Many of us have suffered from upper abdominal pain that we attributed to stress. We may worry that we have even developed an ulcer. The general term for stomach ailments is “gastropathy.” When there is inflammation of the stomach lining, the appropriate term is “gastritis”. Infection, immune disorders, and stress may cause gastritis(https://www.ncbi.nlm.nih.gov/books/NBK544250/).
Symptoms of gastritis include upper abdominal pain, nausea with or without vomiting, and a feeling of fullness (“bloating”). There may be a loss of appetite and unintentional weight loss. The pain associated with gastritis may be sharp or, perhaps more commonly, a gnawing or burning sensationthat we identify as “indigestion.” In severe cases, gastritis can lead to bleeding. This might show up as vomiting bloody material or dark, tarry stools.
How does stress cause gastritis? When we experience significant stress, whether caused by anxiety, illness, or trauma (e.g., being in a car accident), the body releases chemicals that increase stomach acid production. These chemicals include the hormones adrenaline (epinephrine) and cortisol. The high acidity in the stomach may erode its lining cells and produce inflammation and accompanying pain. In addition, these two hormones may cause a reduction of blood flow to the stomach lining, further increasing the risk of gastritis.
Stress-related gastritis is best treated by reducing the root cause, i.e., stress itself. Mindfulness meditation is a great tool, as are deep breathing exercises, aerobic or resistance training, and talking to a partner or therapist. Dietary changes are also helpful, including avoiding very spicy and acidic foods (tomatoes, oranges) and eating smaller, more frequent meals.
If stress reduction does not do the trick, medications may be indicated. There are many over-the-counter medications from which to choose, including antacids such as Tums, Maalox, or Mylanta, as well as histamine (H2) blockers and proton pump inhibitors (PPI). Examples of the former are famotidine (Pepcid), cimetidine (Tagamet), and nizatidine (Axid AR). Proton pump inhibitors include omeprazole (Prilosec) and esomeprazole (Nexium). These drugs are available in stronger doses by prescription.Chronic gastritis may also be treated with Chinese medicines(https://pmc.ncbi.nlm.nih.gov/articles/PMC10258419/).
Other causes of gastritis include alcohol consumption, medications (NSAIDS such as ibuprofen or aspirin), autoimmune disorders, and bacterial infections (H. pylori). The latter is reviewed separately.
Note: Although I am a physician, the content in this article is not meant to diagnose, treat, cure or prevent illness or disease in the reader – it is for educational purposes only.
References
1. https://www.drugs.com/health-guide/gastritis.html#:~:text=Use%20medications%20to%20decrease%20stomach,are%20even%20stronger%20acid%20blockers.
2. Yang L, Liu X, Zhu J, et al. Progress in traditional Chinese medicine against chronic gastritis: From chronic non-atrophic gastritis to gastric precancerous lesions. Heliyon 2023 May 27;9(6):e16764.
3. Azer SA, Awosika AO, Akhondi H. Gastritis. National Library of Medicine, 2024 (https://www.ncbi.nlm.nih.gov/books/NBK544250/).
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