Gastritis is the inflammation of the gastric mucosa caused by irritants that act on the mucosa itself. These irritations can be acute or chronic. It manifests with abdominal pain, nausea, vomiting and bloating. Gastroduodenal ulcer occurs when there is a perforation of the layers of the duodenum (duodenal ulcer) or stomach (gastric ulcer). It manifests with symptoms such as postprandial pain (after meals), heartburn, reflux and heartburn.

Both disorders are included in what is called acid peptic disease, and it has been well established for years that one of the main factors causing them is infection by the bacterium Helicobacter pylori.

Main causes

The etiology is multiple and includes a genetic component, but they always have as a point of connection an increase in acid secretion that may be due to three factors, which in many occasions coexist:

  • Acid hypersecretion, due to the action of certain foods or stress.
  • Pathology secondary to the consumption of some drugs such as acetylsalicylic acid and non-steroidal anti-inflammatory drugs.
  • Helicobacter pylori infection: it is the most frequent non-controllable risk factor in the development of these pathologies. In addition, this infection is also known to be a risk factor for stomach cancer.

Diagnosis of Helicobacter pylori infection

Currently, four main types of diagnostic tests are used:

  • Serological test: the presence of antibodies against Helicobacter pyloriis detected in blood. Its reliability depends very much on the technique used, although it is usually the method of choice when there is gastrointestinal bleeding, atrophic gastritis and certain tumors of the stomach.
  • Stool test: consists of the detection of Helicobacter pylori antigen in the patient's stool. It is reliable only if performed by the ELISA method with monoclonal antibodies, which is not common due to its high cost.
  • Breath test with 13C-labeled urea: it is a non-invasive test that consists of taking a tablet of labeled urea. pylori degrades urea releasing 13CO2which is detected in the exhaled air sample.
  • Endoscopy: this is the most invasive test and allows the collection of biopsies of the gastric mucosa and their histological analysis to detect microscopically the presence of the bacteria. It is generally used when the bacterium has been eradicated and there are still symptoms, or when there is suspicion of gastric ulcer, which allows to evaluate its existence and severity while taking several biopsies for the diagnosis of the infection.

Nutritional treatment

In addition to pharmacological treatment with antihistamines, proton pump inhibitors (omeprazole, pantoprazole, etc.) and antibiotics (amoxicillin, clarithromycin), some basic aspects of nutritional treatment must be taken into account.

If you have Helicobacter pylori infection, the treatment of choice is mainly the administration of a combination of antibiotics. But good nutritional hygiene and healthy habits can help alleviate symptoms.

The diet of patients with acid peptic disease should be balanced and meet their nutritional requirements. It is recommended to eat few meals a day so as not to stimulate acid secretion, to eat slowly and to chew food well.

While it is true that taking small doses of food usually has a beneficial effect on heartburn and epigastric pain, especially in the night phase. It is also recommended to raise the head of the bed to avoid reflux and heartburn.

It also helps to reduce the intake of milk and milk derivatives or, if necessary, to use lactose-free varieties, as well as to avoid highly seasoned foods, spicy foods and some spices.

The consumption of caffeine, theine, cola and carbonated soft drinks, as well as citrus fruits and their juices, should be restricted as much as possible. In addition, very cold and very hot foods should be avoided.

Other recommendations are to increase rest, relaxation methods and physical exercise to reduce the appearance of stress, as well as to completely abandon the consumption of alcohol and tobacco, acetylsalicylic acid and anti-inflammatory drugs.

Bibliography

Malfertheiner P and Ditschuneit H. Helicobacter pylori, gastritis and peptic ulcer.Springer, 2011.

Montes P et al. Epidemiological changes in peptic ulcer and their relation with Helicobacter pylori. Rev. Gastroenterol Peru 2007; 27(4):382-388.