Gastritis Symptoms, Diet, Causes, Treatment

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)
    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Bhupinder S. Anand, MBBS, MD, DPHIL (OXON)

    Dr. Anand received MBBS degree from Medical College Amritsar, University of Punjab. He completed his Internal Medicine residency at the Postgraduate Institute of medical Education and Research, Chandigarh, India. He was trained in the field of Gastroenterology and obtained the DPhil degree. Dr. Anand is board-certified in Internal Medicine and Gastroenterology.

Gastritis can result in stomach pain and digestive problems.

Gastritis definition and facts

  • Gastritis is inflammation of the stomach lining and is usually termed acute or chronic gastritis.
  • The two major causes of gastritis are 1) a bacterium named Helicobacter pylori or H. pylori, and 2) nonsteroidal anti-inflammatory drugs (NSAIDs). However, there are many other causes like other infectious agents, autoimmune problems, diseases like Crohn's disease, sarcoidosis, and isolated granulomatosis gastritis.
  • Although many individuals with gastritis may have no symptoms, both acute and chronic gastritis may have symptoms of
    • abdominal pain,
    • nausea,
    • vomiting, and
    • occasionally, belching, bloating, loss of appetite and indigestion.
  • Gastritis can be diagnosed by the patient's symptoms and history (for example, NSAID and/or alcohol consumption), or by breath, blood, stool, immunological, and biopsy tests to detect H. pylori and other tests such as endoscopy or radiologic studies demonstrate mucosal changes.
  • The treatment for gastritis varies according to the cause. Other less common causes may be treated similarly, but do not treat the underlying cause.
  • Home remedies, for example, over-the-counter antacids or histamine blockers for gastritis help reduce symptoms, but usually does not treat the underlying cause of the condition.
  • Foods and chemical irritants that cause or aggravate gastritis symptoms should be reduced or stopped all together. For example:
    • Stop cigarette smoking.
    • Avoid drinking excessive amounts of alcohol.
    • Avoid caffeinated, decaffeinated, and carbonated drinks; and fruit juices that contain citric acid, for example, grapefruit, orange, pineapple, etc.
    • Avoid high-fat foods.
  • There is no gastritis diet, however, the growth of H. pylori may be stopped by a diet rich in fiber, and foods that contain flavonoids, for example:
    • Certain teas
    • Onions
    • Garlic
    • Berries
    • Celery
    • Kale
    • Broccoli
    • Parsley
    • Thyme
    • Soy foods
    • Legumes
  • Complications from acute gastritis are rare.
  • Complications from chronic gastritis include peptic ulcer, bleeding ulcers, anemia, gastric cancers, MALT lymphoma, renal problems, strictures, bowel obstruction, or even death.
  • People with acute gastritis usually recover completely with no complications.
  • Chronic gastritis may have a range of outcomes from good (early treatment) to poor if serious complications develop.
  • If underlying causes of gastritis (for example, alcohol, or NSAIDs usage) are treated or not used, gastritis also may be prevented.
  • To prevent infectious causes of gastritis practice good hand washing techniques, for example, wash the hands thoroughly and frequently.
  • To reduce the risk of gastritis avoid situations where you are exposed to chemicals, radiation, or toxins.

Quick GuideDigestive Disorders: Common Misconceptions

Digestive Disorders: Common Misconceptions

Gastritis Symptoms

Gastritis, or inflammation of the lining tissues of the stomach, can be either acute or chronic. Symptoms of gastritis include:

  • Upper abdominal pain
  • Burning
  • Heartburn

Symptoms of chronic gastritis include:

  • Feelings of fullness
  • Nausea
  • Intestinal gas
Gastritis is caused by inflammation of the stomach lining also known as the gastric mucosa.

What is gastritis?

Gastritis is inflammation of the lining of the stomach. Unfortunately, the term "gastritis" has been misused to include many different upper abdominal problems, but true gastritis refers to the stomach lining (gastric mucosa) that is inflamed. All or part of the gastric mucosa may be involved. Gastritis may be classified as acute or chronic.

  • Acute gastritis maybe characterized as erosive (damaged areas where mucosal cells are disrupted or missing) and nonerosive.
  • Chronic gastritis is determined by histopathology (appearance of the gastric mucosa) with symptoms lasting a long time. There is no widely accepted classification system although some have been proposed.

This article will focus on true gastritis. Gastritis has many causes, but most causes result in similar symptoms. This has leads to some confusion and is the reason why many health-care professionals now consider the term "gastritis" as a non-specific description of a cluster of symptoms.

H. pylori and other microorganisms can often cause gastritis.

What are the symptoms of gastritis?

Many people with gastritis do not have symptoms. The condition is diagnosed only when samples of the stomach mucosa are examined for other suspected diseases. However, when gastritis symptoms occur, the most common symptoms include the following:

  • Abdominal pain (intermittent or constant burning, gripping or gnawing pain) often accompanied by nausea and vomiting
  • Diarrhea
  • Loss of appetite
  • Bloating
  • Burping
  • Belching

These last four symptoms come and go over time especially with chronic gastritis. Indigestion (dyspepsia) is another term that encompasses this cluster of symptoms.

What causes gastritis?

A major cause of both acute and chronic gastritis is infection of the stomach mucosa by a bacterial species named Helicobacter pylori. Usually, this bacterium first infects the stomach antrum (stomach mucosa without acid-producing cells) acutely and may progress to infect most or all of the stomach's mucosa over time (chronic gastritis) and remain there for years. This infection generates an initial strong inflammatory response and eventually, a long-term chronic inflammation with intestinal cell changes may develop. Another major cause of acute and chronic gastritis is the use (and overuse) of nonsteroidal anti-inflammatory drugs (NSAIDs).

However, there are many other causes of gastritis; the following is a list of common causes of both acute and chronic gastritis; chronic gastritis may occur with repeated or continual presence of most of these causes:

  • Bacterial, viral and parasitic infections
  • Certain drugs (cocaine)
  • Alcohol
  • Bile reflux
  • Fungal infections
  • Allergic reactions
  • Stress reaction
  • Radiation
  • Certain food poisonings (infectious and chemical)
  • Trauma

In general, infectious agents, especially Helicobacter pylori, and NSAIDs are responsible for the majority of people with gastritis.

woman with abdominal pain
Gastritis symptoms include stomach pain, diarrhea, belching and indigestion.

How is gastritis diagnosed?

Gastritis is diagnosed based on the patient's symptoms and history of a previous diagnosis and treatment of gastritis, alcohol consumption, and use of NSAIDs. Definitive diagnosis of gastritis is made by identifying the underlying cause of the gastric mucosal inflammation and/or by tissue (gastric) biopsy. For example, the major infective cause of gastritis is Helicobacter pylori (H. pylori). This bacterium can be detected by breath, blood, stool, immunological and biopsy tests. Although the bacterium can be cultured from the patient, this is seldom attempted. Other pathogens can be identified using culture, stool, and immunological tests.

Biopsy of the stomach mucosa, done during endoscopy examinations, is often used in patients to identify the causes of chronic gastritis and may allow visualization of mucosal erosions and other stomach mucosal changes. Abdominal X-rays or barium studies (upper or lower) may demonstrate the presence of thickened mucosa and folds that are signs of inflammation in the stomach.

Your doctor can help determine which tests should be done, including ancillary tests that may help identify other causes of the non-specific symptoms commonly found with gastritis.

Medications are used to treat the underlying causes of gastritis.

What OTC and prescription medications treat gastritis?

Treating the underlying cause of gastritis is the most effective way to reduce or resolve gastritis. For example, if the cause of gastritis is H. pylori, then treatment with appropriate antibiotics (usually a combination of amoxicillin and clarithromycin [Biaxin, Biaxin XL] plus bismuth subsalicylate [Pepto-Bismol]) should be effective.

If NSAIDs are the cause, then stopping the drug should be effective.

Other treatments often are used in addition to those that treat the specific cause of gastritis, many of which are over-the-counter or OTC, may reduce or stop symptoms of gastritis and allow gastric mucosal healing to begin regardless of the underlying cause. These medications include

  • antacids (Maalox , Rolaids, and Alka-Seltzer),
  • histamine (H2) blockers (famotidine [Pepcid AC], ranitidine [Zantac 75]), and
  • PPI's or proton pump inhibitors (omeprazole [Prilosec], pantoprazole [Protonix], esomeprazole [Nexium]).

They all function by different mechanisms to reduce acid in the stomach but usually do not treat the underlying cause of gastritis.

What home remedies are available to treat gastritis?

Some people consider OTC medications as home remedies, and those medications are mentioned above.

Foods for gastritis relief include yogurt, peppermint, and other stomach friendly foods.

What foods reduce stop H. pylori growth and or soothe gastritis symptoms?

The University of Maryland health-care professionals and others suggest that eating smaller, more frequent meals and avoiding foods that are spicy, acidic, fried or fatty will help reduce symptoms. Moreover, stress reductionis also recommended. Dietary changes such as ginger tea and/or chamomile tea with honey reportedly soothes gastritis symptoms while onions, garlic, cranberries, apples and celery may stop H. pylori growth.

Foods that may stop H. pylori growth and soothes gastritis symptoms include:

  • Teas (green and white in particular)
  • Yogurt
  • Peppermint
  • Wheat bran
  • Carrot juice
  • Coconut water
  • Green leafy vegetables
  • Onions
  • Garlic
  • Apples
  • Fresh fruits and berries
  • Celery
  • Cranberry juice
  • Kale
  • Broccoli
  • Scallions
  • Parsley
  • Thyme
  • Soybeans
  • Soy foods
  • Legumes (beans, peas, and lentils)

Although these home remedies may help reduce or soothe symptoms, home remedies seldom treat the underlying causes of gastritis.

What foods aggravate gastritis symptoms?

Foods and other substances that should be avoided to reduce or prevent gastritis symptoms include:

  • Alcohol
  • Spicy foods
  • Fatty foods
  • Fried foods

Moreover, anything that might be toxic or irritating to the stomach should also be avoided (for example cigarette smoking, acidic drinks like coffee, garlic powder, chili powder, peppers and tomato products).

Some complications of gastritis could be severe if no treatment is given.

What are the complications of gastritis?

The complications of gastritis may occur over time, especially if gastritis becomes chronic and the underlying causes are not treated. Complications of gastritis may include

  • peptic ulcer,
  • bleeding ulcers,
  • anemia,
  • gastric cancers,
  • MALT lymphoma,
  • gastric scarring and strictures with outlet obstruction,
  • dehydration,
  • renal problems, and
  • death.


What is the prognosis of gastritis?

Most people that get gastritis have few or short-term symptoms and recover completely. Those people with underlying causes that are appropriately treated often recover completely. The prognosis of individuals with chronic disease and those who develop serious complications like bleeding ulcers, obstruction and cancer is more guarded.

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Gastritis can be prevented if the underlying cause of gastritis is preventable.

How is gastritis prevented?

If the underlying cause of gastritis is preventable, then gastritis can be prevented and people can get gastritis relief.

  • If alcohol consumption, NSAIDs, or smoking causes an individual's gastritis, treatment and prevention is stopping the consumption or use of these products.
  • Avoid situations where chemicals, radiation or some toxin ingestion could occur.
  • It may be more difficult to prevent some infectious causes of gastritis, but proper hygiene, hand washing, and eating and drinking only adequately cleaned or treated foods and fluids are healthy ways to decrease your risk of getting gastritis from infectious agents.
Reviewed on 10/30/2015
References
REFERENCES:

Marcus, A., MD. "Chronic Gastritis." Medscape. Dec 19,2014
<http://emedicine.medscape.com/article/176156-overview>

NutritionMD. "Gastritis and Peptic Ulcer Disease: Nutritional Considerations."
<http://www.nutritionmd.org/consumers/gastrointestinal/gastritis_nutrition.html>

Oregon State University, Linus Puling Pauling Institute, Micronutrient Information Center. "Flavonoids."
<http://lpi.oregonstate.edu/mic/dietary-factors/phytochemicals/flavonoids#introduction>

University of Maryland Medical Center. Gastritis. Aug 15, 2013
<https://umm.edu/health/medical/altmed/condition/gastritis>

Univeristy of Michigan; Integrative Medicine. "Healing Foods Pyramid™"
>http://www.med.umich.edu/umim/food-pyramid/legs.html>

Wehbi, M. MD. "Acute Gastritis." Medscape. Sep 18,2014
<http://emedicine.medscape.com/article/175909-overview>

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