How Gastritis Is Treated

Amber J. Tresca
·8 min read

Medically reviewed by Robert Burakoff, MD

Gastritis is the irritation or inflammation of the lining of the stomach. It can result for a number of reasons. Treatment for gastritis will coincide with the cause and address the underlying condition. The type of therapy may also depend on whether gastritis symptoms start suddenly (are acute) or are severe or long-lasting (are chronic). Gastritis symptoms can include indigestion, nausea, vomiting, abdominal pain, and bloating.

This article will discuss treatment for gastritis due to various causes, including medications and lifestyle changes, as well as when to see a healthcare provider.

<p>dragana991 / Getty Images</p>

dragana991 / Getty Images

Gastritis Treatments

The treatment of gastritis will depend on the cause. Treatment generally includes medications to reduce stomach acid along with avoiding medications or lifestyle factors that can irritate the stomach. More than one type of gastritis can occur at the same time, which may make finding an effective treatment more challenging.

Treatments for Gastritis Caused by H. pylori

One common cause of gastritis is an infection with a bacterium called Helicobacter pylori (H. pylori). Overgrowth of H. pylori can lead to inflammation of the stomach. People may have H. pylori in their bodies starting from childhood, but the reasons for this are not clear.

Because it is a bacterial infection, H. pylori is treated with an antibiotic and other medications to control stomach acid. A combination of two or three antibiotics may be prescribed.

The type of antibiotic used may depend on factors such as a person's other conditions, allergies (such as an allergy to penicillin), and whether they live in an area where antibacterial-resistant H. pylori are a problem.

A proton pump inhibitor (PPI) medication such as Nexium (esomeprazole) or Prevacid (lansoprazole) is also usually prescribed to slow down the production of stomach acid. Bismuth quadruple therapy (consisting of a PPI, bismuth, tetracycline, and a nitroimidazole) for 10–14 days may be prescribed to help prevent the growth of bacteria in the stomach.

Treating Gastritis Caused by NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen), Indocin (indomethacin), and Aleve (naproxen), can irritate the digestive tract, which could lead to irritation of the stomach lining. NSAIDs are available over the counter and also in prescription form. They are often prescribed for pain and inflammation.

Preventing gastritis from NSAIDs can mean using the lowest dose possible or avoiding their use. For some people, however, it may be difficult or impossible to stop or reduce the dose. Some healthcare providers may prescribe a proton pump inhibitor or another type of drug to reduce stomach acid in order to try to prevent irritation.

When gastritis is caused by NSAIDs, the first step is to stop those drugs and move to a different type of pain relief, if needed. A proton pump inhibitor or a histamine-2 receptor agonist H2 blocker) drug such as Tagamet HB (cimetidine) or Pepcid AC (famotidine) may be prescribed to treat the irritation or inflammation. Other treatments may be needed if the inflammation is serious or has led to complications.

Treatments for Gastritis Caused by Extreme Stress

The brain and the gut interact. The connection between the two (the brain-gut axis) can affect symptoms in the digestive system. It used to be thought that stomach inflammation leading to ulcers was caused by stress, until it was learned that infection with H. pylori was more often the cause.

However, chronic levels of psychological stress, such as those seen in post-traumatic stress disorder (PTSD) or anxiety or mood disorders, can have an effect on the stomach. These high levels of stress may change the cells in the lining of the stomach and even how pain is perceived.

Over time, the result could be inflammation. This condition may be called stress-related erosive syndrome, stress ulcer syndrome, or stress-related mucosal disease.

Treatment may start with therapies to affect the perception of stress, such as relaxation techniques, yoga, exercise, meditation, and mind-body therapies. Additional therapies may be needed for people already being treated for mental health conditions. PPIs or other medications are not usually recommended.

Treating Gastritis Caused by Autoimmune Disorders

Gastritis can also occur with some autoimmune conditions. In an autoimmune disorder, the immune system mistakenly attacks the body's own tissues. Several types of autoimmune conditions are thought to have a connection to stomach inflammation, including the following:

There is no specific treatment for autoimmune gastritis. Treatments are under study, but there are no guidelines on their use. This condition could become chronic and lead to a risk of cancer, so there may be a need for screening at regular intervals.

Treatments for Gastritis Caused by Alcohol

Drinking alcohol in excess may lead to a risk of gastritis. Over time, the stomach lining becomes inflamed and can cause pain and vomiting. Treatment includes cutting back on drinking. PPIs, H2 blockers, and antacids may also be recommended.

If there is an overlap of this type of gastritis with other types, such as those caused NSAIDs or H. pylori, additional treatments may be needed.

Treating Gastritis Caused by Bile Acid Reflux

Bile is a digestive fluid that normally flows from the gallbladder into the small intestine. In bile acid reflux, bile backs up (refluxes) from the small intestine into the stomach or esophagus, which can lead to inflammation. Bile acid reflux could result from bariatric (weight loss), gallbladder, or stomach surgeries.

There's a lack of consensus and guidelines on how to treat bile acid reflux, other than stopping medications that slow the gastrointestinal tract.

Medications that might be used to treat bile acid reflux include Actigall (ursodiol), PPIs, and prokinetic agents such as Reglan (metoclopramide). Lifestyle measures to avoid irritating the stomach lining might also be recommended, such as alcohol, smoking, and spicy foods, though evidence of that is lacking.

Lifestyle Changes and Home Remedies for Gastritis

Treating gastritis will depend on the cause. Because the cause can be serious and/or progressive, it's important to seek medical care. There is little evidence that home remedies or supplements can help treat gastritis. However, there may be some measures people can take at home to help with symptoms.

Eat Smaller, Frequent Meals

Some older evidence suggests that eating smaller meals more frequently may help with gastritis caused by H. pylori. Eating large meals may cause symptoms such as feeling uncomfortably full, on top of any symptoms caused by gastritis. For that reason, smaller meals may help avoid additional discomfort.

Avoid Irritants

Unlike known irritants like alcohol and smoking, food isn't thought to play a major role in the development of gastritis.

However, people with gastritis may want to pay attention to how they feel after a meal or even keep a diary of food and symptoms. Doing so may help identify any foods or supplements that lead to worsening symptoms.

Foods found to be irritating include:

  • Citrus fruits and juices

  • Red meat

  • Highly processed foods

  • Chocolate

  • Coffee

  • Tea

  • Foods high in sugar

Related: Gastritis Diet: Foods to Eat and Avoid to Manage Symptoms

Manage Stress

Stress is thought to contribute to symptoms in some gastrointestinal disorders. It could lead to higher levels of the hormone cortisol in the body, which could, in turn, affect the digestive system and increase inflammation.

Although there is little evidence that treating stress can help manage gastritis, reducing stress is beneficial for overall health. Managing stress involves measures such as:

  • Getting enough sleep

  • Eating nutritious foods

  • Using stress-reducing techniques such as mindfulness or working with a mental health professional

Related: How to Manage Stress: Top Strategies for Stress Relief

Taking Prescription Medications for Gastritis

Prescription drugs are often used to treat the various causes of gastritis. To be effective, it's important to take the medications as instructed by a healthcare provider. Drug-resistant H. pylori is becoming a concern, so if antibiotics are prescribed, it is especially important to take them according to directions.

When to Contact a Healthcare Provider

Gastritis may not cause any symptoms, but abdominal pain, upset stomach, nausea, and vomiting are sometimes experienced. Bleeding in the stomach can also lead to blood in the stool, which may appear dark and tarry. These symptoms are a reason to talk to a healthcare provider to determine if the cause is gastritis.

Signs of a more serious problem that needs immediate medical attention include:

  • Severe abdominal pain

  • Dizziness or fainting

  • Diarrhea or vomiting that won't stop

  • Vomiting blood or what looks like coffee grounds

  • Bleeding from the rectum

If you experience these symptoms, see a healthcare provider in the emergency department or call 911 for an ambulance, if needed.

Related: An Overview of Gastrointestinal Tract Bleeding

Summary

Gastritis can be caused by a number of different conditions or from an infection. Treatment often includes medications to treat the digestive system. Drugs that suppress stomach acid might be prescribed. If there's an infection, one or more types of antibiotics may be needed.

There is little evidence about how supplements and lifestyle changes might be helpful. However, stopping alcohol and quitting smoking are often recommended. A healthcare provider can provide guidance on treating and preventing gastritis.

Read the original article on Verywell Health.