There is no epidemiological data collated by the state about its prevalence, but ask any retail drug store and they will invariably report that some of the most sought after over-the-counter purchases are drugs for gastritis. Thus one can conclude that this ‘gastric’ is a very common phenomena, at least in Nepal.

‘Gastric’ is the word for stomach in Latin. When people use the term, they are undoubtedly referring to the mangled version of ‘gastritis’, which medically means the inflammation of the stomach. The disease is also described as peptic ulcer or acid peptic disease (PUD/ APD), which is the erosion or inflammation of the inner lining of gut due to excess acid and enzyme pepsin secretions.

For doctors it can get tiresome when people use the term gastric to denote a wide variety of conditions — many of these conditions are entirely unlike one another. Indigestion, loss of appetite, frequent or infrequent need to defecate, abdominal pain/ burning sensation, nausea, vomiting, excessive chest pain, foreign-body sensations, excess gas (burping/ flatulence), acidity and ulcer are some of the common meanings that people have come to associate with the term.

It’s not just lay people who seem to be confused; even those who are well-informed regarding health, and sometimes even medical personnel, do not exactly know what the term denotes. Equally shocking are the unscientific practices undertaken to manage this common condition, which often cause more harm to the sufferer.

There is a general understanding that oily and spicy food and excessively caffeinated drinks are to be avoided, but there are also many who believe that certain types of small but extremely hot chillies work as medicines. As stated above, it is food that increases acid-secretion inside the stomach that worsens gastritis. Milk, an alkali, on the other hand, has the capacity to neutralise acid, but somehow, many believe that milk and dairy products worsen the condition. The belief that black-tea or lemon-tea is better than milk-tea for gastritis does not make sense scientifically. There are also many who practice the ritual of drinking two or three glasses of cold/hot water to induce vomiting, believing that it will purify the gut. But this practice needs scientific verification as well. And God help those who believe a little amount of alcohol or tobacco helps in preventing gastritis.

APD arising from unhealthy food habits is simple to treat: basic dietary precautions and a few weeks of medication in order to decrease acid-secretion should be enough. Infections caused by the Helicobacter pylori bacteria, another common reason for gastritis, can also be taken care of with just seven days of oral medication.

However, most people take antacid medications, almost daily, for a long period of time. Often self-prescribed, these relievers tend to disturb the natural digestion-process of the body. And with every complaint of the symptom, health professionals repeatedly carry out every possible investigation, even when they do not need to do so. It is also common to find people undergoing unnecessary repeated endoscopies, x-rays, ultrasonography and blood tests. Most of these expensive tests don’t present new findings, but medical personnel keep prescribing more expensive treatments nonetheless. Such investigations into gastritis symptoms are seldom required unless people at risk are suspected of having other serious illnesses.

The most unfortunate matter is that in our pursuit to find an end to the problem, we have failed to see the whole picture. There are other underlying issues: common mental-health problems, such as depression and anxiety, or alcohol and tobacco use — that can cause gastritis, but all these things go unnoticed. Furthermore, an increase in stress levels, which triggers faster metabolism, can also lead to increased secretion of acid. Unless such causes are addressed, even taking tons of antacid will have no effect. It is thus not surprising to see ‘gastric’ symptoms subside as anxiety, depression or alcohol/ nicotine use is taken care of.

Mental-health problems are far more common than dreadful physical illnesses. It would thus be wise for people and medical practitioners too to think about whether common mental-health issues are the cause of unremitting gastritis.

Dr Rabi Shakya is Assoc. Prof. & Head of the Dept. of Psychiatry, Patan Academy of Health Sciences, Lalitpur