Gastritis and acid reflux – otherwise known as gastroesophageal reflux disease (GERD) – are terms that are often (mis)used interchangeably due to commonalities between them. However, despite overlapping grey areas, they are two different issues that arise from reasons of their own.

Symptoms

Symptoms for the two diseases may include most or all of the following:

Gastritis	Acid Reflux
. burning or gnawing feeling in stomach . indigestion . nausea and/or vomiting . feeling full in upper abdomen after eating	. heartburn (burning in chest) after eating, sometimes worse at night . regurgitation of food or sour/unpleasant taste in mouth . difficulty swallowing

Complications

While the above symptoms are the most common for sufferers of gastritis and acid reflux, the following symptoms may also be observed, usually in chronic or severe cases.

Gastritis	Acid Reflux
. stomach ulcers, resulting from erosive gastritis where the stomach’s mucosal lining has worn away and is now exposed to stomach acids . bleeding from ulcers, observed in bloody and/or darker coloured stools . increased risk of stomach cancer if left untreated (rare)	. bloating and/or nausea . halitosis (bad breath) . change in voice (hoarser) / laryngitis . recurrent cough and/or hiccups . disturbed sleep (night time reflux) . oesophageal constriction or ulcers . Barrett’s oesophagus (precancerous changes – rare)

Causes

Gastritis

Acid Reflux

Gastritis refers to inflammation of the stomach’s inner mucosal lining, and may be acute or chronic. This may arise due to several reasons: . Helicobacter pylori (H. pylori) bacterial infection, which is the most common cause of gastritis . autoimmune gastritis, where the body attacks its own cells – in this case, those of the stomach lining . excessive or long-term use of painkillers, as these could reduce biochemicals or microflora that are responsible for gut preservation . age, with older people being more vulnerable to infection and autoimmune disease . physical or mental stress, which often contributes to acute rather than chronic gastritis . excessive consumption of alcohol, which can make the stomach lining erode . a spice-rich or oily diet, which could also wear out the stomach lining . smoking, which makes people more vulnerable to infection and disease and can also damage the stomach lining

Acid reflux refers to the phenomenon where stomach acid backflows into the oesophagus (food pipe) due to weakening of the lower oesophageal sphincter (band of muscles) between the oesophagus and stomach. These muscles usually remain constricted and relax to allow the passage of food into the stomach. However, if they become slack over time, they allow acid and other stomach contents to move up into the oesophagus. This could happen due to: . obesity, as excess fat can put extra pressure on the abdominal organs . hiatal hernia, where the stomach pushes up into the diaphragm . excessive or long-term use of anti-inflammatory medication or painkillers, as this could affect the biochemical balance in the gut and weaken muscles . delayed stomach emptying . excessive consumption of alcohol and stimulants such as caffeine . having a diet that is rich in spices or fats . smoking, which has a generally degenerative effects . stress and anxiety . pregnancy

Diagnosis

Gastritis

Acid Reflux

In most cases, upper abdominal discomfort is what initially leads people to seek medical advice. However, there are a few tests that can be done in order to get a better idea of what might be causing the gastritis. These include: . a breath test, to check for H. pylori . a stool test, to check for bleeding (from ulceration) or infection . an endoscopy, to observe inflammation and/or ulceration (a biopsy may be done at the same time, IF necessary) . a barium swallow and X-ray, to observe a silhouette of the oesophagus, stomach, and if required, upper intestine

As with gastritis, it is the initial symptoms that mostly drive people to seek medical advice. Again, there are a few tests that can be carried out – some of which are common for gastritis. These include: . an endoscopy, to observe inflammation or other complications (a biopsy may be done at the same time, IF necessary) . an acid (pH) probe test, to detect when and how much stomach acid backflows into the oesophagus . a barium swallow and X-ray, to observe a silhouette of the oesophagus, stomach, and if required, upper intestine

Prevention

Below are a few practices that would help to lead a generally healthy lifestyle. In addition, they might also help to keep gastritis and acid reflux at bay, if there are no other potential causes of either condition:

• maintaining a balanced diet with minimal fats and spices
• refraining from smoking
• limiting consumption of alcohol to infrequent, moderate doses, if at all
• limiting consumption of stimulants such as caffeine
• limiting consumption of anti-inflammatory medication and painkillers, and talking through a plan/schedule with your GP if long-term administration is required
• drinking plenty of water
• maintaining an active lifestyle
• maintaining a healthy weight
• avoiding heavy meals, particularly at night
• avoiding a stressful lifestyle, and seeking help from a professional if you feel like you might be suffering from anxiety, stress or depression

Treatment

Home-remedies that can be practised for quick relief during a sudden or severe attack of either disease include:

• consuming an antacid, such as magnesium carbonate or calcium carbonate tablets or liquid, which neutralises some of the stomach acid produced
• consuming gelatine (or gelatine-based food such as jelly) or aloe vera gel, which coat and soothe the mucosal lining of the gut
• consuming iced water or ice cream, which ease the burning sensation

However, in severe or chronic cases, it may be required to get on a long-term dose of histamine 2 (H2) blockers or proton pump inhibitors (PPI, such as omeprazole). These reduce acid production in the stomach, with the latter believed to be the more effective of the two.

It might also help to have smaller, more frequent meals rather than to have large meals, and having the last meal of the day at least 2-3 hours before going to bed. If sleep is affected, particularly in acid reflux, it may help to sleep with your upper body slightly raised to reduce reflux.

If obesity appears to be a contributing factor, it would additionally be useful to get into a regular exercise routine which would help to reduce fat.

Cover illustration from Cleveland Clinic.