Gastritis is the inflammation of the stomach linings that occurs as a result of the effect of the hydrochloric acid released for the breakdown of our meals on the inner linings or membranes of the stomach. Postpartum gastritis is that gastritis that results following delivery.
it is the result of the interaction between the stomach linings and the differing changes associated with pregnancy on the breakdown and metabolism of food.
In pregnancy, you are at an increased risk of developing postpartum gastritis as a result of your increased susceptibility to Helicobacter Pylori ( H. Pylori) infection and this can continue till after delivery and in combination with the altered hormonal milieu following pregnancy the postpartum gastritis persists and worsens if not controlled.
Causes
Postpartum gastritis is mainly a result of the hormonal changes in the body following delivery coupled with the increased susceptibility of the stomach lining of new mothers to the bacteria Helicobacter pylori.
Progesterone- This hormone alters gastric emptying time and slows down the release of the contents from the stomach to the small intestine. This increases the amount of time the acid in the stomach acts on the mucosa of the stomach and causes its alteration leading to increased acidity and gastritis.
Helicobacter pylori- This is a bacterial infection of the linings of the stomach that predisposes to gastritis and peptic ulcer disease and can also lead to an increased risk of gastric cancers. The steroid hormone induced changes in gastric pH is one of the underlying factors that predispose postpartum women to postpartum gastritis.
Bile reflux- The back flow of digestive juices called bile from the gall bladder to the stomach irritating the stomach lining leads to gastritis and this is worsened by hormonal effect of pregnancy that relaxes the sphincters and smooth muscles leading to reflux.
This reflux effect is also noticed in the esophageal sphincter leading to reflux esophagitis and heartburn that is a common complaint in early pregnancy
An autoimmune reaction- When the immune system mistakenly attacks its own cells and tissues. In this case the stomach linings is the focus of attack leading to autoimmune postpartum gastritis
Pernicious anemia- This is a form of anemia that arises when the stomach cannot absorb vitamin B12 and it irritates the stomach lining causing gastritis both in the prepartum and postpartum period.
Other common causes of postpartum gastritis include alcohol ingestion, eating of spicy foods and smoking.
Symptoms and Signs
The common symptoms of postpartum gastritis are nausea, vomiting, indigestion, easy fullness and bloody stool and vomit in the very severe cases.
The epigastric pain is usually centralized and feels like a nail is hammered into the center of the chest.
You also experience radiating pain to the upper back and the pain can extend up the base of the neck with associated tension headache and down the arms giving the sensation of inability to lift the hands up at times.
Symptoms can be very scary and keeps you uncomfortable and unable to take care of your baby.
The indigestion associated with postpartum gastritis is remarkable and comes with loss of appetite and reflux oesophagitis at times.
You also have an increased flatulence due to the excess production of gas.
Prevention Strategies
Prevention of postpartum gastritis will take place by controlling the factors that lead to development of gastritis in the post delivery period. Particular attention must be paid to:
Alcohol ingestion
Consumption of spicy foods
Smoking.
There are some foods that alleviate gastritis and you should adjust your diet to accommodate those food items.
Control of your predisposition to likely infection with Helicobacter pylori must be considered seriously in the prevention of postpartum gastritis.
The alteration of the milieu of the walls of the stomach is a major factor in the development of postpartum gastritis and the main infection preventive measures are
Ensuring a healthy living habit.
Wash your hands after using the bathroom and before you prepare your meals
Avoid unclean water
Do not eat foods that are not properly cooked
Do not eat meals served by individuals with unclean hands
These measures will help prevent faecoral predisposition to the main culprits in postpartum gastritis.
Home Remedies
If you are suffering from postpartum gastritis there are certain home measures you can undertake to treat the gastritis
- Drink plenty of fluids like coconut water and coconut milk – This has antiseptic and anti bacterial properties and helps in the healing process.
- Eat diet that is rich in fiber – Like meals composed mainly of fruits and vegetables including those that are rich also in vitamin k. These anti inflammatory diet help in relieving the symptoms. Papaya has loads of antioxidant and contains papain an enzyme that reduces the formation of acid in the stomach,
- Drink warm liquids
- Avoid caffeine containing items
- Take non carbonated drinks
- Probiotics – These are good bacteria that have the immense property of eliminating harmful bacteria and improving gut health. It slows down the progression of H. pylori. Yogurt is a common example of a probiotic food source and is helpful in gastritis.
- Low fat foods like fish and lean meat also helps immensely in containing gastritis
- Garlic extract supplement – Garlic has good anti fungal and antimicrobial properties. It targets H. pylori, reducing gas formation in the stomach
- Drink green tea with honey – The addition of honey helps in smoothing out the injured stomach linings while the green tea reduces the production of acid in the stomach
- Avoid overuse of painkillers – Especially painkillers of the non steroidal anti inflammatory group as they destroy the stomach lining making you predisposed to the development of gastritis.
- Reduce stress – Stress is a cause of stress induced ulcers which usually starts as gastritis before proceeding to ulcer if not well treated and this is common in the postpartum period with all the stress associated with taking care of your new born so rest is advocated as a remedy for postpartum gastritis.
Medical Treatment
The goal of treatment is to reduce the amount of acid secretion by the stomach thereby relieving the symptoms. If you relieve the symptoms, you bridge the vicious circle and in the process healing starts occurring and the underlying cause is addressed.
Antacids – The antacids work by diluting the acid secreted by the stomach producing quick and effective pain relief
Histamine H2 receptor blockers – These work by limiting acid production allowing the inflammation to heal
Proton pump inhibitors – This also work by limiting acid production but are more effective at this job than the histamine receptor blockers.
Antibiotics – This is very helpful in eliminating h. pylori when it is the implicating factor in postpartum gastritis. These can be used alone or in combination with the above measures in the treatment of postpartum gastritis.
Conclusion
Postpartum gastritis is a common complaint in mothers who just delivered and treating it is important as it is very uncomfortable and hampers the proper enjoyment of the postnatal period and can lead to peptic ulcer disease and its sequelae if uncontrolled.
Home remedies are effective in most cases of postpartum gastritis but in cases where it is not, your doctor will recommend the best possible care plan bearing in mind the treatment modalities outlined above.
To a pain free motherhood
Dr mawa
mypostnatalmanagement.com
