Acute gastritis is a sudden inflammation of the gastric mucosa, most often triggered by medications, alcohol, bile reflux, viral or bacterial toxins, and physical stress. The condition may range from mild erythema to erosive bleeding, with symptoms developing rapidly and usually resolving within days. Rapid recognition supports removal of the offending factor and prompt symptom relief.
- Core gastric complaints
Epigastric pain: burning, gnawing, or dull soreness centered between the costal margins, often worsened by an empty stomach and partially relieved by food or antacids.
Nausea: persistent urge to vomit, sometimes accompanied by hypersalivation.
Vomiting: initially gastric contents; bile-stained or coffee-ground material appears when erosions bleed.
Early satiety: feeling full soon after starting a meal, leading to reduced intake. - Dyspeptic accompaniments
Bloating and belching: excess gas from delayed gastric emptying or swallowed air.
Heartburn or acid regurgitation: occasional reflux of gastric acid into the esophagus.
Loss of appetite: fear that eating will reignite pain or nausea. - Systemic and volume clues
Low-grade fever <38 °C: may accompany infectious or toxin-mediated forms.
Fatigue and malaise: cytokine-driven response to mucosal injury.
Orthostatic dizziness: suggests bleeding when paired with coffee-ground vomitus or melena.
Cold sweats and tachycardia: early signs of hypovolemia in hemorrhagic gastritis. - Etiology-specific patterns
NSAID or aspirin use: shallow erosions with little preceding pain, sometimes first noticed as dark stools.
Alcohol binge: severe burning pain and repeated vomiting several hours after intake.
Bile reflux post-surgery: constant dull ache and bilious vomiting without food relief.
Stress-related (critical illness): painless coffee-ground aspirate in intensive-care setting. - Red-flag combinations demanding urgent evaluation
Persistent vomiting preventing oral hydration, hematemesis with fresh red blood or clots, melena with orthostatic hypotension, severe epigastric rigidity or rebound tenderness, and confusion plus cold clammy extremities.
Summary table
| Symptom | Typical quality | Alarm threshold |
|---|---|---|
| Epigastric burn | Gnawing, meal-related | >2 h after food or night pain → endoscopy |
| Coffee-ground vomit | Dark granules | Any amount → rule out bleeding |
| Bilious vomiting | Yellow-green fluid | Persistent bile → check bile reflux |
| Early satiety | Sudden fullness | Weight loss >5 % → further work-up |
| Orthostatic dizziness | Standing faint | Plus dark stool → urgent hemoglobin check |