By Lee Hua Loon (CARiNG Pharmacist) | Malaysia | Wed Dec 10, 2014 4:08pm

When a patient walks into a pharmacy, complains of gastric pain and requests for an acid reducing medicine for his condition, he must have thought the gastric pain is of stomach origin with excessive gastric acid.

However, this pain can be due to any organ in the abdomen rather than the stomach.

One of the most common causes of gastric pain is gastritis, but sometimes it can be caused by other problems such as gas pain, indigestion, heartburn or gastroesophageal reflux disease (GERD).

However, there are some rare conditions such as achlorhydria or hypochlorhydria where absent or lack of stomach acid that cause gastric pain. The risk is higher when there is chronic use of proton pump inhibitor (PPI), a common class of medicine given today for gastritis.

Gastritis can be defined as inflammation of the gastric mucosa. Generally, it is multiple causative events that can contribute to gastritis, be it erosive or non erosive. The common causes are Helicobacter pylori, bile reflux, abuse of alcohol or nonsteroidal anti-inflammatory drugs [NSAIDs], autoimmunity, allergic response or stress.

What are the symptoms of gastritis? Generally, for an acute gastritis, it can be accompanied with burning epigastric distress, and it may improve or worsen with eating.

Untreated acute gastritis may progress to become chronic gastritis.

Normally for some chronic gastritis, it may come with the following specific symptoms:-
• H pylori infection, it may come with epigastric pain, fullness, flatulene, malaise or significant weight loss.
• Autoimmune atrophic gastritis, with symptoms of anemia including feeling weak, lightheadedness, dizziness, palpitations or tinnitus.

  Treatment for gastric should be patient-specific depending on the origin of the problem. The following are common treatments recommended for gastritis.
• Antacids (for example magnesium trisilicate)
• H2 Blockers
• Proton Pump Inhibitor (PPI)
• Cytoprotective Agents
• Gastrointestinal Tract (GIT) Regulators
• Antiflatulents

There is a saying that goes “prevention is better than cure”. However, I would prefer “prevention is CHEAPER than cure”. With the higher cost of living today, what we try to avoid is out-of-pocket spending as high medical fees can ruin a person’s quality of life.

I hereby entrust you with some “CHEAP” tips for those who wish to stay healthy and prevent unnecessary stomach problems:-
• frequent small meals and moderate portions are beneficial to relax your stomach
• avoid chewing gum as it may induce swallowing air into your stomach
• avoid reclining or lying after a meal to avoid reflux of your stomach acid
• maintain healthy body weight to reduce the body stress on your stomach
• avoid tight pants as it may induce stress to your stomach
• avoid spicy, acidic, fried foods, creamy sauce that may irritate your gastric lining
• avoid smoking and drinking as it may interfere with the protective lining of stomach
• avoid caffeinated drinks as it may induce acid secretion
• avoid carbonated drinks as it can increase the risk of gastroesophageal reflux disease (GERD)
• avoid common pain-killers such as non-steroidal anti-inflammatory drugs (NSAIDs) for example aspirin, ibuprofen and naproxen. A safer alternative would be
  acetaminophen (also known as paracetamol).

To conclude, gastric pain is just a symptom. It can be as simple as gas pain or it may be as serious as gastric ulcer. Therefore, the next time you happen to visit us with such symptoms, please do not be annoyed by our strings of questions about your conditions. WE ASK BECAUSE WE CARE!

Gastric Pain. In: Leong WF, Ruby DP, Theresa RA et. al. MIMS Pharmacy Malaysia. 5th ed. Petaling Jaya, KL: UBM Medica; 2012. p153-6.

Divyanshoo RK. Achlorhydria clinical presentation. Medscape [Internet]. 2013 July 31 [cited on 2014 July 1]. Available from: http://emedicine.medscape.com/article/170066-clinical

Mohammad W. Acute gastritis. Medscape [Internet]. 2013 May 15 [cited on 2014 July 1]. Available from: http://emedicine.medscape.com/article/175909-overview

Sandeep M. Chronic gastritis. Medscape [Internet]. 2012 May 29 [cited on 2014 July 1]. Available from: http://emedicine.medscape.com/article/176156-overview






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