Gastritis is a medical condition that may sound fairly ‘strange’ to many, but medics actually say it is common in Rwanda. Dr Janvier Rusizana of La Nou Velle Clinic in Remera says gastritis is on the rise and is life threatening if not treated early. He reveals that he attends to about 30 patients with this condition per month.

Rusizana says any person past adolescence can have gastritis if they are exposed to risk factors, and that the risk increases with advancing age because of the longer duration of contact of irritant substances with gastric mucosa. The gastric mucosa is the mucous membrane layer of the stomach which contains the glands and the gastric pits.

What is gastritis?

It is a disease that affects different parts of the inner lining of the stomach. According to Dr Rachna Pandey, a medic at Ruhengeri Hospital, gastritis is a term used to describe dyspeptic symptoms like a burning sensation in the upper abdomen, sense of bloating, nausea and vomiting. It is a state of inflammation of the inner protective lining of the stomach such as deodunum, fundus and eosophagus. It is a digestive disease that affects different parts of the stomach.

"Gastritis is mainly caused by the helicobacter pylori bacteria. Consuming hot or heavily spiced food, drinking alcohol, soda and other soft beverages, as well as excess consumption of tea and coffee are some of the things that can cause gastritis. Eating low fiber foods, chronic constipation, taking heavy meals daily and poor dieting habits are also other risk factors,” says Dr Achille Manirakiza of University Teaching Hospital Kigali (CHUK).Dr Pandey also warns that using painkillers without prescription by the doctor can lead to gastritis.

Some studies indicate that immune response to intestinal infections causes inflammation of the stomach. Gastritis can also be due to allergy to some food substances, and studies indicate that stress is also a major cause of the condition.

Sometimes hereditary factors are also known to cause the condition.

Pernicious anemia - a form of anemia that occurs when the stomach lacks a naturally occurring substance needed to properly absorb and digest vitamin B12 is the other known cause of gastritis.

Bile reflux, which is a backflow of bile into the stomach from the bile tract (that connects to the liver and gallbladder) can also lead to gastritis, according to medics.

"Pain in the upper abdomen, weight loss, nausea or recurrent stomach upset, vomiting, indigestion, burning or gnawing feeling in the stomach between meals or at night, hiccups, loss of appetite and vomiting blood or coffee ground-like material are signs of gastritis,” says Dr Pandey.

Diagnosis and treatment

Rusizana says the best way to diagnose gastritis is by endoscopy. Endoscopy is a non-surgical procedure used to examine a person’s digestive tract. Using an endoscope, a flexible tube with a light and camera attached to it, your doctor can view pictures of your digestive tract on a monitor.

If diagnosed properly, the patient is directed to take small frequent meals as they receive treatment.

"Small meals are easy to digest. A single but heavy meal puts a heavy load on the stomach and makes it difficult to be digested. Similarly, late meals are stressful to the stomach and put the alimentary system to work instead of relaxing,” says Rusizana.

He says people with gastritis should always be given medication that regulates the acid in the stomach.

Excess acid in the stomach, which is referred to as hyperacidity, exacerbates the condition.

"Medicines such as malox and homplazon which reduce acid production in the stomach should be used. Gastritis can also be treated by lifestyle correction,” he says.

Rene Tabaro, a nutritionist and dietician at King Faisal Hospital, says patients with hyperacidity require foods low in acid.

"Basic foods are ideal since they act as a neutraliser to the acid in the stomach. Fresh milk, bananas, rice and papaws are good examples of foods low in acid. Patients should also avoid stressful conditions as stress is known to stimulate an adrenaline jump which is unhealthy to people with gastritis,” explains Rene.

When there is low acid in the stomach (hypoacidity), Tabaro advises that one should look for acid-rich foods.

Foods such as broccoli, eggs, meat, pineapples, oranges and green vegetables are good for people with low levels of acid in their stomach.

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Foods to avoid when you have digestive problems

Dairy products: One food group that can be hard to digest is dairy — mainly because of the sugar lactose found in milk and other dairy products. When lactose isn’t digested properly, such as in people with lactose intolerance, gas and bloating result. If you consume too much lactose, it goes into the large intestine, and diarrhea can develop or worsen. During digestive problems, it may still be okay to eat yogurt and hard cheeses because they have no lactose, or you can try lactose-free milk.

Spicy foods: If you’re experiencing nausea, vomiting, and diarrhea, you’ll want to avoid food choices that stimulate the digestive system, and these include spicy foods. Spicy foods are "incredibly variable” — they have no effect on some people, but cause indigestion for others. In general, you should choose bland foods when you’re having digestive problems, and be sure to avoid spices if you’re sensitive to them.

Acidic foods: Tomato sauce and citrus fruits, such as lemons, limes, oranges, and grapefruits, are acidic and can cause digestive problems. Carbonated beverages are also acidic and so should be avoided.

Fatty foods: Fatty foods stimulate contractions in the digestive tract, which, surprisingly, can either slow down the emptying of the stomach and worsen constipation or speed up movement and worsen or lead to diarrhea.

The effect can depend on the type of fat and your tendency toward constipation or diarrhea. When you’re experiencing a bout of indigestion, put low-fat foods on the menu and eat small meals spaced throughout the day, which can put less pressure on your stomach. Avoid high-fat culprits, like butter, ice cream, red meat, and cheese, at least for a while.

Fried foods: The problem with fried foods is the same as with fatty foods — they can move, undigested, through the body too quickly, leading to diarrhea, or stay in your digestive tract too long, causing you to feel full and bloated. Many fried foods are low in fiber and take longer to digest. So if you’re dealing with either diarrhea or constipation, you’ll want to avoid fried foods for a while.

Processed foods: If you’re constipated, avoid processed foods because they lack fiber, which helps regulate bowel movements. Processed foods also often contain preservatives and artificial coloring, and people with allergies or sensitivities to these additives will feel their effects during digestive problems. Note that some packaged foods contain lactose, which can give you gas and worsen any discomfort you’re already going through.

Agencies