Gastritis is a broad term for inflammation of the stomach lining, also called the gastric mucosa.
This condition can be caused by many factors and, in some cases, may lead to an ulcer. For that reason, many of the same nutrients, herbs, and lifestyle changes for a peptic ulcer might also help someone with gastritis.
Bacterial infection, most notably with Helicobacter pylori,1 is a major cause of gastritis. H. pylori is the same bacterium responsible for most cases of peptic ulcer. When considering treatments for gastritis, many researchers now look for substances that eradicate H. pylori, including bismuth2 and antibiotics.3
Other causes of gastritis include intake of caustic poisons, alcohol, and some medications (such as aspirin or adrenal corticosteroids), as well as physical stress from the flu, major surgery, severe burns, or injuries. For some people, a drug allergy or food poisoning can cause gastritis. Atrophic gastritis is a form of gastritis found particularly in the elderly, where stomach cells are destroyed, potentially leading to pernicious anemia.
What are the symptoms of gastritis?
Acute gastritis is typically characterized by nonspecific abdominal pain. Since gastritis often occurs in severely ill, hospitalized people, its symptoms may be eclipsed by other, more severe symptoms. Gastritis that is caused by H. pylori eventually leads to peptic ulcers, which are characterized by a dull ache in the upper abdomen that usually occurs two to three hours after a meal; the ache is typically relieved by eating.
Medical treatments for gastritis
Over the counter antacids, such as magnesium hydroxide (Phillips’ Milk of Magnesia®), aluminum hydroxide (Amphojel®), calcium carbonate (Tums®), and the combination magnesium-aluminum hydroxide (Mylanta®, Maalox®), help relieve the symptoms of gastritis. The histamine H2 antagonists, such as cimetidine (Tagamet®), ranitidine (Zantac®), and famotidine (Pepcid®), are also beneficial.
Prescription drug therapy might involve antibiotics that eliminate H. pylori infection, such as amoxicillin (Amoxil®), clarithromycin (Biaxin®), metronidazole (Flagyl®), and tetracycline (Sumycin®), in combination with the proton pump inhibitors lansoprazole (Prevacid®) and omeprazole (Prilosec®). Bismuth subsalicylate (Pepto Bismol®) may be added as well. Other medications may be prescribed to control stomach acidity, including prescription strength histamine H2 inhibitors, such as cimetidine (Tagamet®), ranitidine (Zantac®), and famotidine (Pepcid®), as well as the proton pump inhibitors omeprazole (Prilosec®), lansoprazole (Prevacid®), pantoprazole (Protonix®), and rabeprazole (Aciphex®).
Acute gastritis caused by trauma, stress, or severe illness usually heals rapidly when the underlying cause is resolved. Nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol are common stomach tissue irritants and their use should be limited in people with gastritis.
Dietary changes that may be helpful for gastritis
Salt can irritate the stomach lining. Some research suggests that eating salty foods increases the risk of developing a H. pylori infection.4 Researchers have speculated that increased salt intake may also increase the risk of other forms of gastritis.5
Doctors commonly suggest that people with gastritis avoid spicy foods. However, one study found that capsaicin, the pungent ingredient in cayenne or chili pepper, protected against aspirin-induced gastritis in healthy persons. When people ate chili pepper followed by 600 mg of aspirin, stomach injury was considerably less than in people who took only aspirin.6 The researchers of this study speculate that chili pepper helps by increasing blood flow to the stomach. Capsaicin has also been shown to protect against alcohol-induced gastritis in rats,7 though this has yet to be tested in humans.
Some researchers have suggested that food allergies or intolerance may cause gastritis.8 In one double-blind trial, people with proven food sensitivities showed clear evidence of irritation of the stomach lining (including swelling, bleeding, and erosions) when given foods to which they were known to react.9 However, most of these people did not have abnormal results from standard blood tests for allergies. People suspecting food sensitivities or allergies should consider discussing an allergy elimination program with a healthcare professional.
Caffeine found in coffee, black tea, green tea, some soft drinks, chocolate, and many medications increases stomach acid,10 as does decaffeinated coffee.11 Avoiding these substances should therefore aid in the healing of gastritis.
Lifestyle changes that may be helpful for gastritis
Gastritis is common among alcoholics.12 Both heavy smoking and excessive alcohol consumption are known causes of acute gastritis.13 While heavy alcohol intake is clearly damaging to the stomach lining, preliminary evidence suggests that moderate alcohol consumption (generally defined as two drinks per day in women or three drinks per day in men) may actually protect against the development of gastritis by facilitating the elimination of H. pylori.14 When alcohol is consumed in greater than moderate amounts, it causes a wide variety of health problems.
Many medications, such as aspirin and non-steroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen), can induce or aggravate stomach irritation.15 People with a history of gastritis should never take aspirin or related drugs without first discussing the matter with their doctor.
Nutritional supplements that may be helpful for gastritis
When H. pylori causes gastritis, free radical levels rise in the stomach lining.16 These unstable molecules contribute to inflammation and damage to the stomach lining. Vitamin C, an antioxidant that helps quench free radical molecules, is low in the stomach juice of people with chronic gastritis. This deficiency may be the link between chronic gastritis and the increased risk of stomach cancer. When people with gastritis took 500 mg of vitamin C twice a day, vitamin C levels in their gastric juice rose, though not to normal levels.17 In another trial, vitamin C supplementation (5 grams per day divided into several doses for four weeks) appeared to eliminate H. pylori infection.18 While no direct evidence proves that taking vitamin C reduces gastritis symptoms, scientists widely believe that any agent capable of knocking out H. pylori should help people with this condition.
The results of several clinical trials suggest that gamma oryzanol supplementation can help people with gastritis and other gastrointestinal complaints. In one study, people with chronic gastritis were given 300 mg of gamma oryzanol per day.19 After two weeks, 23% of people taking gamma oryzanol reported that it was “extremely effective” and 55% rated it as “moderately effective.” Another study produced similar results: People with various types of gastritis received 300 mg of gamma oryzanol per day. After two weeks, more than 62% of those with superficial gastritis, more than 87% of those with atrophic gastritis, and all people with erosive gastritis experienced improvement. These results were confirmed in a large study involving approximately 2,000 people with various gastrointestinal complaints, including several forms of gastritis.20 Some of these people required as much as 600 mg per day for symptoms to improve. People with gastritis wishing to take gamma oryzanol for more than six months, or in amounts exceeding 300 mg per day, should first consult with a physician.
Various amino acids have shown promise for people with gastritis. In a double-blind trial, taking 200 mg of cysteine four times daily provided significant benefit for people with bleeding gastritis caused by NSAIDs (such as aspirin).21 Cysteine is a sulfur-containing amino acid that stimulates healing of gastritis. In a preliminary trial, 1–4 grams per day of N-acetyl cysteine given to people with atrophic gastritis for four weeks appeared to increase healing.22 Glutamine, another amino acid is a main energy source for cells in the stomach and supplementation may increase blood flow to this region.23 Patients in surgical intensive care units often develop gastrointestinal problems related to a glutamine deficiency.24 When burn victims were supplemented with glutamine, they did not develop stress ulcers, even after several operations.25 Nevertheless, it remains unclear to what extent glutamine supplementation might prevent or help existing gastritis. Preliminary evidence suggests the amino acid arginine may both protect the stomach and increase its blood flow,26 but research has yet to investigate the effects of arginine supplementation in people with gastritis.
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Herbs that may be helpful for gastritis
Many of the same herbs that are helpful for peptic ulcers may also aid people with gastritis. Licorice root, for example, has been traditionally used to soothe inflammation and injury in the stomach. Its flavonoid constituents have been found to stall the growth of H. pylori in test tube studies.35 However, there have been no clinical trials using licorice to treat gastritis. To avoid potential side effects, such as increasing blood pressure and water weight gain, many physicians recommend deglycyrrhizinated licorice (DGL). This form of licorice retains its healing qualities by removing the glycyrrhizin that causes problems in some people.
Goldenseal is regarded as an herbal antibiotic and has been traditionally used for infections of the mucous membranes. While no specific research points to goldenseal as a treatment for gastritis, there is some evidence from test tube studies that berberine, an active ingredient in goldenseal, slows growth of H. pylori.36 Modern herbal practitioners now prefer alternatives to goldenseal, since the plant is threatened with extinction due to overharvesting.
Chamomile, high in the flavonoid apigenin, may soothe injured and inflamed mucous membranes. In addition, a test tube study has shown that apigenin inhibits H. pylori,37 and chamazulene, another active ingredient in chamomile, reduces free radical activity,38 both potential advantages for people with gastritis. Human clinical trials are needed to confirm chamomile’s effectiveness for treating gastritis.
Demulcent herbs, such as marshmallow, slippery elm, and bladderwrack, are high in mucilage. Mucilage might be advantageous for people with gastritis because its slippery nature soothes irritated mucus membranes of the digestive tract. Marshmallow is used for mild inflammation of the gastric mucosa.39
Wood betony(Stachys betonica) has been used in European traditional herbal medicine for the treatment of heartburn and gastritis.
