- Gastritis & Duodenitis: Symptoms, Causes & Treatment
- What Are Gastritis and Duodenitis?
- Acute vs Chronic Gastritis
- Symptoms of Gastritis and Duodenitis
- What Causes Gastritis and Duodenitis?
- H. pylori and Stomach Cancer Risk
- When Is Gastritis an Emergency?
- How Are Gastritis and Duodenitis Diagnosed?
- Gastritis vs GERD vs Ulcer vs Functional Dyspepsia
- Treatment Options for Gastritis and Duodenitis
- Take the Next Step
- FAQ Frequently Asked Questions
Gastritis & Duodenitis: Symptoms, Causes & Treatment
Gastritis and duodenitis occur when the lining of the stomach or duodenum becomes inflamed. Symptoms such as upper abdominal discomfort, bloating, nausea and indigestion are common, and in many cases the underlying cause can be identified and treated successfully.
At Richmond Gastroenterology Centre, Dr John Hsiang provides specialist assessment and treatment for gastritis and duodenitis, with a focus on identifying the cause and reducing the risk of future complications.
What are Gastritis and Duodenitis?
Gastritis is inflammation of the stomach lining. Duodenitis is inflammation of the duodenum, the first part of the small intestine just beyond the stomach. Because the two are closely connected and share many of the same causes, they often occur together and may be referred to as gastroduodenitis.
Gastritis is further classified by appearance during gastroscopy. When the inflammation causes small breaks or raw areas in the lining, it is called erosive gastritis. When inflammation is present without surface breaks, it is called non-erosive gastritis.
Acute vs Chronic Gastritis: Why the Difference Matters
Acute gastritis develops suddenly and often improves once the trigger is removed. Chronic gastritis develops gradually and may persist for months or years.
Chronic gastritis is most commonly caused by long-term H. pylori infection. Ongoing inflammation can gradually alter the stomach lining over time and, in some patients, may increase the risk of stomach cancer. This is why identifying and treating the cause early is important.
Symptoms of Gastritis and Duodenitis
The most common symptom of gastritis is a burning, aching or gnawing discomfort in the upper abdomen. Symptoms can vary significantly. Some people experience only mild discomfort, while others have more persistent digestive symptoms. Some people with chronic gastritis have no symptoms at all.
- Upper Abdominal Pain or Discomfort
A burning, aching or gnawing sensation in the upper abdomen, the hallmark symptom. - Indigestion (Dyspepsia)
A persistent feeling of fullness, heaviness or discomfort during or after eating. - Bloating
Abdominal distension or a sense of trapped gas after meals. - Nausea and Vomiting
Nausea is common; vomiting may occur in more severe cases. - Frequent Belching
Excessive burping, often worsened after eating. - Feeling Full After Small Meals
Early satiety, a small amount of food produces a strong sense of fullness. - Loss of Appetite
Reduced desire to eat, sometimes associated with nausea or discomfort.
What Causes Gastritis and Duodenitis?
Gastritis and duodenitis have several possible causes, including H. pylori infection, painkillers, alcohol, smoking, autoimmune conditions, bile reflux and lifestyle factors such as chronic stress, poor sleep and irregular diet. Because the treatment approach depends on the underlying cause, an accurate diagnosis is important.
| Cause | How It Affects the Stomach |
|---|---|
| H. pylori Infection | The most common cause of chronic gastritis worldwide. The bacteria live beneath the stomach's mucus layer and produce enzymes that damage the lining, triggering persistent inflammation. |
| NSAIDs & Aspirin | Ibuprofen, naproxen, diclofenac and aspirin block prostaglandin production, weakening the stomach's protective mucus barrier and increasing acid output. Corticosteroids (e.g. prednisone) do not typically cause erosions alone but significantly increase mucosal vulnerability when taken alongside NSAIDs. |
| Alcohol | Directly irritates and damages the stomach lining. Binge drinking can cause acute chemical gastritis; long-term heavy drinking progressively degrades the mucosal layer. |
| Smoking & Vaping | Nicotine increases acid production, reduces blood flow to the lining, inhibits bicarbonate production and slows the cellular repair needed to heal minor erosions. |
| Physical Stress | Major surgery, serious illness, severe burns or significant injury can trigger acute stress gastritis by drastically reducing blood flow to the stomach lining. |
| Psychological Stress & Poor Sleep | Chronic mental stress and disrupted sleep keep stress hormone levels persistently elevated. This can slow gastric emptying, reduce mucosal blood flow and impair the stomach lining's ability to repair itself, increasing vulnerability to irritants over time. |
| Irregular Diet & Meal Timing | Persistent consumption of high-fat or highly processed foods, combined with irregular meal timing, can impair digestive rhythms and weaken the stomach's natural defence mechanisms. |
| Autoimmune Gastritis | The immune system mistakenly attacks the stomach lining, particularly the cells that produce stomach acid. This can lead to vitamin B12 deficiency and pernicious anaemia. |
| Bile Reflux | Digestive fluid flows backwards from the small intestine into the stomach, causing chronic chemical irritation. Often seen after gallbladder removal or gastric surgery. Treated differently from acid-related gastritis. |
Can Vaping Cause Gastritis?
Yes. Nicotine can increase stomach acid production, reduce blood flow to the stomach lining and interfere with healing. Whether nicotine comes from cigarettes, vaping devices or nicotine pouches, it may contribute to ongoing stomach irritation and symptoms in some individuals.
Can Stress and Poor Sleep Cause Gastritis?
Chronic psychological stress and poor sleep can contribute to gastritis, though the mechanism differs from physical stress injuries seen in critically ill patients.
Prolonged mental stress keeps the body’s stress response persistently activated. This can slow gastric emptying, allowing stomach acid to remain in contact with the lining for longer, reduce the blood flow needed for mucosal repair and heighten the stomach’s sensitivity to everyday irritants such as spicy foods or standard painkiller use.
Poor sleep and insomnia compound these effects. Disrupted sleep impairs the body’s overnight repair processes, including mucosal cell regeneration in the stomach lining. Over time, this can make the stomach more susceptible to inflammation.
Stress and sleep disruption do not usually cause gastritis in isolation, but they can worsen existing symptoms and make recovery more difficult, particularly when other contributing factors are also present.
H. pylori and Stomach Cancer Risk
Long-term H. pylori infection can increase the risk of stomach cancer, but the process usually develops slowly over many years and can often be interrupted with early diagnosis and treatment.
H. pylori is the single most important risk factor for stomach cancer worldwide. In some people, ongoing inflammation can gradually damage the stomach lining, leading to changes such as atrophic gastritis and gastric intestinal metaplasia (GIM).
Most people with H. pylori do not develop stomach cancer. However, identifying and treating the infection early can significantly reduce future risk.
If changes such as atrophic gastritis or GIM are found during gastroscopy, regular surveillance may be recommended to monitor the stomach lining and detect any further changes early.
For more on how H. pylori is diagnosed and treated, see: Helicobacter pylori
For patients with gastric intestinal metaplasia: GIM Surveillance
When is Gastritis an Emergency?
Most cases of gastritis are not emergencies, but certain symptoms require urgent medical attention.
Seek Prompt Medical Assessment
Seek prompt medical assessment if you experience any of the following: vomiting blood or material that looks like coffee grounds · black, tarry stools · unexplained weight loss · persistent vomiting · difficulty swallowing · severe abdominal pain · symptoms of anaemia, such as unusual tiredness, dizziness or shortness of breath. These symptoms may indicate bleeding, an ulcer or another serious condition.How are Gastritis and Duodenitis Diagnosed?
Gastroscopy is the most accurate way to diagnose gastritis and duodenitis because it allows the stomach lining to be examined directly and tissue samples to be taken if needed.
| Method | What It Involves | When It Is Used |
|---|---|---|
| Gastroscopy (OGD) | A thin, flexible camera examines the oesophagus, stomach and duodenum. Biopsies may be taken. | Persistent or alarm symptoms or when a definitive diagnosis is needed |
| Urea Breath Test | A non-invasive breath sample detects active H. pylori infection. | Initial H. pylori testing or post-treatment confirmation |
| Stool Antigen Test | Detects H. pylori in a stool sample. | Confirming infection or confirming it has cleared after treatment |
| Rapid Urease Test (CLO) | Performed on a biopsy sample taken during gastroscopy. Provides a rapid H. pylori result. | During gastroscopy when H. pylori is suspected |
For more on what a gastroscopy involves, see: Gastroscopy (Upper Endoscopy)
Gastritis vs GERD vs Ulcer vs Functional Dyspepsia
Many digestive conditions can cause similar symptoms, which is why persistent upper abdominal discomfort should not be self-diagnosed.
| Condition | What It Is | Common Symptoms |
|---|---|---|
| Gastritis | Inflammation of the stomach lining | Upper abdominal pain, nausea, indigestion |
| GERD (Acid Reflux) | Acid flowing back into the oesophagus | Heartburn, sour taste, regurgitation |
| Peptic Ulcer | An open sore in the stomach or duodenum | Burning pain, nausea, possible bleeding |
| Functional Dyspepsia | Persistent indigestion without an identifiable structural cause | Bloating, fullness, early satiety, upper abdominal discomfort |
Treatment Options for Gastritis and Duodenitis
The most effective treatment for gastritis focuses on identifying and treating the underlying cause, rather than simply relieving symptoms.
| Treatment Approach | What It Involves |
|---|---|
| Treating H. pylori Infection | A combination of acid-suppressing medication and antibiotics. A follow-up test confirms successful eradication. |
| Reducing Stomach Acid | Proton pump inhibitors (PPIs) and H2 receptor blockers reduce acid and allow the stomach lining to heal. |
| Reviewing Medications and Lifestyle | Addressing painkiller use, alcohol, smoking or vaping that may be contributing to inflammation. |
| Managing Less Common Causes | Autoimmune gastritis and bile reflux gastritis require specific treatment approaches tailored to their cause. |
| Ongoing Monitoring | Patients with atrophic gastritis or gastric intestinal metaplasia (GIM) may require periodic surveillance. |
Take the Next Step
Persistent indigestion, bloating, nausea or upper abdominal discomfort should not be ignored, especially when symptoms continue to return despite medication.
While many cases of gastritis are straightforward to treat, some require further investigation to identify the underlying cause and rule out more serious conditions.
Dr John Hsiang provides comprehensive assessment and treatment for gastritis and duodenitis, including H. pylori testing, gastroscopy and long-term surveillance where appropriate.
Arrange a consultation to better understand the cause of your symptoms and the treatment options available.
Can gastritis turn into stomach cancer?
How long does gastritis take to heal?
Mild gastritis may improve within days or weeks, while chronic gastritis can take longer. Recovery depends on identifying and treating the underlying cause.
Can gastritis be cured permanently?
Can vaping or nicotine cause gastritis?
What is the difference between gastritis and an ulcer?
Is difficulty swallowing a symptom of gastritis?
Do I need a gastroscopy for gastritis?
What foods should I avoid with gastritis?
References
- Hunt RH, et al. Helicobacter pylori in Developing Countries. World Gastroenterology Organisation Global Guideline. 2011.
- Malfertheiner P, et al. Management of Helicobacter pylori infection, the Maastricht VI/Florence Consensus Report. Gut. 2022;71(11):1921–1951.
- Sugano K, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64(9):1353–1367.
- Rugge M, et al. Gastritis: the histology report. Digestive and Liver Disease. 2020;43 Suppl 4:S373–384.
- Lanas A & Chan FKL. Peptic ulcer disease. Lancet. 2017;390(10094):613–624.
- National Cancer Centre Singapore. Singapore Cancer Registry Annual Report. 2023.
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