European Journal of Cardiovascular Medicine

Gastritis is a significant public health concern in both developed and developing countries, impacting individuals' health behaviors, socioeconomic status, lifestyles, living conditions, and habits. Gastritis primarily involves inflammation or irritation of the gastric mucosa and can be categorized into three main forms: acute gastritis, characterized by a brief and sudden onset; chronic gastritis, a long-lasting condition; and a rare, severe variant that can be life-threatening due to persistent symptoms or internal bleeding 1.

One notable form of gastritis is associated with Helicobacter pylori (H. pylori) bacteria, which can cause excessive inflammation, mucous membrane irritation, and increased gastric secretion, potentially leading to the rupture and inflammation of the stomach mucosa. Several risk factors contribute to the development of gastritis, including smoking, alcohol consumption, tobacco use, spicy foods, medications, stress, accidental ingestion of foreign objects, and infections 2.

Globally, gastritis is a prevalent health issue, affecting 50.8% of the population in developing countries and causing health-related problems in 34.7% of individuals in developed countries 3. In India, the estimated incidence of gastritis is approximately 3 cases per 869 individuals, equating to around 12,25,614 people out of a total population of 1,06,50,70,607. Recent studies in Bangalore have shown a high prevalence of H. pylori infection at 78%, while a similar study in Allahabad reported a prevalence of 77.2% among adults aged 19-26 years. In African countries, a systematic review found that 38% of women and 18% of men suffer from gastritis. Kenya reported a clinical diagnosis of gastritis in 73.3% of children and 54.8% of adults among patients visiting healthcare institutions 4. In Uganda, 44.3% of individuals under 12 years old were found to be suffering from gastritis, and in Nigeria, 40.7% of children aged 6 to 10 years were diagnosed with gastritis caused by H. pylori infection 3.

Numerous studies have highlighted the significant impact of factors such as gender, age, socioeconomic status, biological aspects, environmental influences, and individual behaviors on the development of gastritis. Besides extensive research on the prevalence of gastritis in relation to H. pylori infection, our study aims to investigate the role of socio-demographic factors, dietary habits, economic status, stress levels, family status, medication use, and other medical conditions in the occurrence of gastritis. Given the absence of prior studies at Hospital in Berhampur, it is crucial to determine the prevalence of gastritis in this region concerning the aforementioned contributing factors. Our primary objective is to provide valuable insights into the factors significantly contributing to the occurrence of gastritis and to disseminate information about its prevalence.

This descriptive, observational, non-interventional study included 150 subjects. The inclusion criteria encompassed all patients diagnosed with gastritis aged 14-65 years of both sexes admitted to the General ward of MKCG Medical College and Hospital, Berhampur. Pediatric patients, patients from the OPD, and other wards were excluded. Data collection was done using a structured questionnaire, and written consent was obtained from each patient before the interview. The data were categorized into socio-demographic details, dietary habits, economic status, family history, stress level, drug use, and medical history.

Demographic factors included age (classified as 14-25, 26-35, 36-45, 46-55, and 56-65 years), gender (male and female), residence (rural and urban), educational level (SSC, HSC, below SSC, graduate, and illiterate), occupation (laborer, farmer, driver, housewife, student, and others), blood pressure (normal, hypertensive, and hypotensive), and blood group (A, B, AB, O, and Rh factor positive and negative). Social history included daily habits such as alcohol consumption (alcoholic and non-alcoholic), smoking (smokers and non-smokers), tobacco chewing (yes or no), and marital status (married, unmarried, divorcee, or widow).

Dietary status included diet classification (vegetarian and mixed diet), bloated feeling after eating (yes or no), and inclusion of fibers in the daily diet (yes or no). Medical history covered family history of gastritis, known diseases or disorders, previous hospitalizations, and known allergies. Medication history involved past medication use, frequent use of NSAIDs, and OTC medications. Stress history was investigated using the perceived stress scale, measuring stress levels with scores ranging from 0 (never) to 4 (very often).

Exercise habits, menstrual history in female subjects (including rate of blood flow, pain, and regularity), and sleeping patterns (sleep duration classified as <6 hours, 6-8 hours, and >8 hours, and irregularity in sleep) were also investigated. The study aimed to determine the prevalence of various etiological factors such as demographic, socio-economic, stress, dietary habits, and drug use in the occurrence of gastritis, assess the association between blood group and the incidence of gastritis, and identify the most common causes of gastritis in the locality.

The study was conducted on IPD patients at MKCG Medical College and Hospital, Berhampur. The sample included 150 patients diagnosed with gastritis aged 14-65 years of both sexes. Written informed consent was obtained from each participant, and confidentiality was maintained throughout the study.

In the present study, various parameters were considered to analyze the distribution pattern of gastritis. Out of 150 cases, 73% were male, and 27% were female, indicating a male predominance. Figure 1 shows the age-wise distribution of the subjects.

Marital status revealed that 75% of the subjects were married, 21% were unmarried, and 4% were widows,

suggesting that a majority of gastritis patients were married. 25% of the subjects had a history of certain diseases or disorders, with hypertension at 10%, diabetes mellitus at 4%, AIDS at 3%, arthritis at 2%, burns at 1%, pulmonary tuberculosis at 1%, and others at 4%.

Figure 1: Age wise distribution of the Gastritis among study participants

75% of the subjects had a mixed diet, and 25% were vegetarians, aligning with findings from a cross-sectional study on lifestyle factors and gastritis development. Regarding literacy, 77% were below SSC level, 34% had SSC, 19% had HSC, 15% were illiterate, and 5% were graduates. The study found an association between a lack of higher education and gastritis prevalence, with illiterate subjects being less affected than those below SSC level.

Figures 2 and 3 show the occupation-wise distribution of gastritis among males and females.

An observational study found a significant relationship between H. pylori infection and hypertension. About 23% of the population had a past medication history, with 9% on antihypertensive therapy (Amlodipine), and 6%, 4%, 3%, and 1% on NSAIDs, oral hypoglycemics, antiretroviral therapy, and Directly Observed Therapy, respectively. 61% had a history of frequent NSAID consumption. Long-term NSAID use can lead to gastrointestinal complications, including gastritis, which our study supports.

In males, laborers (33%) and drivers (22%) were predominant, while in females, housewives (47%) were most affected, indicating that physical hard work might be a factor for gastritis. 68% lived in urban areas, and 32% in rural areas, which contrasts with another study showing 52% living in rural areas. This urban predominance may be due to lifestyle differences and increased exposure to pollutants.

Regarding blood groups, 46% were A Rh+, 21% B Rh+, 6% AB Rh+, 12% O Rh+, 5% A Rh-, 5% B Rh-, 3% AB Rh-, and 1% O Rh-, which contradicts findings from a study linking H. pylori infection to blood group O. Blood pressure measurement showed 6% were hypertensive, with the rest normotensive, not supporting a higher incidence of gastritis in hypertensive patients.

Table 1: Distribution of sample characteristics in terms of frequency and percentage

Smoking was considered a risk factor for gastritis, but our study found no significant difference, with 49% smokers and 51% non-smokers. Alcohol consumption, however, showed 54% were alcoholics, with no female subjects reporting alcohol use, but 74% of males were alcoholics, indicating alcohol's significant role in gastritis.

Table 2: Dietary pattern related distribution of sample characteristics in terms of frequency and percentage

68% of the subjects had an annual income below 1 lakh, suggesting poverty as a contributing factor. 47% experienced emotional stress often (level 3 on the stress scale), consistent with findings linking stress to gastric mucosal abnormalities. Most subjects (92%) did not exercise, aligning with previous studies suggesting exercise reduces gastritis symptoms.

Dietary habits revealed 73% consumed spicy food, and 27% did not. Regarding tea consumption, 18% drank it more than four times daily, 31% drank it four times, and 43% twice daily. Spicy food and caffeine can irritate the stomach lining, as our study confirms. 84% felt bloated after eating, supporting regular exercise to reduce gastritis. 72% slept 6-8 hours, 21% less than 6 hours, and 7% more than 8 hours. Sleep irregularity affected 51%, highlighting the importance of good sleep for preventing gastritis.

Among women, 47% had moderate menstrual flow, 35% were menopausal, and 60% were perimenopausal or menopausal, experiencing more gastritis symptoms. Bowel habits showed 47% had normal movements, 34% were constipated, and 19% had loose movements. Refer to Table 1 for the distribution of sample characteristics and Table 2 for dietary pattern distribution in terms of frequency and percentage.

Gastritis is a prevalent health issue worldwide. The findings of this study indicate that males face a higher risk of gastritis, primarily due to lifestyle changes, occupational factors, and social habits, especially alcohol consumption. The prevalence of gastritis is significant among individuals aged 14-25 and 36-45 years, with physical labor increasing susceptibility. Urban residents exhibit a higher incidence of the disease. The consumption of spicy food and tea aggravates gastritis symptoms, and frequent NSAID use is a notable risk factor.

Significant correlations are observed with blood group (predominantly A Rh+), psychological stress, menstrual history, sleeping patterns, and educational levels as potential risk factors for gastritis. This study provides a comprehensive overview of various risk factors, offering insights crucial for preventing gastritis. The results underscore the need for targeted interventions to mitigate the impact of these identified risk factors and enhance public health outcomes. Future perspectives should focus on developing tailored preventive strategies and interventions to reduce the burden of gastritis within the studied population.

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