Erosive gastritis

What is it? Erosive gastritis

Erosive gastritis is an acute or chronic condition of the stomach characterized by a disruption in the integrity of its inner lining, leading to the formation of surface defects called erosions. It sometimes presents without symptoms, while in other cases, it manifests with prominent symptoms such as abdominal pain, nausea, vomiting, and the presence of blood in vomit or stool. Without treatment, it can progress to gastric ulcer formation, anemia, and other serious conditions. Seeking medical attention upon the appearance of the first signs and symptoms of erosive gastritis and regular preventive check-ups can help timely identify the problem and initiate effective treatment, which can normalize the patient’s condition and prevent complications in a short period.

Treatment for this condition is provided by:

  • General practitioners
  • Gastroenterologists

About the Disease

Gastric erosions are defects in the mucous membrane occurring at sites of necrosis that do not reach the muscular layer. The documented prevalence of this pathology in different regions of the Russian Federation ranges from 15 to 30%, but it is likely higher due to frequent asymptomatic courses and associated underdiagnosis. More than half of patients who have taken nonsteroidal anti-inflammatory drugs for a long time suffer from erosive gastritis, and even after discontinuation, the risk of developing this condition remains elevated. Erosive gastritis develops three times more often in men than in women, with the acute form being typical in young patients and the chronic form in elderly ones. One-third of erosions are complicated by bleeding, which in three percent of cases is so severe that it results in a fatal outcome.


Based on the characteristics of the endoscopic picture, three types of erosive gastritis are distinguished:

  1. Hemorrhagic (defects in the mucous surface, deep with a pale rim, covered with a bloody crust).
  2. Flat (do not rise above the surface of the mucous membrane, have full-blooded edges, covered with a whitish coating).
  3. Hyperplastic (slightly swollen, raised above the surface of the mucous membrane, externally resembling polyps, localized on the crests of the mucosal folds). Erosions that epithelialize within 2-7 days are considered acute, while those persisting for 30 days or more are chronic.


In most cases, erosive gastritis is asymptomatic, and the patient experiences no discomfort and is unaware of being ill. Less commonly, symptoms of the pathology may include:

  • Nausea, vomiting with blood, sometimes “coffee grounds” (a sign of severe bleeding).
  • Black stools.
  • The feeling of discomfort, heaviness, and fullness in the epigastrium, is more intense during or immediately after meals.
  • Unpleasant bitter or sour taste in the mouth.
  • Belching air, food.
  • Heartburn.
  • Gurgling in the stomach, intestinal bloating.
  • Bowel disturbances (constipation, diarrhea).


The most common causes of erosive gastritis include:

  • Helicobacter pylori bacteria.
  • Uncontrolled use of certain medications (e.g., NSAIDs for joint pain relief).
  • Alcohol abuse.
  • Smoking.
  • Acute psychological or physical stress, including severe injuries or extensive burns. Less frequently, this disease is caused by radiation, viral or bacterial (staphylo-, streptococcal) infections, Crohn’s disease, trauma to the gastric mucosa during surgery, nasogastric tube insertion, or endoscopic examinations.


The diagnostic process includes collecting complaints, and medical history, assessing the objective status, and additional methods of investigation – laboratory and instrumental.

First of all, the doctor will attentively listen to the patient’s complaints, inquire about when and under what conditions they occurred, and what the patient associates their appearance with. The doctor will ask if similar symptoms have occurred before, as well as episodes of vomiting, swallowing difficulties, or gastrointestinal bleeding. They will inquire about any other diseases, especially digestive disorders, that the patient suffers from, what medications they are taking, and if they have any harmful habits.

During the objective examination, the doctor may notice the patient’s paleness, dry skin, intestinal bloating, sensitivity, or moderate tenderness under the xiphoid process.

To refine the diagnosis, the patient may be recommended further examination:

  • Complete blood count (will show a decrease in hemoglobin levels, erythrocytes – signs of anemia).
  • Fecal occult blood test.
  • Helicobacter pylori detection (urea breath test, urease test during gastroscopy).
  • Esophagogastroduodenoscopy (EGD) – the “gold standard” for diagnosis; allows the doctor to examine the gastric mucosa in multiple enlargements, assess its integrity, detect erosions, determine their quantity, shape, depth, and features of the base, and identify signs of bleeding or other complications. Additionally, if there are no contraindications, a biopsy will be taken during EGD – fragments of the affected mucosa for subsequent histological and morphological examination.
  • If EGD is unavailable, a stomach X-ray (will show erosions or ulcers of the mucous membrane).
  • Abdominal ultrasound (for the diagnosis of concomitant pathology and qualitative differential diagnosis).


Patients suffering from exacerbation of this pathology usually receive treatment in gastroenterological hospitals.

First of all, it is necessary to minimize the impact on the body and the gastric mucosa, in particular, risk factors – stop consuming alcohol and smoking, avoid overexertion, and replace medications that damage the stomach with safer ones.

Diet during exacerbation of erosive gastritis includes 5-6 meals a day in small portions, and the food should not have a thermal, mechanical, or chemical damaging effect on the stomach. Strong broths, fried, smoked, spicy, fatty foods, preserves, alcohol, acidic fruits, coffee, and strong tea are excluded from the diet. The diet should include lean fish, meat, eggs, dairy products, cereals, and baked or stewed vegetables.

Food should be chewed thoroughly, and eaten in a calm environment, without a phone, TV, or bad news.

Medical treatment may include drugs from such pharmacological groups:

  • Antibiotics (to eradicate Helicobacter pylori).
  • Proton pump inhibitors, H2-receptor blockers, and antacids (to reduce gastric acid secretion).
  • Gastroprotective agents (to accelerate tissue healing, and activate metabolic processes in them).
  • Antispasmodics (relax the muscle layer of the stomach wall, relieving pain).
  • Prokinetics (improve the motility of the upper gastrointestinal tract, help cope with nausea and stomach heaviness).


To reduce the likelihood of developing erosive gastritis, it is advisable to:

  • Quit harmful habits (smoking, alcohol consumption).
  • Adhere to the principles of healthy eating (eat regularly, and fully; minimize the content of fried, fatty, spicy, smoked foods and dishes, strong coffee, and carbonated drinks in the diet).
  • Avoid overexertion, and maintain a work-rest regimen.
  • Avoid hypodynamia – move enough, and walk daily.
  • Avoid stress, and develop stress resistance.
  • To prevent the risk of Helicobacter infection, use a personal toothbrush, and dishes.
  • When symptoms of gastric pathology or other gastrointestinal organs appear, consult a doctor and take the prescribed treatment.


Patients who have completed a course of treatment for erosive gastritis should consult a therapist or gastroenterologist for outpatient follow-up, visit for regular check-ups as directed by the doctor, undergo examinations, and possibly courses of relapse prevention treatment. A month after achieving stable remission, the patient may be referred for sanatorium treatment.