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Digestive Health

Gastritis Causes, Types, Symptoms, Prevention, Home Remedies

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Gastritis is inflammation of the inner lining of the stomach. It manifests in three forms –

  1. Acute Gastritis – severe inflammation occurs suddenly.
  2. Chronic Gastritis – inflammation takes place over a long period of time.
  3. Erosive gastritis – is a form of rare gastritis. Bleeding and ulcers may occur in the stomach lining though there isn’t much inflammation involved.
    Read – Severe Bloating And Gas? Ayurvedic Herbal Home Remedies

Causes

Backdrop for gastric lining damage 

The digestive juices tend to damage and cause inflammation if stomach lining is weak. Damage of stomach lining is caused by –

Infection

Bacterial infection of the gastrointestinal system, commonly that of H. Pylori can also cause gastritis. H. pylori bacteria are the most common causes of gastritis. It accounts roughly to 90% of cases. This bacterium infects the stomach lining. The infection is also passed from one person to the other and also to the persons through contaminated food or water. If this occurs in childhood and continues to cause problems in adulthood, the bacterium becomes the chief cause of chronic gastritis also.

Major injury or illness

Injury to stomach may predispose one to get gastritis. In fact, injury anywhere in the body or any illness that affects blood flow to the stomach may increase acid in the stomach and cause stress gastritis.
Read – Effect of Stress, Anxiety on Stomach And Intestines: Remedies

Autoimmune diseases

Gastritis may be caused due to autoimmune diseases. In this your immune system attacks the healthy tissues in the stomach lining.

Food allergies

Eosinophilic gastro-enteritis is a rare type of gastrointestinal inflammation which may eventually lead to symptoms of gastritis. This condition is caused by food allergies. Identification of food allergies is very essential to have gastritis under control or even to get rid of it.

Risk factors

  • Too much consumption of alcohol and tobacco
  • Too much use of cocaine
  • Regular and too much use of NSAIDs – Non-steroidal anti-inflammatory drugs
  • Age factor – the stomach lining naturally thins with advancing age and this makes stomach susceptible for gastritis
  • Stress – caused by illness, injury or surgery
  • Viral infections
  • Digestive disorders – like Crohn’s disease etc
  • Autoimmune disorders
    Read – Ayurveda Ulcerative Colitis Diet Tips, Home Remedies

Symptoms of Gastritis

  • Feeling of fullness especially in the upper belly, particularly after eating food
  • Indigestion
  • Nausea
  • Vomiting

Symptoms specific for erosive gastritis –

  • Black, tarry stools
  • Vomiting of blood / coffee ground material

Complications

  • Stomach bleeding
  • Stomach ulcers
  • Risk of developing stomach cancer (in those having thinned stomach lining)

These are the reasons to consult a doctor and know about the status of stomach especially when you have gastritis for a longer time period i.e. in chronic gastritis conditions.
Read – Gastro intestinal Bleeding Causes, Symptoms, Differential Diagnosis

Fate of Gastritis

Acute conditions quickly resolve with prompt diagnosis and treatment. H. pylori infections can be treated with appropriate courses of antibiotics.

Diagnosis

Diagnose of gastritis done after thorough examination and taking case history and family history. For confirmation, your doctor may recommend you to take a breath, blood or stool test to check for H. Pylori involvement.

An endoscopy will help in checking and confirming inflammation in your stomach lining. The biopsy of the stomach lining too will be helpful. Barium X-rays will further help in looking at areas of concern and clinch the diagnosis.

Diet plan

Eating certain foods like fried, spicy or highly acidic foods may worsen symptoms of gastritis.
Below mentioned foods and drinks might ease the gastritis symptoms. They may vary from person to person and one needs to choose stomach friendly foods specific for them.

Good foods and drinks in gastritis are –

  • High fiber foods – whole grains, fruits, vegetables, beans etc
  • Low fat foods – fish, lean meats, vegetables etc
  • Foods having low acids – vegetables, beans etc
  • Probiotics – according to some studies probiotics could help with stomach issues caused by H. pylori.
  • Supplements – Deficiencies of iron and vitamin B12 and related symptoms may manifest due to their deficit absorption as a consequence of gastritis. Your doctor may help you with supplements for the same.
  • Non-carbonated drinks
  • Caffeine free drinks

Losing weight, managing stress, eating small and frequent meals will also help patients of gastritis.

Foods rich in antioxidants like flavonoids –

Foods to avoid

High fat foods – may worsen inflammation of stomach lining.
Food allergies – can trigger symptoms of gastritis, one needs to identify and avoid these foods.
Avoiding alcohol – frequency and quantity
Avoiding foods which irritate the stomach –

  • Oily foods and fried foods – French fries, onion rings etc
  • Spicy foods
  • Acidic foods such as tomatoes and some fruits
  • Meat – red meat, processed meats
  • Alcohol
  • Fatty foods
  • Carbonated and caffeinated drinks
  • Sugary foods like – cakes cookies etc
  • Citric fruits
  • Foods containing distilled vinegar
  • Coffee
  • Fruit juices
  • Avoiding any food or food group which makes your symptoms worse

Patients should also avoid things that trigger their gastritis – like alcohol, aspirin or pain medicines.

Diet for ‘gastritis with ulcer’

Peptic or gastric ulcers are complications of untreated or badly managed gastritis. Follow the same dietetic restrictions as those of gastritis if you have an ulcer in your stomach. You should also take food with rich nutrients.

You may take –

  • Milk, Yoghurt
  • Low fat cheeses, Fruits – apples, melons, bananas
  • Vegetables – green leaves, carrots, spinach
  • Lentils, chickpeas and soybeans
  • Vegetable oils and olive oil, Natural juices
  • Lean meats

Avoid these –

Anti-inflammatory foods – Diet to cure inflammation or to prevent it

  • Fruits and vegetables rich in vitamin K
  • Beans and nuts
  • Whole grains – brown rice, oats, whole-wheat bread
  • Fishes like salmon, tuna and sardines
  • Turmeric

Avoid foods which tends to cause inflammation –

  • Acidic foods
  • Spicy foods
  • Processed foods
  • Dairy products
  • Sugar rich foods
  • Gluten
  • Alcohol

Foods that relieve gastritis symptoms

Foods that may stop H. pylori growth and relieve gastritis symptoms –

Tips for prevention of gastritis

  • Avoid medications which irritate stomach lining like NSAIDs and corticosteroids.
  • Identify foods which might irritate the stomach, mainly fried and spicy foods.
  • Keep away from smoking and reduce alcohol intake.
  • Keep your mind relaxed by practicing yoga and meditation. This will eventually relieve stress which is a common reason behind gastritis.
  • Drink at least 6-8 glasses of water every day and keep yourself hydrated.
  • Exercise for 30 minutes at least 3-4 times in a week period.

Yoga for Gastritis

Regularly practice Pavanamuktasana, Viparita Karani and Ardha Shirsasana, whichever you are comfortable doing. Vajrasana, Nadi Shodhana Pranayama, Kapalabhati and Ustrasana are also beneficial.

Home Remedies

Food diary – It is a good habit to write a food diary. This will help one to list down the foods which trigger the symptoms and foods which are good for the stomach. This will also help to reduce the intake of trigger foods or avoid some foods altogether.

Effective inclusions in home remedies

Cus Cus grass long pepper remedy

We are back with a home remedy today and probably the simplest of all the home remedies that we have discussed so far. This is a churnam home remedy, meaning it is just a simple mixture of herbal powders. It involves only two herbal ingredients that are quite easily available. 

Home remedy video – Watch on youtube here

Ingredients

Pippalimoola – Root of long pepper – Piper longum – fine powder – half teaspoonful
Usheera – Cus Cus grass / Vetiver – Vetiveria zizanioides – fine powder – half teaspoonful.

How to take?

The fine powder of above two are mixed and half to one teaspoon of this powder mixture is traditionally administered along with little bit of ghee to relieve heartburn and gastritis.
After administration, a small quantity of lukewarm water can be given for easy swallowing.

Benefits
Helps to relieve Gastritis, Heartburn, Indigestion

How it works? 
This is one of the best home remedies for heartburn.
Long pepper root is a powerful digestive. It boosts digestive enzymes and promotes easy absorption of digested food.
Usheera / Vetiver / cus cus grass is a natural coolant. It has calming and soothing effect over gastric mucosa. It balances out increased Pitta during heartburn and gastritis. It also relieves vomiting sensation.
Ghee is again helpful in calming Pitta and is good to soothe the stomach mucosa.

Other remedies:
Ginger – Chew a small piece of ginger for a few minutes and gulp it with water. You can take a pinch each of ginger powder, rock salt and asafetida mixed in a cup of warm water. This can be taken every morning. It has antibacterial and anti-inflammatory properties.

Turmeric – Mix turmeric powder (1 teaspoon) with water, make it into paste and take it mixing with yoghurt or banana. Curcumin in turmeric is anti-inflammatory, antifungal and antibacterial properties. It soothes gastric mucosa and reduces irritation in the gastrointestinal tract.

Licorice – Add 1 teaspoon of licorice root powder to a glass of hot water and leave it to steep for 10-15 minutes, strain it and drink at least once a day. It protects your stomach’s lining and reduces chances of ulcer formation from gastritis since it stabilizes the stomach acids.

Garlic – Studies suggest that garlic helps to reduce gastritis symptoms.

Yoghurt – Take yoghurt with meals or as a snack. Have 1-2 cups daily. It is an excellent probiotic and accelerates healing of gastric ulcers and eradicates H. pylori.

Honey – Mix 2 tablespoons honey in a glass of warm water and drink it on an empty stomach. You may drink it every morning. It kills harmful bacteria, is anti-inflammatory and has antioxidants which can heal the stomach lining in gastritis.

Cumin water – Mix 1 tablespoon of ground roasted cumin seeds in a glass of warm water and drink it with meals, twice or thrice in a day. It has antibacterial and anti-inflammatory properties which helps alleviate gastritis symptoms.

Coconut water – 1 glass of coconut water can be consumed in between meals. You can take up to 3-4 glasses a day. This is anti-inflammatory and soothes your inflamed stomach lining. It is antiseptic and may also kill bacteria.

Aloe vera – Mix 2 teaspoons of fresh aloe vera gel in a glass of water and drink it once or twice daily. Aloe vera soothes the stomach, reduces inflammation therein, is antiseptic and inhibits infection causing bacteria.

Green Tea – Steep 1 teaspoon green tea herb in a cup of hot water fora few minutes, strain and add honey, mix well and sip it. You may have 2 cups of green tea in a day. It contains antioxidants which protects stomach lining and alleviate gastritis symptoms. This tea also relieves symptoms of chronic gastritis. Green tea taken with honey helps soothe your stomach. Studies have shown that prevalence of H. pylori in the gut significantly reduces when green or black tea is taken at least once in a week.

Apple Cider Vinegar – reduces acid production, kills the microorganisms damaging stomach lining and soothes the stomach lining. For further soothing the gastric lining you may add honey to ACV. Add 1 tablespoon each of honey and apple cider vinegar to a glass of water, mix them well and drink once or twice daily.

Broccoli – has many nutrients, can be used as food inclusion and relieves gastritis symptoms.

Papaya – contains antioxidants and an enzyme papain. They reduce formation of gases in the stomach and soothes your stomach.

Baking Soda – Mix 1 teaspoon of baking soda in a glass of water and drink it as and when required. It acts as an antacid, brings down acid levels in the stomach and relieves burning sensation associated with gastritis.

Cabbage juice – Drink fresh green cabbage juice 3-4 times a day. You may add carrots and celery stalks to it. It has ulcer healing factor – Vitamin U. this can heal your stomach lining and help your gastritis symptoms. This juice also cleanses your stomach and intestines.

Coconut oil – you can have 2-3 teaspoons of this oil for ingestion or as a part of your meals. This oil contains antioxidants which help to reduce oxidative stress exerted on stomach lining due to gastritis. It also possesses anti-inflammatory properties and relieves gastritis symptoms.

Oatmeal – Cook half cup oatmeal with half to one cup of water or milk and eat it. You may add non-acidic fruits like bananas, pears and apples to it. Oatmeal is rich in fiber and minerals and regulates digestion. It soothes the stomach lining due to its alkaline nature.

Pineapple – You may consume 1 cup of ripe pineapple as breakfast or snack. You may have 1 cup every day. It aids digestion. Pineapple contains digestive enzymes. It counteracts increased acids in your stomach.  Avoid unripe pineapples since they may aggravate gastritis.

Potato Juice – Squeeze juice from 2-3 peeled and grated raw potatoes and drink half glass mixed with warm water before meals, at least twice daily. This juice is rich in alkaline salts which neutralizes stomach acids. It also reduces inflammation of the stomach.

Vitamin C – It enhances immunity, helps the body to fight infection, heals and protects the stomach and intestinal lining from damage and ulcers.

Probiotics – helps improve digestion and also in regular bowel movements. They introduce good bacteria into the digestive tract. This might help in stopping the spread of H. pylori. Yoghurt is one famous food inclusion which contains probiotics.

Essential Oils – resistance to H. pylori was found to increase by usage of essential oils like lemongrass oil. Peppermint, ginger and clove oils were found to have a positive effect on the digestive system. These oils are not for ingestion but can be applied to the skin after diluting them with carrier oil.

Lighter meals – Gastritis may be aggravated by taking large, carbohydrate rich meals. On the other hand, eating small meals regularly may help in easing the digestive process. Light foods also reduce gastritis symptoms.

Avoid smoking and painkillers – One should avoid smoking since it damages the stomach lining and also predisposes one to stomach cancer. Similarly taking too much painkillers can worsen your gastritis.

Keep your stress under control – Gastritis can flare up due to stress. It is important you keep your stress under control. Include meditation, Yoga, breathing exercises and soothing massages to control your stress.

Lifestyle changes – lose weight, stop smoking and taking alcohol and avoid OTC medicines.
Read – Ash Gourd Remedies For Memory, Gastritis, Kidney Stones

Treatment of Gastritis

Treatment of gastritis depends on the cause of the disease.

One needs to avoid NSAIDs or other drugs if they are responsible for causation of the disease.

  • Antibiotics will be used to treat gastritis caused by H. pylori.
  • Proton Pump Inhibitors (PPI) – are medicines which block the cells that create stomach acids. They include omeprazole, lansoprazole and esomeprazole.
  • Acid reducing medications – like famotidine are also prescribed.
  • Antacids – helps in quick relief from pain caused by gastritis and also neutralize the acids in the stomach.
  • Probiotics – help in replenishing the digestive flora and heal gastric ulcers.

Acute Gastritis

It is a sudden inflammation in your stomach lining. If your intestines are also involved with the stomach, it will be called gastroenteritis. Most common causes are intake of NSAIDs and corticosteroids.

Acute gastritis may present with severe pain which is often short lived. It comes suddenly. It may be caused one or more of –

  • Injury
  • Bacteria and viruses
  • Stress
  • Too much intake of alcohol
  • Intake of NSADIs, steroids
  • Too much consumption of spicy food

Difference from chronic gastritis – On the other hand, chronic gastritis comes more slowly and stays for a longer time. It causes consistent dull ache in comparison to the more intense pain of acute gastritis. In developing countries the prevalence of chronic gastritis has decreased while that of acute gastritis is still common.

Difference from gastroenteritis – This condition includes inflammation of both stomach and intestines and may include diarrhea along with nausea or vomiting. Gastritis includes nausea and vomiting.
Read – Amlapitta – Meaning, Symptoms, Types, Prognosis

Causes of Acute Gastritis

This condition occurs when your stomach lining is either damaged or weakened. This allows the acids to irritate your stomach.

Important causes include medications such as NSAIDs and corticosteroids (most common causes), infections from H. pylori and excessive consumption of alcohol. H. pylori infection is the most common cause of peptic ulcers also.

Other less common causes

  • Viral infections
  • Excessive stress
  • Digestive disorders such as Crohn’s disease
  • Autoimmune disorders
  • Bile reflux
  • Ingestion of corrosive substances
  • Surgery
  • Too much use of cocaine
  • Kidney failure
  • Being on a respirator or breathing machine for long

Risk factors

Symptoms acute gastritis

Sometimes there may be no symptoms at all. At other times the symptoms may be mild or severe.

Common symptoms of acute gastritis are –

  • Indigestion
  • Loss of appetite
  • Nausea
  • Vomiting
  • Black colored stools
  • Bloody vomiting having coffee ground appearance
  • Pain in the upper part of the belly (abdomen)
  • Fullness in the upper part of the abdomen after taking food

Persistence of symptoms for longer duration and vomiting of blood should alert you to take your doctor’s opinion immediately.

Diagnosis of acute gastritis

Diagnosis is usually done following thorough case taking and examination by your physician. Doctors may suggest some tests to confirm the diagnosis –

  • CBC – complete blood count – to check overall health
  • Blood, breath or saliva test – to check for H. pylori
  • Fecal test – to see if your stool consist of blood
  • Endoscopy or esophago-gastro-duodenoscopy – for reading your stomach lining
  • Gastric tissue biopsy
  • X-ray to look for structural problems in your stomach

Preventive measures

  • Hand Wash – wash your hands thoroughly with soap and water before meals regularly. This reduces the risk of H. pylori infection.
  • Proper cooking – foods when properly cooked reduces the risk of infection.
  • Keep away from alcohol – or limit the usage of alcohol.
  • Avoid NSAIDs or reduce frequency of usage.

Home Care

 Lifestyle changes which can help reduce your symptoms –

  • Avoid / limit alcohol
  • Avoid – spicy, fried and acidic foods
  • Keep away from stress
  • Avoid NSAIDs / aspirin
  • Eat frequent and small meals

Alternative treatments

Some herbs apart from improving digestive health also help to destroy H. pylori and are also used to treat acute gastritis –

  • Licorice
  • Clove
  • Myrrh
  • Slippery elm
  • Berberine

If acute gastritis is not treated promptly or if the treatment fails, it can lead to the manifestation of chronic gastritis which further increases your risk of developing gastric cancer.
Read – Yastimadhu: Licorice Benefits, Usage, Research, Remedies, Side Effects

Home remedies for gastritis – H. pylori infection

Probiotics – helps in balancing the gut bacteria. It also helps in improving rate of eradication of H. pylori if taken before or after standard H. pylori treatment. They replenish the good bacteria which are destroyed by antibiotics and also reduce the risk of overgrowth of yeast. According to researches bacteria Lactobacillus acidophilus yields best results.

Green Tea – Green tea has shown to kill and slow the growth of Helicobacter bacteria as per some studies conducted on mice. If consumed before infection it helps in preventing inflammation of stomach. It reduces severity of the disease and symptoms if consumed during infection.

Honey – Studies have shown honey having antibacterial action against H. pylori.

Olive oil – has been shown to have strong antibacterial abilities against 8 of H. pylori strains as per studies.

Licorice – Root of Licorice is a natural remedy for stomach ulcers. In Ayurveda licorice is used effectively to treat gastritis and ulcers in stomach and duodenum. A study shows that licorice prevents the H. pylori from sticking to the cell walls in the stomach. Thus it helps in fighting the H. pylori infection.

Broccoli sprouts – Broccoli sprouts consist of sulphoraphane, a compound which may be effective against H. pylori. It has found to reduce gastric inflammation and lowers bacteria colonization in the stomach. Its antibacterial role has also been studied.

Phototherapy – UV light used in phototherapy helps in eliminating H. pylori in the stomach.
Read – Fullness Of Abdomen – Ayurvedic Approach And Treatment

Treatment of acute gastritis

In some cases of acute gastritis no treatment will be required. Treatment of acute gastritis depends on the causes. Bland diet sometimes helps in quick recovery. Foods low in fats, fiber and natural acids are best tolerated. Lean meats may be added to the diet seeing the suitability of the patient. H. pylori infections need antibiotic courses.

Medicines – include antacids to neutralize stomach acids, H2 antagonists to reduce the acid production in the stomach and Proton Pump Inhibitors which also inhibit the acid production. Antibiotics are needed only when there is bacterial infection such as from H. pylori. Antibiotics may be prescribed along with a PPI, antacid or H2 antagonist. You might be advised to stop NSAIDs or corticosteroids.

Ayurveda understanding of Gastritis
A condition called Amlapitta has often been compared to Gastritis explained in modern texts.

Click to Consult Dr Raghuram Y.S. MD (Ayu) 

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