Indian infection

A bout of acidity could mean more than just a heavy meal playing up. Aspirin, spicy food and chewing tobacco — widely used by Indians — are triggers of gastritis.  A look at why we are more vulnerable to the stomach infection.

Ninety per cent of the population is exposed to H. Pylori bacteria, which is the leading cause for chronic gastritis in India,” found Dr HG Desai in his research for a book on gastritis. With symptoms like nausea, a burning pain above your navel, a ‘bloated’ feeling and indigestion, the stomach infection is usually ignored as acidity.

That’s exactly what happened with Neha Oberoi, who works with an airline. Neha had gone on a crash-diet eight years back and lost a tremendous amount of weight. “At the time there were no side effects. I ignored the acidity attacks that followed,” says the 25-year-old.

However, about two years back, the attacks started getting more severe and she was admitted to a hospital. “The pain was unbearable,” she cringes. “It’s as if I’m on my deathbed.” Still going through tests, consultations and medication, Neha says she’s “leading a 60-year-old’s life” because she’s completely given up spicy and fried foods, cigarettes and alcohol.

Though Neha’s is one of the more severe cases of gastritis, doctors say it is not at all uncommon. They see patients with stomach ulcers and cancer all the time.

Gastroenterologist Ajay Choksi says he gets one patient with cancer symptoms every six months. “And this is usually a patient under 40. Over 40, I get about four such cases in six months,” he says. 

Understanding the infection
Because of the extent of the problem and the fact that symptoms are usually neglected, Dr HG Desai compiled a book titled Gastritis, Indian Perspective, which was release last month. Director of gastroenterology at the Jaslok Hospital, Dr Desai profiles the specific triggers and treatment of gastritis in India. Normally, gastritis afflicts people as they age and the stomach lining wears this. However, in India, most people are exposed to the bacterium that triggers gastritis (H. Pylori) starting at age five: “By age five, 50 per cent of the population has been exposed to the bacteria because of contaminated water and unhygienic conditions,” explains Dr Desai. “In the West, the same percentage is exposed to the bacteria by 50.”

Other triggers for gastritis are painkillers, stress, spicy food and chewing tobacco. Studies have shown that painkillers like aspirin that are prescribed for joint pains and headaches cause acute gastritis. “It is always better to see a specialist than to self medicate as the painkiller itself can cause problems,” advises gastroenterologist and GI endoscopist, Dr Amit Maydeo.

“Indian cuisine is rich in spices and chillies. That, and Indian-Chinese food — where ajinomoto and red chillies are used in abundance — can cause severe chronic gastritis which is a precursor to ulcer formation in the stomach,” says Dr Bhooshan Pandit, gastroenterologist at the Hiranandani hospital. Chewing tobacco — guthkha — is also typical only to Indians. Especially in Maharashtra and Gujarat, notes Dr Desai.

“Chewing tobacco causes cancer of the mouth, cheek and oesophagus. It also exfoliates the cells in the lining of the stomach causing gastritis,” he adds.

Not many treatment options
In most cases, gastritis is asymptomatic and progresses slowly over decades. Even when symptoms do appear, they are easily mistaken for acidity and reflux and most people tend to ignore them. This can lead to the formation of gastric ulcers or can cause lymphoma (cancer). “Gastritis also hinders the absorption of vitamin B12,” says Dr Maydeo. And because people ignore the symptoms or pop pills for acidity, most people approach a specialist with symptoms of an ulcer. “If symptoms persist for more than 10-15 days, the patient must see a doctor immediately,” advises Dr Choksi.

You can avoid complications if you catch the symptoms early. “There is no recommended treatment for the bacteria,” says Dr Desai. So, most doctors prescribe medicines that treat the symptoms. “There are two antibiotics, but over-prescribing these will increase the bacteria’s resistance to the drug. Moreover, these antibiotics have uncomfortable side effects like diarrhoea,” he adds. Therefore, it is important to avoid the trigger once it has been found. “For instance, if tobacco is causing gastritis, the patient has to stop chewing it.”  

j_geetanjali@dnaindia.net