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Gastritis (Chronic, Atrophic, or Acute): Treatment & Diet

Written by Jasmine Foster, BS (Biology), BEd | Last updated:
Puya Yazdi
Medically reviewed by
Puya Yazdi, MD | Written by Jasmine Foster, BS (Biology), BEd | Last updated:

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Gastritis is an often-painful condition caused by inflammation in the lining of the stomach. Read on to learn how it is diagnosed and treated, plus what complementary approaches might help manage it.

What is Gastritis?

Gastritis is a condition characterized by inflammation of the stomach lining. It may be acute (sudden and short-term) or chronic (developing slowly and long-term). One type of gastritis called erosive gastritis breaks down the lining of the stomach, sometimes leading to ulcers. Another type, called atrophic gastritis, causes a loss of glandular tissue in the lining of the stomach, often replaced by scar tissue; this type is often caused by an autoimmune reaction [1, 2].

Gastritis can have a number of causes. These include H. pylori infection, long-term NSAID use, alcohol abuse, cocaine use, or autoimmune disease. Severe injuries, burns, sepsis, and some drugs can also cause acute erosive gastritis [1].

H. pylori is the most common cause of gastritis, and about 35% of the US population is infected with this bacteria [1].

Gastritis is characterized by inflammation of the stomach lining. It may be caused by H. pylori, drugs like NSAIDs, autoimmune disease, or severe injury.

How is Gastritis Diagnosed?

If your doctor suspects that you might have ulcers, they will go through a series of tests to confirm or refute their suspicions.

Upper GI Endoscopy

Endoscopic procedures use a tiny camera and light to visually inspect diseased tissues. To check for gastritis, endoscopy is typically performed by feeding the camera down the esophagus and into the stomach [3, 4].

At this time, the doctor may use the endoscope to take a tiny tissue sample (a biopsy) for lab analysis [3, 4].

Lab Tests

If your doctor suspects an H. pylori infection, they will likely order blood tests, urea breath tests, or stool tests. A breath test with higher CO2 concentration than normal indicates H. pylori infection, while a stool sample is directly tested for the presence of the bacteria [3, 4].

Upper GI Series

This procedure uses a chalky liquid containing barium to coat the upper digestive tract and make it more visible to an X-ray. The patient typically fasts and stops drinking water before the procedure (your doctor will tell you how long you must be fasted) and drinks the barium liquid while sitting or standing in front of the X-ray machine [3, 4].

Doctors use a series of tests to diagnose gastritis. These may include lab tests, endoscopy, and an upper GI series.

How is Gastritis Treated?

Be sure to follow any and all prescriptions and recommendations from your doctor, which may or may not include therapies and strategies described here. Never use any of the following strategies in place of what your doctor recommends or prescribes.

Dietary Interventions

Most researchers agree that diet doesn’t cause most cases of gastritis; however, dietary modifications may be recommended to help support treatment and recovery [5].

Mediterranean Diet

Some diets may encourage less stomach acid production, which can be helpful in gastritis and other stomach ailments [6].

The Mediterranean diet has shown some promise in reducing gastric acid production. In a study of 130 patients with gastritis (38 of which were diagnosed with reflux gastritis), eating a Mediterranean diet led to a decrease in stomach pH (an increase in stomach acidity) and a decrease in gastric symptoms and heartburn [6].

In this same study, a Mediterranean diet with the addition of acidic foods actually improved outcomes. The authors suggested that a more acidic diet could suppress the production and release of stomach acid, thereby indirectly protecting the stomach lining [6].

No single diet may be appropriate for every gastritis patient. Talk to your doctor before making any significant changes in your diet.

The Mediterranean diet may reduce inflammation in the stomach by suppressing stomach acid production, but there is limited evidence to support this claim.

Elimination Foods

Your doctor may recommend that you avoid certain foods that may aggravate gastric inflammation. It is important to follow any dietary restrictions your doctor recommends; if you do not receive dietary guidance, you may want to ask them about the foods on this list:

  • Soft drinks: soft drinks and other carbonated beverages are also believed to stimulate acid secretion and are therefore often on the list of things to avoid if you have gastritis [7, 8].
  • Sweets & simple sugars: some evidence suggests that simple carbohydrates may stimulate the production of stomach acid and worsen outcomes in gastric inflammation [6].
  • Very fatty food: some doctors may advise against fatty meats and cheeses, and you may be advised to cut deep fried foods entirely [8].
Your doctor may recommend that you cut back on or eliminate foods that may increase gastric acid production, including coffee, soft drinks, sweets, acidic fruits, and fatty foods.

Stress Management

It is broadly recognized that psychological stress and gastritis are linked, and some researchers believe that stress may directly cause or worsen gastritis. As such, one important element of treating almost any case of gastritis is to minimize stress [9, 10].

Stress-induced gastritis is managed in the same way as any other type, though your doctor may emphasize mental healthcare or a reduced workload. You may also want to try some stress-busting hobbies like yoga, though these have not been directly studied in patients with gastritis. Broad stress management, rather than one particular stress-reducing activity, is recommended [9, 11].

Qigong

Qigong is a form of movement meditation, similar to yoga or tai chi. One study of 103 patients with chronic atrophic gastritis found that practicing qigong improved markers of the disease in 70% of cases, without the need for medication. However, there was no placebo group in the study, and its results have not been repeated [12].

Qigong may be a good stress-management activity to try alongside other conventional strategies that your doctor recommends. However, it should never be used in place of conventional therapies.

Psychological stress is believed to significantly worsen gastritis. Many doctors will therefore recommend a variety of stress management strategies as part of treatment.

Supplements for Gastritis

The FDA has not approved any natural substances for medical use in gastritis, and supplements generally lack solid clinical research. Speak with your doctor before using any of these substances, and never use them in place of something your doctor recommends or prescribes.

To Combat Deficiencies

People with gastritis may have more difficulty absorbing essential nutrients like vitamin B12, iron, calcium, magnesium, and zinc [13, 5, 14].

If your doctor suspects that you may be deficient in these nutrients, they may order blood tests and recommend supplementation. Excessive supplementation of some nutrients may be harmful in gastritis, so take care to discuss any supplements with your doctor before using them.

1) Vitamin C (Possibly Effective)

Some research suggests that vitamin C could potentially improve the effectiveness of conventional gastritis therapies. However, vitamin C alone has not been found to improve gastritis. Talk to your doctor to see if adding a vitamin C supplement could be helpful in your case [15].

Insufficient Evidence For

The following substances have shown promise against gastritis in limited, low-quality clinical studies; there is currently insufficient evidence to support their use in this context, and they should never replace what your doctor prescribes. Remember to talk to your doctor before starting any new supplement or making significant changes to your diet.

2) Hyaluronic Acid & Chondroitin Sulfate

In a study of 50 patients with gastritis, a liquid product based on hyaluronic acid and chondroitin sulfate reduced upper abdominal pain and improved healing of stomach tissue. The authors suggested that hyaluronic acid and chondroitin sulfate may have coated the lining of the stomach, protecting it from further erosion by the gastric juices. However, there have been no other studies to investigate the use of this product in gastritis [16].

3) Garlic

In a study of 66 patients, a combination product containing garlic improved digestion and inhibited H. pylori. However, the effect of garlic alone is impossible to determine based on this study [17].

4) Lion’s Mane Mushroom

Lion’s mane mushroom (Hericium erinaceus) is an edible mushroom with medicinal properties. It has been used in traditional Chinese and Japanese medicine throughout history. It is also commonly consumed in many other Asian countries such as Korea and India [18, 19, 20].

One study found that lion’s mane supplements improved upper abdominal pain in just over a quarter of gastritis patients over the course of 3 months. 23% of patients furthermore had reduced inflammation in the stomach lining. The authors did not suggest a reason why only a minority of patients appeared to benefit, but significantly more improved on the lion’s mane than on the placebo [21].

5) Omega-3 Fatty Acids

Omega-3 fatty acids are generally anti-inflammatory and may have some protective activity against H. pylori-induced stomach diseases like gastritis [22].

However, the relationship between omega-3 fatty acids and stomach disease isn’t straightforward. One Japanese study found that people who ate more omega-3 fatty acids (usually from fish) had a lower success rate in H. pylori eradication therapies. Vitamin D and cholesterol had similar relationships with eradication rates in this study; the authors did not speculate on why this link might exist [23].

6) Probiotics

Probiotic supplements are a popular way to support conventional therapies for digestive ailments. In gastritis, they may only be helpful in cases where H. pylori infection is a concern [24, 25].

According to some researchers, probiotic bacteria compete with H. pylori in the digestive tract, possibly making this harmful infection more susceptible to antibiotics and other drugs [26, 24, 27].

Probiotics have not been tested in clinical studies for gastritis, specifically. Your doctor may recommend them if you are on a course of antibiotics to treat H. pylori. Otherwise, please talk to your doctor before using them.

7) Green Tea & Honey

One popular folk remedy for gastritis is warm tea and honey. There is some evidence to suggest that this combination could help; both honey and tea consumption (green and black) have been associated with reduced rates of H. pylori infection in people with gastritis and other digestive ailments. However, no studies have yet examined whether tea or honey consumption can help improve existing cases of gastritis [28].

Medical Interventions

Medical treatment for gastritis (atrophic or otherwise) depends heavily on the cause of the condition. Once your doctor has completed a number of tests to determine the cause of gastritis, they will decide on the appropriate course of action. They may recommend that you start or stop certain medications or that you change your diet; however, it’s very important not to change anything about your medications without the go-ahead from your doctor.

H. pylori Gastritis

The first step to treating H. pylori gastritis is the eradication of these harmful bacteria. Typically, a combination of drugs is prescribed to treat H. pylori; these may include at least two antibiotics and a proton pump inhibitor (PPI). Bismuth subsalicylate may also be included in this cocktail [29, 30, 31].

In order to maximize the odds of eradicating H. pylori, it is very important to take all of the medications your doctor prescribes for the entire period of time prescribed, even if you start to feel better. Stopping antibiotics before the course is over may lead to the remaining bacteria developing drug resistance [29].

Reactive Gastropathy

If your gastritis is caused by the use of NSAIDs or other drugs, your doctor will almost certainly advise you to stop taking or reduce the dosage of the offending drug as a first step. Call your doctor before discontinuing the use of any prescribed medication [29, 30, 31].

Depending on the severity of gastritis, your doctor may prescribe other medications to counteract gastric inflammation and help heal your stomach [29, 30, 31].

Autoimmune Gastritis

Autoimmune gastritis is associated with iron, folate, and vitamin B12 deficiencies, so your doctor may recommend supplementing these nutrients to prevent pernicious anemia. Talk to your doctor about whether supplements are appropriate before starting them yourself [29].

Acute Erosive Gastropathy

Doctors may prescribe drugs that reduce stomach acid in cases of severe acute gastritis. These may include proton pump inhibitors (PPIs), H2 histamine blockers, or sucralfate [29].

Medical interventions to treat gastritis depend on the cause of the condition. H. pylori infections require triple or quadruple therapy to eradicate them, while other types require different specialized treatments.

Takeaway

Gastritis is an often painful condition characterized by inflammation of the lining of the stomach. If this inflammation leads to the death of glandular tissue and its replacement with intestinal or scar tissue, then it is termed atrophic gastritis. Gastritis can be acute or chronic, and it can be caused by H. pylori infection, drugs (like NSAIDs), autoimmune disease, and more.

Doctors use a series of tests to diagnose gastritis, including lab tests, endoscopy, and sometimes an upper GI series (X rays with a barium swallow). Once diagnosed, doctors will prescribe medication and recommend management strategies based on the cause and severity of the condition. It is essential to follow your doctor’s instructions carefully to ensure that gastritis resolves and any bacterial infection is completely eradicated.

Some complementary approaches may be helpful in managing gastritis. The Mediterranean diet may reduce the amount of acid produced by the stomach. Because of the close link between psychological stress and gastritis, your doctor is also likely to recommend stress management strategies.

Some supplements have also shown promise in gastritis. Vitamin C may be helpful alongside certain conventional therapies, while other supplements have insufficient evidence to recommend them.

Further Reading

About the Author

Jasmine Foster

Jasmine Foster

BS (Biology), BEd
Jasmine received her BS from McGill University and her BEd from Vancouver Island University.
Jasmine loves helping people understand their brains and bodies, a passion that grew out of her dual background in biology and education. From the chem lab to the classroom, everyone has the right to learn and make informed decisions about their health.

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