Gastritis: An In-Depth Review

Acute gastritis affects 8 out of every 1,000 people, while chronic gastritis affects 2 out of 10,000 people. 

Types and Causes of Gastritis

Erosive gastritis is inflammation and wearing away of the stomach lining. It typically develops slowly in otherwise healthy people. Nonerosive gastritis is inflammation of the stomach without compromise of the stomach lining. 

Acute Gastritis

Acute gastritis typically lasts between two and ten days and can result from:

  • Contaminated food
  • Irritating food
  • Aspirin or NSAIDs
  • Alcohol ingestion
  • Bile reflux (bile is involved in fat digestion, so eating high-fat foods is associated with this)
  • Radiation treatment 

Acute stress gastritis is an erosive form of gastritis developing from decreased blood flow to the stomach and an impairment of the stomach lining. It develops after significant injury or illness, such as major bleeding, extensive burns, or brain injury. 

Chronic Gastritis

Chronic gastritis can last for weeks to years and can be caused by:

  • Benign or malignant tumors
  • Infection with H. pylori
  • Autoimmune diseases such as celiac disease – atrophic gastritis is an autoimmune disease in which antibodies attack the stomach lining.
  • Portal hypertension
  • Poor diet
  • Medication use
  • Alcohol ingestion
  • Smoking
  • Cocaine use
  • Chronic reflux
  • People who are post-gastrectomy sometimes develop gastritis due to either a lack of blood flow to the stomach lining or excessive bile production. 

H. pylori

H. pylori infection is the number one cause of atrophic gastritis, causing inflammation with deterioration of the mucous membranes and glands. As we age, H. pylori infection is much more common because the decrease in the hydrochloric acid secretion that occurs as we get older allows for bacterial growth. H. pylori infection affects 10% of the total population in developed countries, 20% of those between the ages of 60 and 69, and 40% of those over 80. 

Symptoms of Gastritis

  • Gnawing or burning pain that sometimes improves with eating
  • Loss of appetite and feeling full
  • Nausea and vomiting
  • Headache
  • Hiccupping
  • Reflux
  • Heartburn
  • Belching
  • Sour taste in the mouth

Complications of Gastritis

Severe, untreated erosive gastritis can progress to hemorrhagic gastritis, resulting in tachycardia (fast heart rate), hypotension (low blood pressure), blood in stool, and bloody vomit. Vitamin B12 deficiency can cause a compounding of symptoms, including numbness or tingling of the extremities, difficulty walking, and confusion. MALT lymphoma, stomach cancer, kidney problems, strictures, and bowel obstructions are associated with severe gastritis.

H. pylori infection is linked to both duodenal and gastric cancers, as well as cirrhosis. 

Testing for H. pylori Infection

In a breath test, you will swallow a capsule, drink a liquid, or eat a pudding that contains urea tagged with carbon. You will then breathe into a container. If carbon is present, it signals a high amount of urease and indicates a positive H. pylori result. 

Blood tests can look for high levels of H. pylori antibodies, and stool testing looks for antigens to H. pylori. Keep in mind that blood antibody levels can remain elevated for a year after infection is eradicated. 

Medical Treatment of Gastritis

Antibiotics (Metronidazole, Amoxicillin, and/or Clarithromycin)

Bismuth – slows the growth of bacteria (the most popular brand is Pepto-Bismol)

Lactoferrin – seems to slow the growth of bacteria by starving them of nutrients

Sucralfate – forms a coating over ulcers, preventing further injury

Ursodiol – changes the characteristics of bile

Misoprostol – decreases the risk of serious ulcer complications, such as bleeding

H2 Blockers – decrease the amount of acid released into the digestive tractPPIs – reduce the acid by blocking the action of the parts of cells that produce acid
famotidine (Pepcid)
cimetidine (Tagamet HB)
nizatidine (Axid AR)
omeprazole (Prilosec)
lansoprazole (Prevacid)
rabeprazole (Aciphex)
esomeprazole (Nexium)
dexlansoprazole (Dexilant)
pantoprazole (Protonix)

Diet for Gastritis

Foods that are thought to increase gastric irritation and should be either excluded or strictly limited include:

  • Refined sugars and desserts
  • White flour products
  • Salt
  • Carbonated beverages and soft drinks
  • Tea and coffee
  • Chocolate
  • French fries and other fried foods
  • Milk
  • Onions and peppers
  • Citrus fruits
  • Tomatoes and tomato products (such as red sauce)

If you are suffering from gastritis, adding the following foods to your diet may be helpful:

  • Yogurt
  • Kimchi
  • Kombucha
  • Flaxseeds 
  • Pumpkin seeds
  • Sunflower seeds 
  • Sesame seeds
  • Walnuts
  • Wheat bran
  • Nori, wakame, and kelp
  • Carrot juice
  • Coconut water
  • Green, leafy vegetables
  • Berries
  • Celery
  • Kale
  • Broccoli and broccoli sprouts
  • Parsley
  • Thyme
  • Beans

Complementary Treatment of Gastritis

These treatments should be considered medications and should be used only under the watch of a credentialed medical professional. All complementary therapies carry a risk of adverse effects and can interact with each other and other medications you take. 

  • Carrot seed, cinnamon bark, mauka, and savory essential oils might inhibit H. pylori. 
  • Turmeric can be used to treat the inflammation caused by the ulcer. 
  • Curcumin has been used in healing peptic ulcers as well as preventing H. pylori growth. 
  • Ginger inhibits the growth of H. pylori. 
  • Borage oil contains polyunsaturated fatty acids that might be of benefit for atrophic gastritis. 
  • Licorice root has a long history of use for soothing inflamed and injured mucous membranes in the digestive tract. Flavonoids in licorice may also inhibit the growth of H. pylori. 
  • Gamma oryzanol may improve gastritis symptoms. 
  • Cranberry juice, as part of a standard therapy protocol, may improve the eradication of H. pylori. 
  • Caraway might improve digestion and reduce spasms in the stomach and intestines. 
  • Glutamine has been shown to increase blood flow to the gut, thereby helping the healing process.