Chronic Gastritis: Symptoms, Treatment, and Digestive Changes

Chronic gastritis

Hello Doctor, I had issues with stomach acid and changes in my bowel habits a while ago, so I went to the hospital for an examination.
I underwent an upper endoscopy, which revealed gastritis, but I did not have a colonoscopy.
I would like to ask:
1.
My bowel habits have changed from what they used to be.
Now, I have a normal bowel movement once in the morning after waking up, but after breakfast, I always need to go 1-2 more times.
The shape is abnormal, meaning I have 1-3 bowel movements daily.
The first one is normal, but any subsequent ones are of abnormal shape, and this all happens before noon.
Since I had surgery for intussusception as a child, I have had sections of my small and large intestines removed, so my intestines are shorter than normal.
Is this bowel habit considered normal?
2.
The doctor prescribed PPI "Omeprazole" 20mg, to be taken twice daily for a month.
He mentioned that if my bowel movements do not improve, I would need to undergo a colonoscopy.
However, I only took it for three days before I started feeling discomfort in my stomach.
On the fourth day, I experienced pain in my lower abdomen before needing to have a bowel movement, but it felt better afterward.
By the fifth day, it felt like I had food poisoning, with severe diarrhea, so I was afraid to continue taking it.
I only took a total of five PPI pills, but it seems that my stomach acid has improved (my throat no longer feels tight).
Can PPI cause severe diarrhea?

Lin Xuan, 40~49 year old female. Ask Date: 2016/10/03

Dr. Chen Qifeng reply Gastroenterology and Hepatology

1.
If there have been recent changes in bowel habits, a colonoscopy should be considered.

2.
There seems to be no direct relationship between proton pump inhibitors (PPIs) and whether or not to perform a colonoscopy.

3.
Diarrhea is not a common side effect of PPIs in clinical practice; if symptoms persist, a colonoscopy may be warranted.

Reply Date: 2016/10/03

More Info

Chronic gastritis is a common condition characterized by inflammation of the stomach lining. It can manifest in various ways, including symptoms like abdominal pain, nausea, vomiting, and changes in bowel habits. Understanding the symptoms, treatment options, and potential digestive changes associated with chronic gastritis is essential for effective management.

Symptoms of Chronic Gastritis
Patients with chronic gastritis may experience a range of symptoms, which can vary in intensity. Common symptoms include:
1. Abdominal Pain: This may present as a dull ache or a burning sensation in the upper abdomen.

2. Nausea and Vomiting: Some individuals may feel nauseous or may vomit, especially after eating.

3. Bloating and Gas: Many patients report feelings of fullness or bloating, which can be uncomfortable.

4. Changes in Bowel Habits: This can include diarrhea or constipation, and in some cases, patients may notice changes in the shape or consistency of their stools.

5. Loss of Appetite: Due to discomfort or nausea, individuals may find it challenging to eat normally.

6. Heartburn: This is often associated with acid reflux, which can accompany gastritis.

Treatment Options
The treatment for chronic gastritis often involves a combination of lifestyle modifications, dietary changes, and medications. Here are some common approaches:
1. Proton Pump Inhibitors (PPIs): Medications like "瘍寧" (a PPI) are commonly prescribed to reduce stomach acid production, helping to alleviate symptoms and promote healing of the stomach lining. While effective, PPIs can sometimes lead to side effects, including diarrhea in some patients.

2. Antibiotics: If Helicobacter pylori infection is present, antibiotics may be prescribed to eradicate the bacteria, which can contribute to gastritis.

3. Dietary Changes: Avoiding irritants such as spicy foods, alcohol, and caffeine can help reduce symptoms. A bland diet may be recommended during flare-ups.

4. Stress Management: Since stress can exacerbate gastritis symptoms, techniques such as mindfulness, yoga, or counseling may be beneficial.

5. Regular Follow-ups: Monitoring symptoms and adjusting treatment as necessary is crucial. If symptoms persist or worsen, further investigations, such as a colonoscopy, may be warranted to rule out other conditions.

Digestive Changes and Bowel Habits
In your case, the changes in bowel habits you described—having normal stools in the morning but experiencing irregularities after breakfast—can be concerning, especially given your history of bowel surgery. It’s not uncommon for individuals with a history of bowel surgery to experience changes in bowel habits due to alterations in the digestive tract.
The fact that you are experiencing abdominal pain before bowel movements and changes in stool consistency could be related to several factors, including:
- Dietary Changes: If your diet has changed due to gastritis or medication, this could impact your bowel habits.

- Medication Side Effects: PPIs can sometimes lead to gastrointestinal side effects, including diarrhea. However, they are generally well-tolerated.

- Underlying Conditions: Given your surgical history, it’s essential to consider that there may be other underlying issues affecting your bowel function.

Recommendations
1. Monitor Symptoms: Keep track of your symptoms, including the frequency and consistency of your stools, and any associated pain. This information will be valuable for your healthcare provider.

2. Consult Your Doctor: If your symptoms persist or worsen, especially the abdominal pain and changes in bowel habits, it is crucial to follow up with your healthcare provider. They may recommend further testing, such as a colonoscopy, to investigate the cause of your symptoms.

3. Dietary Adjustments: Consider maintaining a food diary to identify any potential triggers for your symptoms. Eating smaller, more frequent meals may also help manage gastritis symptoms.

4. Hydration: Ensure you stay hydrated, especially if you are experiencing diarrhea. Drinking plenty of fluids can help prevent dehydration.

In conclusion, chronic gastritis can lead to various digestive changes, and it’s essential to manage symptoms effectively. Regular communication with your healthcare provider is key to ensuring appropriate treatment and monitoring for any complications.

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