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  Gastritis  
 
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Signs, symptoms and indicators | Conditions that suggest it | Contributing risk factors | Recommendations

 

Gastritis is defined as inflammation of the lining of the stomach. This inflammation occurs when H. pylori or one of several other organisms infect the stomach. This is often associated with low levels of stomach acid. When stomach acid levels are very low, or chronically neutralized by antacids, H. pylori is less likely to be the cause and the overgrowth of others becomes more likely. Other causes, some of which act through low stomach acid, include medications, alcohol, ingestion of corrosive substances and extreme physiological stress. Acute gastritis is often associated with a sudden and severe illness or trauma. The incidence is about 8 out of every 1,000 people.

Sometimes the inflammation of the stomach lining can become so serious that an ulcer develops. Gastritis can be diagnosed by biopsy and specimen examination under a microscope, where the presence of increased white blood cells is seen.
 

 
 

Signs, symptoms & indicators of Gastritis:
 
 
Ayurvedic Typing  Low tolerance of spicy foods
 Spicy foods are a common trigger for gastritis.

Symptoms - Bowel Movements

  (Very) frequent stools or normal stool frequency

Symptoms - Food - General

  Weak appetite

Symptoms - Gas-Int - General

  Epigastric pain
  Unexplained nausea
  Unexplained vomiting

Symptoms - Metabolic

  Having a high/having a moderate/having a slight fever
 
 

Conditions that suggest Gastritis:
 
 
Digestion  Gastric/Peptic Ulcers
 Severe inflammation of the stomach lining (gastritis) can result in ulceration.

Tumors, Benign

  Stomach Polyps
 
 

Risk factors for Gastritis:
 
 
Supplements and Medications  Using NSAIDs
  Significant/moderate daily/mild daily aspirin use
  (Frequent/daily) aspirin use

Symptoms - Gas-Int - General

  History of unexplained nausea
 
 

Recommendations for Gastritis:
 
 
Botanical  Neem
 Neem extracts reduce the concentration of acid in the stomach and have anti-bacterial and anti-inflammatory properties that can provide relief from the effects of gastritis. Drink neem tea or ingest neem leaf powder as needed to protect the stomach and reduce discomfort.

  Robert's Formula
 See the link between Gastritis and Slippery Elm.

  Slippery Elm (Ulmus rubra)
 Slippery elm's soothing mucilage effect has been used for disorders of the gastrointestinal tract. It is part of the herbal combination called "Robert's Formula", which is widely prized by naturopathic physicians for such intestinal inflammations as gastritis, Crohn's disease, and ulcerative colitis. For digestive disorders, taking 500-1,000mg of powder tid is often recommended. It may be used in lozenge form as well.

  Bladderwrack
 Demulcent herbs, such as bladderwrack, are high in mucilage. Mucilage might be advantageous for people with gastritis because its slippery nature soothes irritated mucus membranes of the digestive tract.

  Marshmallow root (Althea officinallis)
 Marshmallow is used for mild inflammation of the gastric mucosa. [The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 167]

Drug

  Antibiotics
 Antibiotics are used to treat H. pylori and should be used to treat other bacterial overgrowths in the stomach as well. Since these overgrowths are usually responsible for the inflammation, eradication allows the stomach to heal and normal acid-control mechanisms to be restored. Prescription drug therapy that eliminates H. pylori infection, such as amoxicillin (Amoxil®), clarithromycin (Biaxin®), metronidazole (Flagyl®), and tetracycline (Sumycin®), in combination with the proton pump inhibitors lansoprazole (Prevacid®) and omeprazole (Prilosec®). Bismuth subsalicylate (Pepto Bismol®) may be added as well. Other medications may be prescribed to control stomach acidity, including prescription strength histamine H2 inhibitors, such as cimetidine (Tagamet®), ranitidine (Zantac®), and famotidine (Pepcid®), as well as the proton pump inhibitors omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), and rabeprazole (Aciphex®).

Lab Tests/Rule-Outs

  Test for Helicobacter Pylori Infection
  Hydrochloric Acid (Trial)
 Once the stomach lining has been healed by the use of other agents, a hydrochloric acid (HCl) trial is often useful since it may have been an HCl deficiency that contributed to bacterial overgrowth and subsequent inflammation in the first place. Do not take HCl until the stomach lining has fully recovered, which usually takes at least a month.

  Test for Occult Blood

Mineral

  Zinc
 Zinc Carnosine: Nutraceutical Therapy for Ulcers (and Gastritis).

Excerpted from Holistic Primary Care, a Summer 2004 Special Report published by Metagenics. The report in its entirety may be viewed at needs.com

Zinc carnosine, a patented combination of two nutrients that have beneficial effects on the gastrointestinal mucosa, represents an important advance in the management of peptic ulcers. Widely used in Japan, where it is recognized as a drug by regulatory authorities, zinc carnosine given alone was shown by endoscope to resolve ulcers by 60 to 70%, a result comparable to conventional drug therapies and with a safety profile as good as or better than commonly used pharmaceuticals.

This novel compound contributes to ulcer healing through a number of different mechanisms, including the inhibition of Helicobacter pylori (H. pylori) - a bacterial strain thought to be causative of ulcers. Zinc carnosine has been shown to promote wound healing, reduce inflammation, improve secretion of the protective mucosal lining, and possess antioxidant effects. It can be used as a natural therapy, an antibiotic, or an alternative to conventional pharmaceuticals, such as proton pump inhibitors (i.e., Nexium) and H2 receptor antagonists (i.e., Pepcid), both of which serve to decrease hydrochloric acid (HCl). It can also be used as adjunctive therapy in combination with conventional ulcer drugs. Moreover, patients can safely take zinc carnosine with non-steroidal anti inflammatory drugs (NSAIDs) as a way of preempting their adverse gastric effects.

In many ways, zinc carnosine is an ideal complementary therapy for ulcers. Conventional allopathic medicines are suppressive and address the problem of peptic ulcers by controlling the corrosive aspects of stomach function (i.e., reducing acid secretion and eliminating H. pylori). Zinc carnosine enhances and strengthens the stomach's natural defensive and self-protective capacities. It thus provides benefits characteristic of natural products and holistic strategies by treating the cause of the problem, but with the strong scientific pedigree of a pharmaceutical.

WHAT IS ZINC CARNOSINE?

Elemental zinc is known to speed healing of mucosal wounds and damaged cells, particularly in the gut. Carnosine is a naturally-occurring dipeptide, comprised of the amino acids, beta-alanine and L-histidine. It is a strong free-radical scavenger capable of blocking free radical chain reactions, inhibiting cell damage. It is also essential for DNA and RNA polymerase activity to aid cell damage.

Zinc carnosine was developed in an effort to provide a therapy that bolsters the ability of the gastric lining to repair and protect itself. A chelate of elemental zinc and carnosine in a 1:1 ratio, zinc carnosine entered the Japanese market as a pharmaceutical for ulcer treatment in the early 1990s and has been marketed there under the trade name Polaprezinc.

GASTRIC MUCOSAL BALANCE: A NEW WAY OF THINKING ABOUT ULCER DISEASE

The digestive tract has a curious challenge. It must produce caustic matter (stomach acid, pepsin, enzymes, bile) capable of breaking down many different substances, including animal tissue much like those comprising the digestive organs themselves. Consequently, the mucosa must produce sufficient quantities of mucus and other protective factors to keep digestive juices from going to work on its own walls. Digestive health hinges on the balance between secretions of digestive substances and maintenance of the mucosal wall.

Peptic ulcers are best understood as the net result of an imbalance between the caustic processes of digestion and stomach-wall maintenance. When the latter can't keep up with the former, the stage is set for stomach-wall disruption and ultimately ulceration.

And even with the best pharmacotherapy, ulcer recurrences are common, suggesting that acid suppression and eradication of microbial pathogens are insufficient.

Hyper-secretion of stomach acid may play a role in some cases and this is clearly stress-related. However, under-secretion of mucus and/or a breakdown in stomach cell repair mechanisms likely play an equal, if not more significant, role. The current therapeutic challenge is to restore the delicate balance by addressing the factors that impair healing of the gastric lining and improve mucosal integrity.

CONVENTIONAL PHARMACOTHERAPIES AND THEIR LIMITATIONS

Pharmacologic treatment of ulcer disease is big business. Aside from costs, long-term treatment with acid-suppressing drugs can result in a number of untoward effects, many of which run counter to the primary objective of restoring digestive health.

Effective digestion is based upon maintaining strongly acidic pH in the stomach and a base pH in the intestines.Many people with heartburn and indigestion actually tend to have too little gastric acid, rather than too much, a condition especially common among the elderly. Thus, many older individuals with ulcers are already acidsuppressed before being given acid-suppressing drugs.

Further suppression via pharmacotherapy has downstream consequences, including poor digestion, malabsorption, and gradually deteriorating nutritional status. Acidsuppression therapy also reduces the secretion of gastric mucus, a natural response to reduced stomach acidity. However, when a patient discontinues acid suppression drugs and returns to normal acid secretion levels, the gastric lining is left even more vulnerable than it was initially. This accounts for the high recurrence rate following treatment cessation.

Bear in mind that stomach acid is among the body's primary defense strategies, providing a way to destroy pathogens ingested with food. By reducing HCl, suppressive therapies increase the possibility that pathogenic organisms will be able to pass through the gastric phase and colonize the lower GI tract.When stomach acid production is deficient and gastric digestion incomplete, it is more difficult to maintain a healthy intestinal ecology. Similarly, antibiotics that kill off H. pylori knock off a lot of friendly flora as well, increasing the chances of intestinal overgrowth with pathogenic bacteria or yeasts. Plus, gastric acid triggers the release of enzymes in the small intestine, and reducing this stimulus results in an inadequate release of digestive juices.

BASIC RESEARCH

In rats subjected to aspirin-induced gastric mucosal injury, zinc carnosine markedly reduced lipid peroxidation, neutrophil accumulations, and inflammatory factors. The net result was significant reduction in mucosal erosions. A separate study, also in rats, showed that zinc carnosine could prevent the reduction in gastric mucus secretion that follows the exposure to alcohol, another ulcer trigger.

CLINICAL TRIALS: SAFE AND EFFECTIVE MONOTHERAPY

To date, there have been eight clinical trials of zinc carnosine for the treatment of peptic ulcers. Initial dose-ranging and safety studies evaluated doses of 75 to 600 mg per day, given under fasting conditions, as well as at meal times. The data indicate that zinc carnosine is entirely safe up to 600 mg per day. The only adverse effects were mild heartburn-like symptoms in two patients on the highest dose taken without food. There was no toxic accumulation of zinc in the lood, and the compound was readily excreted in urine and stool without adverse kidney or lower GI effects. Researchers demonstrate zinc carnosine to be highly effective when used continuously for 8 weeks. A fitting recommendation is one tablet, twice a day, of Zinlori 75 from Metagenics Inc. Beyond its applications in the management of peptic ulcers, zinc carnosine may have a role in treatment of gastritis and stomatitis.

  Calcium-2AEP

Oxygen / Oxidative Therapies

  Ozone / Oxidative Therapy
 Cubans are using capsules filled with ozonated oil to treat gastroduodenal ulcers, gastritis, giardia and peptic ulcers.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
May do some good
Likely to help
Highly recommended







GLOSSARY

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Antacid:  Neutralizes acid in the stomach, esophagus, or first part of the duodenum.

Biopsy:  Excision of tissue from a living being for diagnosis.

Gastritis:  Inflammation of the stomach lining. White blood cells move into the wall of the stomach as a response to some type of injury; this does not mean that there is an ulcer or cancer - it is simply inflammation, either acute or chronic. Symptoms depend on how acute it is and how long it has been present. In the acute phase, there may be pain in the upper abdomen, nausea and vomiting. In the chronic phase, the pain may be dull and there may be loss of appetite with a feeling of fullness after only a few bites of food. Very often, there are no symptoms at all. If the pain is severe, there may be an ulcer as well as gastritis.

Helicobacter Pylori:  H. pylori is a bacterium that is found in the stomach which, along with acid secretion, damages stomach and duodenal tissue, causing inflammation and peptic ulcers. Although most people will never have symptoms or problems related to the infection, they may include: dull, 'gnawing' pain which may occur 2-3 hours after a meal, come and go for several days or weeks, occur in the middle of the night when the stomach is empty and be relieved by eating; loss of weight; loss of appetite; bloating; burping; nausea; vomiting.

Stomach:  A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Ulcer:  Lesion on the skin or mucous membrane.

White Blood Cell:  (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.