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Difference Between Gastritis and Acid Reflux

Gastritis is defined as inflammation of the inner lining of stomach which can be due to any irritant and can also lead to erosion. Acid reflux is defined as moving of stomach acid backwards towards the mouth, usually because of weakened valve, lower esophageal sphincter that prevents the backwards flow.

What is Gastritis?

Introduction

When the lining of the stomach is irritated, eroded, or inflamed due to an external trigger factor, it is known as gastritis. Gastritis can be of two types: acute, which causes sudden and intense pain, and chronic, which causes symptoms for a long time and increases gradually.

Pathophysiology

The stomach is lined internally by a mucosal wall that releases gastric juices to aid in digestion. Sometimes, the conditions like unhealthy eating habits, alcohol, NSAIDs, or other conditions contribute to excess acid production which leads to damage in the mucosal wall, causing Gastritis.

Symptoms

It can either be asymptomatic or different individuals present with different symptoms. Some of the common symptoms are:

  • Nausea accompanied by an upset stomach
  • Constant bloating
  • Unable to digest food properly
  • Pain in epigastrium
  • Episodes of vomiting
  • Heartburn
  • Significant decrease in appetite
  • Stools can be black/tarry in color

Causes

The few common causes of gastritis are:

  1. Acid reflux due to conditions like GERD (Gastrointestinal regurgitation disease)
  2. Alcohol abuse
  3. Some medications like NSAIDs (Non-steroidal Anti-inflammatory Drugs)
  4. Taking too much stress 
  5. A bacteria called Helicobacter Pylori.

Diagnosis

  • Upper GIT endoscopy
  • Blood test 
  • Biopsy
  • Stool test
  • H. Pylori breath test

Prevention and Treatment

A healthy lifestyle is key to preventing gastritis and other GIT-related illnesses. 

Treatment options are:

  • Medications like antacids, proton pump inhibitors, and H2 blockers can be used to minimize the production of gastric acids.
  • Reducing stress levels through a healthy lifestyle, stress-releasing maneuvers, and taking antianxiety medications.
  • Reducing the intake of spicy food.
  • Limiting dairy if lactose intolerance is the underlying cause
  • Antibiotics therapy if H. Pylori is detected.

What is Acid Reflux?

Introduction

The backward flow of stomach acid through the esophagus from the stomach to the upper GIT is known as acid reflux. It occurs when a valve located at the end of the esophagus, known as the lower esophageal sphincter (LES) is unable to close when food passes through it. The acid can irritate the lining of the esophagus and cause burning symptoms. 

If acid reflux persists for a longer period of time, it is known as GERD (Gastroesophageal Reflux Disease)

Causes

  • Hiatus Hernia
  • Eating bigger food portions
  • Lying down flat immediately after eating
  • Eating right before going to bed
  • Excessive consumption of soft drinks or alcohol
  • Excessive consumption of citrus foods or foods containing acid
  • Pregnancy
  • Certain medications like NSAIDs, antihypertensive etc.

Symptoms

  • Heartburn which starts from the epigastrium can be felt all the way along the esophagus up to the throat.
  • Regurgitation of acid that tastes bitter at the back of the throat.
  • The feeling of being bloated
  • Frequent burps
  • Difficulty swallowing, also known as dysphagia
  • Unexplained long-term cough
  • Hoarseness of voice 
  • Nausea and vomiting
  • Frequent hiccups
  • Asthma

Diagnosis

  • Clinical signs and symptoms
  • Esophagram (barium swallow x-ray)
  • Esophageal endoscopy
  • Histopathology
  • Monitoring of pH in the esophagus
  • Esophageal manometry

Treatment

  • Lifestyle changes like small, frequent meals.
  • Raising the pillow 4-6 inches to reduce nighttime reflux.
  • Eating the last meal 2-3 hours before bedtime
  • Antacids 
  • H-2 inhibitors
  • Proton pump inhibitors
  • Prokinetics to ensure early emptying of stomach.

Difference between Gastritis and Acid Reflux

Summary of comparison between Gastritis and Acid Reflux

  1. Gastritis is the inflammation of the mucosal lining of the stomach while GERD is a condition that causes acid reflux and inflammation of the esophageal lining.
  2. Gastritis lasts for a few days before it resolves while acid reflux resolves within a few hours period and doesn’t persist for days.
  3. There is no functional abnormality involved in gastritis while GERD is accompanied by a weakened Lower Esophageal Sphincter which allows the stomach acid to go back from the stomach.
  4. A burning at the base of the throat is felt in GERD, with persistent cough and hoarseness of voice. No such symptoms are seen in gastritis.
  5. Stomach is the involved GIT organ in gastritis while the esophagus is involved in GERD.
  6. Medication is required to manage gastritis and it can recur if medication is discontinued. Lifestyle changes and some habit changes can treat GERD, no lifelong medications are required.

FAQs

Can gastritis cause acid reflux?

Gastritis does not cause acid reflux but both these conditions can co-exist because of the same origin.

What are the warning signs of gastritis?

Vomiting blood or bloody stools are warning signs of gastritis, indicating internal bleeding which can be life-threatening.

How do you fix gastritis?

Gastritis can be fixed by medications like antacids, H2 inhibitors, proton pump inhibitors, and lifestyle changes.

How do you get rid of acid reflux and gastritis?

Acid reflux and Gastritis can be treated by medications or lifestyle changes like small meal portions, not lying down immediately after eating, avoiding oily and spicy food, and less consumption of alcohol and soft drinks.

Can gastritis be mistaken for acid reflux?

Due to almost similar symptoms and causes, gastritis can be mistaken for acid reflux and a necessary diagnosis is required to differentiate between the two.

Why do I suddenly have gastritis?

If gastritis appears suddenly, it is usually acute gastritis. It can be caused by viral or bacterial infections, NSAIDs, stress, or excessive alcohol consumption.

What causes gastritis flare-ups?

Hot and spicy food, acidic beverages, smoking, alcohol, NSAIDs, and stress are all flare-up factors for gastritis.

Does drinking water help gastritis?

Drinking plenty of water helps to neutralize the acid in the stomach; hence it can control gastritis to some extent.

What drinks help gastritis?

Water, herbal green tea, skimmed milk, and other acid-countering drinks can help with gastritis.

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References :


[0]Clarrett, D. M., & Hachem, C. (2018). Gastroesophageal reflux disease (GERD). Missouri medicine. Retrieved February 24, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140167/

[1]Finocchio, E., Locatelli, F., Sanna, F., Vesentini, R., Marchetti, P., Spiteri, G., Antonicelli, L., Battaglia, S., Bono, R., Corsico, A. G., Ferrari, M., Murgia, N., Pirina, P., Olivieri, M., & Verlato, G. (2021, February 8). Gastritis and gastroesophageal reflux disease are strongly associated with non-allergic nasal disorders - BMC pulmonary medicine. BioMed Central. Retrieved February 24, 2023, from https://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-020-01364-8

[2]John Maret-Ouda, M. D. (2020, December 22). Gastroesophageal reflux disease. JAMA. Retrieved February 24, 2023, from https://jamanetwork.com/journals/jama/article-abstract/2774414

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