than half of the world’s population, and the infection continues to play a key role in the pathogenesis of a number of gastroduodenal diseases. Colonization of the gastric mucosa with Helicobacter pylori results in the development of chronic gastritis in infected individuals, and in a subset of patients chronic gastritis progresses to complications (e.g., ulcer disease, gastric neoplasias, some distinct extragastric disorders). However, over 80 percent of individuals infected with the bacterium are asymptomatic and it has been postulated that it may play an important role in the natural stomach ecology.
• Viral infections
• Fungal (yeast) infections
• Parasites and worms
Other Causes
• Stress
• Excessive Alcohol consumption
• Caffeine
• Smoking
• Autoimmune: your body attacks the cells that line your stomach. This is usually found in people with underlying autoimmune disorders.
• Eosinophilic Gastroenteritis: An uncommon form of gastritis due to eosinophilic infiltration of the stomach wall.
• Bile reflux: This condition is a post-gastrectomy complication leading to stomach pain, vomiting bile and weight loss.
Critical illness
Gastritis may also develop after major surgery or traumatic injury (“Cushing ulcer”), burns (“Curling ulcer”), or severe infections. Gastritis may also occur in those who have had weight loss surgery resulting in the banding or reconstruction of the digestive tract.
Diet
Specific foods including spicies, chillies, acidic foods, junk foods, excessive tea,coffee etc plays a major role in the development of peptic ulcers. People are usually advised to avoid foods that bother them.

Symptoms
Symptoms may vary among individuals depending upon the severity of the problem, However, the most common include:
• Nausea or recurrent upset stomach
• Abdominal bloating
• Abdominal pain
• Vomiting
• Indigestion
• Burning sensation in the epigastric region or feeling of heaviness in the stomach between meals or at night
• Hiccups
• Loss of appetite
• Haemopsis means blood with vomiting or coffee ground-like material
• Black, tarry stools or blood in the stools
• Unexplained weight loss
• Pallor, sweating, and rapid (or “racing”) heartbeat.
• Feeling faint or short of breath
• Severe stomach pain or chest pain that may mimic like heart pain.

However, upper central abdominal pain is the most common symptom; the pain may be dull, vague, burning, aching, gnawing, sore, or sharp. Pain is usually located in the upper central portion of the abdomen, but it may occur anywhere from the upper left portion of the abdomen around to the back.
In more severe gastritis, bleeding may occur inside the stomach. Erosive gastritis causes an erosion of the gastric mucosa leading to bleeding.
Diagnosis

Gastritis can be diagnosed based on the following:
• Detailed medical history
• Complete physical examination
• Upper Gastrointestinal endoscopy
• Other blood, stool tests
Other Tests, that may include
• An x-ray examination, especially barium meal x-ray.
• Blood tests. To check for anemia, mainly pernicious anemia
• Stool test. To check for blood in the stool, another sign of bleeding in the stomach, and for H. pylori infection.
• Urea breath test. To check for H. pylori infection.
• Liver function test, kidney function test, or pancreas function test
• Urinalysis
• ECGs
• Sometimes Stomach biopsy, to test for gastritis and other conditions like malignancies

Types
Gastritis may be acute or chronic:
• Acute gastritis starts suddenly and lasts for a short time.
• Chronic gastritis is long lasting. If chronic gastritis is not treated, it may last for years or even a lifetime.
Gastritis can be erosive or non-erosive:
• Erosive gastritis can cause the stomach lining to wear away, causing erosions—shallow breaks in the stomach lining—or ulcers—deep sores in the stomach lining.
• Non erosive gastritis causes inflammation in the stomach lining; however, erosions or ulcers do not accompany non erosive gastritis.

Gastric- Ayurvedic view
Modern era’s changing lifestyle along with changing food culture and one’s body constitution all are the contributing foctors for getting Amlapitta or gastritis. Amlapitta is one of the most common symptom (disease) seen in the society.
‘Hurry’, ‘Worry’, and ‘Curry’ are the three main reasons for the disease.
All the factors which result in excessive increase of ‘Pitta dosha’ in the body either intrinsic or extrinsic contributes in getting the problem of amlapitta, by Vitiating the agni in Amashaya (stomach) region due to their various causes, results in Amlapitta. Some of the common causes are – fasting, eating between meals, worry, hurry, spicy foods etc. are some pitta vitiating factors etc. These factors derange the pachaka pitta (digestive enzymes etc.) and as a result pachaka pitta vitiates. Thus developed condition is called Amlapitta.
The Ayurvedic reason for gastric disorder is a viation of pitta. Pitta governs the metabolic process and basically this mean that the sufferers’ digestive system and overall metabolism has been compromised or damaged.

In ayurvedic texts gastric is correlated with urdhwa amlapitta. This disease is considered to be due to the vitiation of the agni (the digestive fire ). When the agni gets vitiated by its causative factors, the food which we eat will stay inside the stomach for long time to get proper digest, which gets rotten and produces lot of acidic material called amla padarth inside the stomach, which erodes the linning of the stomach, results in the above said disease gastritis or amlapitta.
Persons having pitta pradhana prakruti or persons indulge in pitta dosha enhancing activities, diet and life style are more prone to get this problem.
Mainly pitta vitiating factors are:
• Stressful daily routine.
• Insufficient sleep at night.
• Irregular meal times or skipping meals.
• Eating too late at night.
• Spicy food habits like pizza, burger, chinese food, chilly, pickles, etc.
• Oily foods, pickles.
• Salty and sour foods like chips .
• Over eating of stale, fermented foods(bakery foods, idli, dosa, etc).
• Sleeping immediately after meals.
• Lack of rest , fast moving lifestyle.
• Suppression of urges.
• Too much of worries.
• Walking for long hours in hot sun very often, or working near hot areas .
• Prolonged ingestion of aspirin or some anti-inflammatory drugs
• Prolonged alcohol ingestion
• Heavy smoking
• Stress is also an important cause for hyperacidity
• Eating during indigestion
• Over eating Irregular eating
• Intake of unsuitable food
• Faulty place, time and preparation of food
• Hereditary

Classical causes
1. Incompatible food (viruddhaara)
2. Polluted food (dushta ahara)
3. Sour substances (atyamla ahara)
4. Spicy food (vidahi ahara)
5. Pitta provoking food, beverages and habits (pittala ahara)
Classification of amlapitta as per ayurvedic texts:
Depending upon the other doshas predominancy the amlapitta can be classified into three:
Vataja amlapitta
Pittaja amlapitta
Kaphaja amlapitta,
Also the symptoms of the disease depends upon the predominant doshas,
Symptoms of Vata predominant Amlapitta
• Tremors
• Delirium
• Fainting
• Feeling of pins and needles
• Weakness of body parts
• Pain and darkness before eyes

Symptoms of Pitta Predominant Amlapitta
• Feeling of heaviness
• Weakness
• Coldness
• Vomiting
• Coating on tongue
• Burning sensation
• Itching of skin

Symptoms of Kapha predominant Amlapitta
• Fainting
• Loss of apetite
• Headache
• Salivation
• Sweet taste in the mouth

Amlapitta (Acidity)
Treatment
The main key for treating Amlapitta is to improve digestion.
As the saying goes “Prevention is better than cure” it is better to avoid all the causative factors of amlapitta.
Ayurvedic line of treatment:
As the disease is of Pitta origin, all measures are undertaken to pacify pitta. So, first of all, in worsened conditions, Shodhana karma especially Vamana ( induced emesis ) or Virechana karma (induced purgations ) will be carried out so as to eliminate the accumulated pitta dosha (acidic substances) from the stomach. There measures are taken for the pacification of pitta. Once the accumulated pitta gets eliminated, shamana aushadies ( internal medications ) will be administered so as to check the remission or re-manifestation of the similar episode in coming days.
Shamana aushadies include:
Medicines:
1. Avipattikar churna
2. Triphala churna – 1/4th tsp of churna should be taken with warm water at night.
3. Sutshekhar rasa
4. Kamdugha rasa (plain)
5. kamdugha rasa ( mukta yukta)
6. swarna shootashekhara rasa ( in acute severe conditions)
7. Prawal panchamrit
8. Laghusutshekhar rasa
9. Dry ginger powder 1/4th tsp + ghee 1tsp + 1 tsp sugar should be taken in the morning at empty stomach.
10. Churnas like – shatavari churna, yastimadhu churna, sariva churna, vasa, bhringa, dhamasa churna, amla churna, chandan, guduchi satwa, musta, parpatak churna should be taken under consultation.
11. Chandanasav, ushirasav, bhunimbadi kadha, abhayarishta, amlapitta kadha, punarnavasava, etc should be taken with enough qty of water after lunch and dinner.
12. Shatavari ghrit, yashti ghrit also helps in certain cases.
It is so simple to stay away from ‘Amlapitta’ (Acidity) but only if proper care is taken…

Foods to avoid with gastritis (gastritis diet)
Changes to diet can also help improve your symptoms. Common avoidable triggers of gastritis symptoms include:
• Spicy foods
• Alcohol
• Coffee and other beverages and drinks that contain caffeine (for example, colas and teas)
• Fatty foods
• Fried foods
Several small meals a day also can help gastritis symptoms.

Herbs

Licorice root has been traditionally used to soothe inflammation and injury in the stomach. It also checksthe growth of H. Pylori. Take one teaspoonful of this powder and mix with half a teaspoonful of pure ghee and one teaspoonful of pure honey. Take this medicine twice daily on an empty stomach, once in the morning before breakfast and once in the afternoon before tea when the stomach is nearly empty.

If you are having constipation along with gastritis, then Avipattikara choorna is the medicine of choice. Take two teaspoonfuls at bedtime. This neutralises the acid, stimulates the liver, and thus works as a laxative.

Asparagus racemosus (shataavar) is a refrigerant and antispasmodic. It allays internal heat. Several studies have demonstrated that the root of this plant is an effective drug in hyperacidity. Mineral contents, which are biochemically important for the human system, were found in significant concentration in different parts of the herb. This powder should be taken three to six grams, twice daily.

Emblica officinalis (amla) is found useful in dyspepsia, burning sensation, anorexia, vomiting and haemorrhage. You can take this in powder form, two teaspoonfuls four times a day. (Clinical studies were conducted to investigate the effect of amla in gastric syndrome. Aamalaki choorna was given in 20 cases in a dose of three grams, three times a day for seven days. The drug was found effective in 85 per cent of the cases).
Common herbs used in gastritis remedies and treatment:
Patola (pointed gourd) – Trichosanthes dioica Roxb.
Nimba – Neem – Azadirachta indica A. Juss.
Amalaki – Emblica officinalis Gaertn.
Parpataka – Fumaria vaillantii Loise.
Guduchi (Giloy)- Tinospora cordifolia (Willd.) Miers.
Bhoonimba – Juncia kurroa Linn
Haritaki – Terminalia chebula Retz.
Bhringaraja – Eclipta alba (Linn) Hassk.
Ela – Cardamom – Eletharia cardamomum Matom.
Chandana – Sandalwood Santalum alba Linn.
Usheera – Vetiveria zizanioides (Linn.) Nash.
Draksha – Raisins – Vitis vinifera Linn.
Jiraka – Cumin seeds – Cuminum cyminum Linn.
Musta – Cyperus rotundus Linn.

Home remedies for gastritis
You may not try all of these, you can follow a few.
• Long pepper powder- half a gram with one spoon of honey – two times a day is one of the effective home remedies for gastritis.
• Lemon juice helps to relieve vomiting sensation and bloating.
• Boiled Ash gourd with jaggery relieves bloating and burning sensation in stomach associated with acidity and gastritis.
• One table-spoon of Triphala powder added with one glass of water, boiled and reduced to half a glass, filtered. This water decoction in hot condition, along with one table-spoon of honey or ghee relieves gastritis.
• Regular chewing of half a teaspoon of fennel seeds after food is good for digestion and gastritis.
• Half glass of buttermilk, added with a pinch of asa foetida, turmeric, half tea-spoon of fenugreek drunk at night, is good for effective treatment of gastritis.
• Crush cumin seeds into fine powder. add half tea-spoon of cumin seeds to one liter of water. boil the water for two minutes and filter. Drink this water, in place of normal water. But new water needs to be made every day. This is a natural remedy for gastritis.
• Things that are included in gastritis diet aid in gastritis cure. (Click to read)
• Ginger – 5 grams.
• Milk – 100 ml
• water – 100 ml.
• Boil this till there is only 80 – 100 ml remaining. (meaning water is emptied)
Filter and drink. This is a good gastritis remedy.
• In the same way, garlic – drink is also a good home remedy for gastritis.

• Papaya is good for stomach and for digestion, during the period of gastritisavoid meals and have onle papaya diet for few couple ofdays.
• • Drink a large glass of water at the first sign of heartburn, if the symptoms are not too strong this will help.
• Make a juice using raw potatoes. Wash the potato very well do not peel it, just place it in the juicer, mix it with some other juice for taste and drink immediately after juicing.
• Chew a few Tulsi leaves to get relief of the symptoms.
• Keep a small piece of gur in your mouth and suck it slowly. Repeat it every hour till the symptoms subside.
• Eat Watermelon, Banana or Cucumber every hour.
• Eat a few Almonds when symptoms are present.
• Drink Coconut water 4 – 5 times a day.
• Drink a glass of cold milk for fast relief.
• Keep a small piece of Harad in your mouth and chew it after every meal.

  • Sleep with your head and shoulder on a high pillow for elevation.

So, these home remedies for gastritis aid in early gastritis cure along with medication.

Wholesome diet
Barley, wheat, green gram, old rice, warm water, sugar candy, inflorescence of the plantain, cucumber, matured ashgourd, pomegranate, gooseberry, dry grapes etc.
Related articles:

Unwholesome diet
All factors mentioned under the reasons for the disease, sesame, black gram, horsegram, oil cake, sheep’s milk, sour gruel, salty- sour and pungent food, heavy meals, fasting, curd, alcohol etc.

Yoga Asanas beneficial in amlapitta
• Vajra Asana
• Yoga mudra
• Shitali Pranayama

Food Plan:

o Fast for two or three days or more, depending on the severity of the condition.
o Drink only warm water during this period. This will give rest to the stomach and allow the toxic condition causing the inflammation to subside.

  • When condition is acute patient should be given a liquid diet of liquefied cooked vegetables and Khichari.

After the acute symptoms subside, adopt fruit diet for the next three days and take juicy fruits like apples, pears, grapes, grapefruit, oranges, pineapple, peaches and melons.
Thereafter gradually come to a balanced diet consisting of seeds, nuts, grains, vegetables and fruit.

  • Barley water can be taken throughout the day. Boil 1 cup of barley with 3 cups of water and boil down to 2 cups of water and drink as tea 3 times per day.

Avoid the use of alcohol, tobacco, spices, meat, red pepper, sour foods, pickles, strong tea and coffee. Should also avoid sweets, pastries, rich cakes and aerated waters.

  • Avoid onions, garlic and pungent, salty and sour foods.
  • Increase consumption of bitter foods.
  • Avoid hot drinks and foods.
  • It’s better not to take spicy and oily foods.
  • Curds and cottage cheese should be used freely.
  • Life Style:
    • Avoid exposure to hard mental or physical work.
    • Avoid anxiety, worry and anger.
    • Take complete rest.
    • A walk in the early morning for about a mile is very useful.

Points to Remember
• Gastritis is a condition in which the stomach lining—known as the mucosa—is inflamed, or swollen.
• Common causes of gastritis include Helicobacter pylori (H. pylori) infection, damage to the stomach lining, and an autoimmune response.
• Some people who have gastritis have pain or discomfort in the upper part of the abdomen. However, many people with gastritis do not have any signs and symptoms.
• Erosive gastritis may cause ulcers or erosions in the stomach lining that can bleed. A person with any signs or symptoms of bleeding in the stomach should call or seek a doctor
• A health care provider diagnoses gastritis based on a medical history, a physical exam, upper GI endoscopy, and other tests.
• Health care providers treat gastritis with medications to reduce the amount of acid in the stomach and treat the underlying cause.