How To Cure Gastritis Permanently?

Overview

About gastritis

Gastritis is the name of a set of conditions that is characterised by the inflammation of the stomach lining. Gastritis is characterised by stomach pain and discomfort, bloating, belching, nausea and vomiting, bloody stools and burning sensation in the chest/throat caused by acid reflux.¹ Gastritis can be caused by one or a combination of any of the following:

• Drinking excess alcohol may corrode the stomach lining 
• Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen or use of these agents on an empty stomach
• Bacterial infections such as helicobacter pylori infection (stomach bug)
• Autoimmune diseases like HIV infection
• Bile (acid) reflux 
• Surgical procedures 
• Anaemia (iron deficiency) and vitamin B12 deficiency 
• Serious trauma/injury to the stomach area 

There are several categories of gastritis depending on the cause:^1,3

1. Infectious gastritis - caused by bacteria, viruses and fungi; for example, bacteria that are causative agents of gastritis are H. Pylori, mycobacterium tuberculosis, mycobacterium pavum, and treponema pallidum; viral organisms implicated in gastritis (rare) are cytomegalovirus, herpes simplex virus, and varicella virus; and Candida species of fungi have been associated with gastritis. There are also parasitic causes of gastritis
2. Non-infectious gastritis - associated with conditions like Crohn's disease, sarcoidosis, idiopathic lymphocytic gastritis, and autoimmune gastritis

The most common form of gastritis is infectious gastritis caused by H.pylori.^2,3 In immunocompromised patients like HIV patients or patients receiving immunosuppressive agents due to organ transplant, viral (cytomegalovirus) gastritis is the most common.

Acute cases of gastritis that result from heavy alcohol consumption, ingestion of salicylic acid and other anti-inflammatory drugs and acid reflux are often referred to as reactive gastritis. Chronic gastritis has been associated with alcoholism, anti-inflammatory drugs, and stress and is sometimes called hemorrhagic gastritis.^1,

Diagnosing gastritis 

Diagnosis of gastritis will involve investigating the underlying cause. Tests which may be conducted include:

• A urea breath test– checking for the presence of H.pylori whereby a drink containing urea is given and the breath tested afterwards  
• Stool analysis – testing for the presence of the bacteria in a stool sample  
• Blood sample test – checking for the presence of H. pylori 
• Endoscopy to see the stomach lining from the inside 

Your doctor may also check for the clinical signs of gastritis, including abdominal pain, indigestion, nausea, and vomiting. These symptoms usually occur when gastritis has resulted in stomach ulceration (formation of stomach ulcers). Gastritis may also cause bleeding of the oesophagus (throat) if you are experiencing acid reflux.

How to cure gastritis

Curing gastritis starts with tackling the underlying causes.^4,5 Eradication of H.pylori is very important in treating gastritis since it can cause stomach ulcers if allowed to reside in the body. Stomach acid production can be reduced with the use of H2 receptor blockers (Histamine H2 receptor antagonists) and proton pump inhibitors (PPI). This prevents the erosive effect of acids in the stomach and facilitates the healing process. Cimetidine, famotidine and nizatidine are some examples of medicines used as H2 receptor blockers. 

Other drugs that can reduce stomach acid production include 

• Omeprazole 
• Pantoprazole 
• Esomeprazole 
• Lansoprazole

Treating H. pylori infection

Eradication of H. pylori using antibiotics will be mostly effective but not suitable for a person allergic to penicillin drugs or who has previously been exposed to macrolides. Eradication of H. pylori with the standard triple therapy of Clarithromycin 500mg, Amoxicillin 1000mg and either a single dose of PPI or H2 receptor blocker for 14 days has resulted in 70-75% eradication of H. pylori.^1,5

For patients who are allergic to penicillin drugs, amoxicillin is replaced with Metronidazole 400mg (Flagyl) taken three times a day, though resistance is greater with metronidazole than amoxicillin. For those who have previously been exposed to macrolides, standard quadruple therapy of Bismuth subcitrate, tetracycline, standard PPI dose, and metronidazole may be prescribed by your doctor.⁶

Easing symptoms

• Antacids

Abdominal discomfort, pain and inflammation can be alleviated with antacids to neutralise the acid produced in the stomach. Antacids include formulas such as calcium carbonate, Phillips' milk of magnesia, magnesium hydroxide, Gelusil, Gaviscon and many other over-the-counter or prescription products 

• Histamine 2 Blockers

Histamine 2 blockers block histamine-induced acid secretion in the stomach. Nizatidine, cimetidine, ranitidine, and famotidine are some examples of histamine 2 blockers. 

• Proton Pump Inhibitors

Proton pump inhibitors stop stomach acid secretion by irreversibly blocking the H+/K+ ATPase proton pump. Examples of protein pump inhibitors include: esomeprazole, dexlansoprazole, pantoprazole, lansoprazole, rabeprazole, and omeprazole

Lifestyle changes

• Relaxation techniques to reduce stress

Lifestyle modification is the best way to avoid gastritis and support medicative treatment for its symptoms

• Avoid NSAID painkillers, smoking and alcohol

Non-steroidal Anti-inflammatory agents (NSAIDs) like ibuprofen, diclofenac, and piroxicam work by reducing the amount of inflammatory substances in the body which cause pain. However, NSAIDs also inadvertently reduce the production of other important substances that protect the stomach lining (prostaglandins). Therefore, taking NSAIDs exposes the stomach to the risk of ulceration

Cutting down on alcohol consumption is also paramount to the curing of gastritis since alcohol has been implicated in otherwise unexplained cases of gastritis. Smoking of any type should also be avoided to cure gastritis

• Eat smaller meals more regularly 

If you have a stomach ulcer, it is recommended to eat a normal calorie distribution (50-60% carbohydrate, 10-15% protein and 25-30% fats).⁸ A good meal plan while treating gastritis includes food that is rich in fibre, protein and oil as these are protective for the stomach lining. Meals should not be eaten late or skipped as this can result in the over-secretion of acids in the stomach

Good foods to include in your meals include: 

• Yogurts (which contain probiotics)
• Low-fat dairy products 
• Seeds and nuts such as flaxseeds, Brazilian nuts and walnuts
• Vegetable/olive oil
• Low-acid fruits such as apples, papaya, melon or banana
• Leafy greens 
• Other vegetables, such as carrots and green beans
• Legumes such as soybeans and chickpeas 
• Lean-cut meats
• Cut down on fried, spicy or acidic trigger foods 

It is important to note the trigger foods and avoid them. Carbonated drinks, spicy foods, fried foods and alcohol should be avoided to improve healing. This is because these foods affect the stomach lining by either inhibiting the secretion of mucus or by corroding the gut lining

Foods to avoid while treating gastritis include:

• High-fat dairy
• Fried foods
• Acidic fruits such as oranges, pineapple and lemons
• Vegetables such as cabbage, cucumber and red peppers
• Spicy foods, including chilli peppers
• Fatty meats 
• Chocolates and sweets 
• Carbonated (fizzy) beverages 

Summary

Curing gastritis requires not just medical therapy but diet therapy, lifestyle modification and total avoidance of some foods.^7,8 However, even if some therapies are used to both suppress gastric acid secretion and eradicate the causative organism, H. pylori, gastritis can still reoccur when you get exposed to certain triggers. Therefore, it is highly recommended that you avoid known triggers as much as possible, such as quitting both alcohol and smoking, which are known to corrode the stomach wall, avoiding or taking NSAIDs with caution/strict instructions from your doctor and reducing stress and stressful activities to help in the healing process.