Every year in our country, digestive disorders affect 25% of adults: gastritis, dyspepsia and gastro-esophageal reflux are the most common. How can we distinguish them and recognize the symptoms that characterize them? Professor Silvio Danese, gastroenterologist and head of the center for chronic inflammatory bowel diseases in Humanitas, spoke about this topic in an interview.

Gastritis is inflammation of the inner walls of the stomach and appears due to excessive secretion of hydrochloric acid, a digestive acid, the increase in which may be linked to incorrect nutrition, the taking of anti-inflammatory drugs, alcohol abuse or stress; as well as factors that increase the production of cortisol, the hormone that slows down physiological intestinal movements.

Gastritis is characterized by the following symptoms: burning at the level of the stomach pit or pain in the middle of the chest, which may be associated with swelling, nausea and loss of appetite.


How do you treat gastritis?

If these symptoms occur, consult your doctor, who will suggest the most appropriate remedy.

Antacids, over-the-counter drugs containing sodium citrate taken about two hours after a meal, or proton pump inhibitors that control excess gastric acid may help. It is important to try to relax and fight stress, perhaps by doing activities such as yoga.


What in the case of Helicobacter pylori?

Gastritis may be due to an infection with Helicobacter pylori, a germ that settles in the mucous membranes of the stomach. To verify its presence, a urea breath test is required, a diagnostic test involving the collection of samples of exhaled air, following the administration of a solution containing urea marked with a carbon isotope. In the stomach, in the presence of Helicobacter pylori, the marked urea is broken down into ammonia and carbon dioxide; if this is found in the breath, the germ is present in the body. In these cases the treatment is antibiotic, in combination with the intake of proton pump inhibitors.


Dyspepsia or poor digestion

Dyspepsia (or poor digestion) may be due to stress, poor nutrition or a habit of eating in a hurry. These phenomena overload the stomach, which is slow to empty, resulting in heaviness and tension.

Typical symptoms are a sense of swelling and stomach heaviness after meals, sometimes associated with drowsiness and difficulty concentrating. Those who suffer from it can also be led to constantly erupt and have heavy breath. It is therefore advisable to eat calmly, chewing each bite well, avoiding talking constantly during the meal. Prokinetics, drugs capable of accelerating and modulating peristalsis (i.e. the physiological movements of the intestine) can then be indicated, thus restoring the correct gastric emptying times. In this case, also consult your doctor.


The gastro-esophageal reflux

Finally, we talk about gastro-esophageal reflux in the presence of a heartburn that appears both after meals (with acid regurgitation and abnormal heartbeats) and during the night. Patients often also report dry and irritating cough (especially when awakening), which may be associated with hoarseness, pain in the stomach pit, or a feeling of a foreign body in the throat.

The reflux is due to the incomplete closure of the cardias, a valve that usually keeps the stomach tight during digestion. The food ingested is then mixed with acids and goes up again, with irritation and inflammation of the esophagus walls and causes coughing. The stomach also remains more relaxed and interferes with the work of the heart, promoting the presence of abnormal heartbeats.

In case of reflux, do not lie down after eating, do not wear clothing or belts that are too tight and limit physical effort. A short walk is recommended and it is good to go to bed at least two hours after dinner. The drug treatment uses anti-reflux drugs, which create a kind of film that protects the esophagus walls, and proton pump inhibitors, which help block acid gastric secretion.