Gastritis: Can It Cause Stomach Bleeding Without Ulcers?

Gastrointestinal bleeding

Doctor: Hello! A few days ago, I underwent an endoscopy due to prolonged abdominal pain, and the doctor said I have gastritis causing gastric bleeding, with only a few small spots, and no gastric ulcers or dyspepsia, just bile accumulation.
I was told to take medication for three days and that a follow-up visit is not necessary, as it is not serious.
Can gastritis cause gastric bleeding even without gastric ulcers? Additionally, the next day, when I visited the same doctor for a cold, he mentioned that I should continue taking gastric medication for another month or two.
How can this be? How serious is my condition? Is it possible to have gastric bleeding without gastric ulcers?

cynthia, 30~39 year old female. Ask Date: 2007/07/11

Dr. Liu Nanshan reply Gastroenterology and Hepatology

Hemorrhagic gastritis typically refers to pinpoint mucosal or submucosal bleeding, which can be caused by conditions such as gastroenteritis, medications (such as analgesics like aspirin), and portal hypertension.
It is essential to perform an endoscopy or conduct a thorough patient history to differentiate the causes, as most cases are not serious.

Reply Date: 2007/07/11

More Info

Gastritis, which refers to the inflammation of the stomach lining, can indeed lead to stomach bleeding even in the absence of ulcers. This condition is often characterized by various symptoms, including abdominal pain, nausea, vomiting, and in some cases, gastrointestinal bleeding. The bleeding can occur due to the erosion of the stomach lining caused by the inflammation itself, rather than the presence of ulcers.

In your case, the doctor noted that you have gastritis leading to minor bleeding, which is not uncommon. The inflammation can cause the blood vessels in the stomach lining to become fragile and bleed, resulting in hematemesis (vomiting blood) or melena (black, tarry stools). This bleeding can occur even when there are no visible ulcers present, as the inflammation alone can be sufficient to disrupt the integrity of the stomach lining.

The fact that your doctor recommended continuing medication for one to two months suggests that they are taking a cautious approach to ensure that the inflammation is adequately treated and to prevent further complications. Medications typically prescribed for gastritis include proton pump inhibitors (PPIs) or H2 receptor antagonists, which help reduce stomach acid production, allowing the stomach lining to heal. Additionally, if there are concerns about the presence of Helicobacter pylori (a common bacterial cause of gastritis), further treatment may be warranted.

Regarding the severity of your condition, while gastritis can lead to bleeding, it is often manageable with appropriate medical treatment. The key is to follow your doctor's recommendations, adhere to the prescribed medication regimen, and maintain a diet that avoids irritants such as alcohol, caffeine, spicy foods, and NSAIDs (non-steroidal anti-inflammatory drugs), which can exacerbate gastric irritation.

If you experience worsening symptoms, such as increased abdominal pain, persistent vomiting, or signs of significant blood loss (like fainting or severe weakness), it is crucial to seek medical attention promptly. Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

In summary, gastritis can indeed cause stomach bleeding without the presence of ulcers. It is important to follow your doctor's advice regarding medication and lifestyle changes to promote healing and prevent further complications. If you have any concerns about your symptoms or treatment plan, do not hesitate to discuss them with your healthcare provider for clarification and reassurance.

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