Treatment of gastritis depends on the cause of the problem. Some cases of gastritis may resolve by themselves over time, or be relieved when you stop drinking alcohol, smoking cigarettes, or taking NSAIDs. You may need to change your diet, although doctors now know that a bland diet is not required. If your gastritis is due to H. pylori infection, your doctor will prescribe antibiotics.
The treatment for gastritis that is caused by irritants is to stop using them. These include:
- Acidic beverages, such as coffee (both caffeinated and decaffeinated), carbonated beverages, and fruit juices with citric acid
- NSAIDS, such as aspirin and ibuprofen. Switch to other pain relievers (like acetaminophen).
These steps may also help:
- Eat a fiber-rich diet.
- Foods containing flavonoids like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may stop the growth of H. pylori.
- Avoid high-fat foods. In animal studies, high-fat foods increase inflammation in the stomach lining.
If you have H. pylori, you will probably be prescribed three medications. Doctors commonly use "triple therapy," to treat H. pylori-related gastritis and ulcers, including a proton pump inhibitor to reduce acid production and two antibiotics. Bismuth salicylate (Pepto Bismol) may be used instead of the second antibiotic. This drug, available over the counter, coats and soothes the stomach, protecting it from the damaging effects of acid.
Some of the same drugs used for non-H. pylori gastritis as are used for symptoms (like indigestion) due to ulcers:
Available over the counter, they may relieve heartburn or indigestion but will not treat an ulcer. Antacids may block medications from being absorbed and thereby decrease the medicine's effectiveness. Doctors recommend taking antacids at least 1 hour before or 2 hours after taking medications. Ask your pharmacist or doctor for more information. Antacids include:
- Aluminum hydroxide (Amphojel, AlternaGEL)
- Magnesium hydroxide (Phillips' Milk of Magnesia)
- Aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta)
- Calcium carbonate (Rolaids, Titralac, Tums)
- Sodium bicarbonate (Alka-Seltzer)
Reduce gastric acid secretion. They include:
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Nizatidine (Axid)
- Famotidine (Pepcid)
Proton pump inhibitors
Decrease gastric acid production. They include:
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Omeprazole (Prilosec)
- Pantoprazole (Protonix)
- Rabeprazole (AcipHex)
Nutrition and Dietary Supplements
Doctors used to recommend eating bland foods with milk and only small amounts of food with each meal. Researchers now know that such a diet is not required to treat gastritis or ulcers.
Following these nutritional tips may help reduce symptoms:
- Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may inhibit the growth of H. pylori.
- Eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
- Eat foods high in B vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
- Avoid refined foods, such as white breads, pastas, and sugar.
- Eat lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
- Use healthy oils, such as olive oil.
- Reduce or eliminate trans fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
- Avoid beverages that may irritate the stomach lining or increase acid production including coffee (with or without caffeine), alcohol, and carbonated beverages.
- Drink 6 to 8 glasses of filtered water daily.
- Exercise at least 30 minutes daily, 5 days a week.
- Identify and eliminate food allergies.
The following supplements may help with digestive health:
- A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
- Omega-3 fatty acids, such as fish oil, may help decrease inflammation. Fish oil may increase the risk of bleeding. If you take aspirin or other anticoagulants (blood thinners), talk to your doctor before taking fish oil.
- Probiotic supplement (containing Lactobacillus acidophilus). Probiotics or "friendly" bacteria may help maintain a balance in the digestive system between good and harmful bacteria, such as H. pylori. Probiotics may help suppress H. pylori infection, and may also help reduce side effects from taking antibiotics, the treatment for an H. pylori infection. Some probiotic supplements need to be refrigerated for best results. People who have weakened immune systems, or who are taking immune-suppressive drugs, should take probiotics only under the direction of their physician.
- Vitamin C. Studies show that pharmacological doses of vitamin C may improve the effectiveness of H. pylori-eradication therapy. Speak with your physician about what dose might be appropriate for you.
Herbs may strengthen and tone the body's systems. As with any therapy, you should work with your health care provider before starting any treatment. You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Herbs can interact with medications or other supplements, and some herbs may not be appropriate for people with certain medical conditions. Work with a knowledgeable herbal prescriber and keep all of your medical providers informed of any herbs or supplements you are considering. Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
- Cranberry (Vaccinium macrocarpon). Some preliminary research suggests cranberry may inhibit H. pylori growth in the stomach. Avoid cranberry extract if you have an aspirin allergy. Cranberry may increase the risk of bleeding in people who take blood-thinning medications, such as warfarin (Coumadin) or aspirin, among others. Cranberry may decrease the speed at which your body processes certain medications and therefore increase the amount of those medications in your bloodstream at a given time. Speak with your doctor if you have concerns.
- Mastic (Pistacia lentiscus) standardized extract. Mastic is a traditional treatment for peptic ulcers and inhibits H. pylori in test tubes. More studies are needed to see whether it works in humans.
- DGL-licorice (Glycyrrhiza glabra) standardized extract, chewed either 1 hour before, or 2 hours after meals, may help protect against stomach damage from NSAIDs. Glycyrrhizin is a chemical found in licorice that causes side effects and drug interactions. DGL is deglycyrrhizinated licorice, or licorice with the glycyrrhizin removed. Take medications at least 1 hour before or after taking DGL.
- Peppermint (Mentha piperita). May help relieve symptoms of peptic ulcer. Each tablet contains 0.2 ml peppermint oil. Be sure to use the enteric coated form to avoid heartburn. Peppermint can potentially interact with a variety of medications, and it can be toxic at high doses. Speak with your physician.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitution, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment.
- Pulsatilla. For heartburn, queasiness, a bad taste in the mouth brought on by eating rich foods and fats (especially ice cream); symptoms may include vomiting partly digested food. This remedy is most appropriate for someone whose tongue is coated with a white or yellow substance.
- Ipecacuanha. For persistent and severe nausea, with or without vomiting and diarrhea, caused by an excess of rich or fatty foods.
- Carbo vegetabilis. For bloating and indigestion, especially with flatulence and fatigue.
- Nux vomica. For heartburn, nausea, retching without vomiting, and sour burps caused by overeating, alcohol use, or coffee drinking. This remedy is most appropriate for people who also feel irritable and sensitive to noise and light.
Acupuncture may help reduce stress and improve overall digestive function.
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