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Chronic Gastritis – Causes, Symptoms and Treatment

Chronic gastritis is a long-lasting inflammation of the stomach lining. It can be caused by bacteria, medications, or autoimmune processes and requires medical evaluation and treatment.

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Things worth knowing about "Chronic Gastritis"

Chronic gastritis is a long-lasting inflammation of the stomach lining. It can be caused by bacteria, medications, or autoimmune processes and requires medical evaluation and treatment.

What is Chronic Gastritis?

Chronic gastritis is a persistent or recurrent inflammation of the gastric mucosa (the lining of the stomach). Unlike acute gastritis, which develops suddenly and usually resolves quickly, the chronic form develops gradually over months or years. If left untreated, it can permanently damage the stomach lining and increase the risk of peptic ulcers or even stomach cancer.

Causes

Chronic gastritis is classified into different types based on its underlying cause:

Type A – Autoimmune Gastritis: The immune system attacks the body's own stomach lining cells. This can lead to a vitamin B12 deficiency and pernicious anaemia.
Type B – Bacterial Gastritis (most common form): Caused by the bacterium Helicobacter pylori, which colonises the stomach lining and causes chronic inflammation. More than 80% of chronic gastritis cases are attributed to this bacterium.
Type C – Chemical or Toxic Gastritis: Results from regular use of NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin), excessive alcohol consumption, or bile reflux into the stomach.

Less common causes include radiation therapy, Crohn's disease, or certain infections.

Symptoms

Chronic gastritis often causes no clear symptoms for a long time. When symptoms do occur, they may include:

Pressure or a feeling of fullness in the upper abdomen
Nausea and occasional vomiting
Heartburn and acid reflux
Loss of appetite
Pain or a burning sensation in the stomach area, especially after eating
In cases of vitamin B12 deficiency (Type A): fatigue, tingling in the limbs, pale skin

Diagnosis

Diagnosis is typically made through gastroscopy (endoscopy of the stomach), during which the doctor directly examines the stomach lining and can take small tissue samples (biopsies) for microscopic analysis. To detect a Helicobacter pylori infection, additional tests such as a breath test, stool antigen test, or blood test may be used.

Treatment

Treatment of Type B Gastritis (Helicobacter pylori)

The primary treatment for Helicobacter pylori-related gastritis is eradication therapy: a combination of two antibiotics and a proton pump inhibitor (PPI) taken over 7–14 days. This approach successfully eliminates the bacteria in most cases.

Treatment of Type A Gastritis (Autoimmune)

There is no cure for the underlying cause in autoimmune gastritis. Management focuses on regular monitoring and vitamin B12 supplementation (usually by injection) to prevent deficiency-related complications.

Treatment of Type C Gastritis (Chemical or Toxic)

The triggering cause should be addressed: discontinuing or switching harmful medications, avoiding alcohol, and taking gastric protective agents such as proton pump inhibitors.

General Lifestyle Measures

Avoiding irritants such as alcohol, nicotine, coffee, and heavily spiced foods
Eating regular, small meals
Reducing stress, as psychological strain can worsen symptoms

References

German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS): Guideline on Helicobacter pylori Diagnosis and Treatment, 2022.
Malfertheiner P. et al. – Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut, 2022.
Fischbach W., Malfertheiner P. – Helicobacter pylori Infection. Deutsches Ärzteblatt International, 2018; 115(25): 429–436.

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