Also indexed as: Stomach Inflammation
A dull ache in your belly may be a sign of gastritis, an
inflammation of the stomach lining. First uncover the cause. Then control the discomfort.
According to research or other evidence, the following self-care steps may be helpful:
- Get to know gamma oryzanol
- Take 300 mg a day of this supplement to improve gastritis
symptoms
- Steer clear of irritants
- Help with the healing process and prevent recurrences by reducing
your intake of salt, caffeine, decaf coffee, alcohol, and spicy foods
- Say no to smoking
- Reduce your risks by kicking the habit
- Get a checkup
- Visit your healthcare provider to find out if your gastritis is
due to a treatable medical condition and whether you should avoid taking certain irritating
medications
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full gastritis article for more
in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and
lifestyle changes that may be helpful.
About gastritis
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.
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gastritis
What are the symptoms?
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 options
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®), as well as the
proton pump inhibitor omeprazole
(Prilosec-OTC®), 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
prescription strength proton pump inhibitors omeprazole (Prilosec®), lansoprazole
(Prevacid®), pantoprazole (Protonix®),
esomeprazole (Nexium®), 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
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
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.
Vitamins that may be helpful
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.
The antioxidant beta-carotene may reduce
free radical damage in the stomach,27 and eating foods high in beta-carotene has
been linked to a decreased risk of developing chronic atrophic gastritis.28
Moreover, people with active gastritis have been reported to have low levels of beta-carotene
in their stomachs.29 In a preliminary trial, giving 30,000 IU of beta-carotene per
day to people with ulcers or gastritis led to
the disappearance of gastric erosions.30 In another study, combining vitamin C and
beta-carotene also led to improvement in most people with chronic atrophic
gastritis.31
Zinc and vitamin A, nutrients that aid in healing, are commonly
used to help people with peptic ulcers. For example, the ulcers of people taking 50 mg of zinc
three times per day healed three times faster than those of people who took
placebo.32 Since some types of gastritis can progress to peptic ulcer, it is
possible that taking it may be useful. Nevertheless, the research does not yet show that zinc
specifically helps people with gastritis. The amount of zinc used in this study is very high
compared with what most people take (15–40 mg per day). Even at these lower levels, it
is necessary to take 1–3 mg of copper
per day to avoid a zinc-induced copper deficiency.
People with ulcers who took 50,000 IU of vitamin A three times a day experienced a
significant decrease in both ulcer size and pain.33 Because this amount of vitamin
A is very high and can be quite toxic, usage requires the guidance of a doctor. A safe amount
for women of childbearing age is 10,000 IU per day and probably 25,000 IU for other adults. In
other preliminary research, using vitamin A together with drugs and proper nutrition
eliminated erosive gastritis after three weeks in about 75% of affected people.34
Research has not yet shown that vitamin A supplementation specifically helps people with
gastritis.
People with pernicious anemia due to
atrophic gastritis require very high amounts of
vitamin B12.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Herbs that may be helpful
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.
Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.
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