Chronic gastritis is a disease characterized by inflammation of the stomach lining that lasts more than three months and is not resolving on its own. Chronic gastritis is a common reason why patients reach out to Thrive GI requesting naturopathic care.

There are several potential causes of chronic gastritis, which can be broadly categorized into two main types: non-infectious and infectious. In order to treat Chronic gastritis effectively, it is vitally important to figure out the underlying cause for each specific patient.

Non-Infectious Causes:

  1. Autoimmune Gastritis: This occurs when the body’s immune system mistakenly attacks the cells that produce stomach acid and intrinsic factor (needed for vitamin B12 absorption), leading to inflammation and damage to the stomach lining.
  2. Reflux of Bile: Bile, a digestive fluid produced by the liver, can reflux into the stomach and contribute to chronic gastritis.
  3. Medications: Long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, corticosteroids, and some painkillers, can irritate the stomach lining and lead to chronic inflammation.
  4. Alcohol and Tobacco: Excessive alcohol consumption and smoking can both contribute to chronic gastritis by irritating and inflaming the stomach lining.
  5. Stress: Chronic stress and psychological factors can affect the stomach’s ability to produce protective mucus and increase the risk of gastritis.
  6. Autoimmune Disorders: Conditions like Crohn’s disease, systemic lupus erythematosus, and pernicious anemia can be associated with chronic gastritis.
  7. Food intolerances: Intake of foods that a patient is intolerant to can cause irritation of the lining of both the small intestine and the stomach.
  1. Infectious Causes:
  1. Helicobacter pylori: This bacteria is the most common cause of infectious gastritis. It colonizes the stomach lining and can lead to chronic inflammation, ulcer formation, and in some cases, stomach cancer.
  2. Other Bacterial Infections: Apart from H. pylori, other bacterial infections can also cause gastritis, although they are less common. These include Mycobacterium tuberculosis and certain strains of E. coli.
  3. Viral Infections: Some viral infections, such as cytomegalovirus (CMV) and herpes simplex virus (HSV), can lead to gastritis.

It’s important to note that chronic gastritis can vary in severity and symptoms. Common symptoms may include abdominal pain, bloating, nausea, vomiting, and a feeling of fullness after eating.

How is Chronic Gastritis Treated?

The treatment for chronic gastritis depends on the underlying cause and the severity of the condition. Here are some common approaches that are used:

  1. H. pylori Eradication (if present): If chronic gastritis is caused by an H. pylori infection, the primary treatment goal is to eliminate the bacteria. This is typically done through a combination of antibiotics (such as amoxicillin, clarithromycin, and metronidazole) along with acid-suppressing medications (proton pump inhibitors or PPIs). H. pylori eradication can help alleviate inflammation and prevent further damage to the stomach lining. It is also possible to treat H. pylori with a similarly aggressive herbal protocol, though the herbal treatment typically requires a longer treatment time.
  2. Acid-Suppressing Medications: Proton pump inhibitors (PPIs) and H2 blockers are commonly used to reduce stomach acid production. These medications can help relieve symptoms and promote healing of the stomach lining by reducing acid-related irritation. Many of my patients are surprised to hear that I use antacid medications when treating chronic gastritis as these are typically thought of as “bad” medications. And while these medications are certainly problematic when used long-term, in the short-term it is extremely important to decrease the acid burden on the stomach so that it can heal.
  3. Demulcent Herbs and Supplements: Demulcent simply means, “relieving inflammation and irritation”. I find that combining an antacid medication with demulcents is much more effective when treating gastritis than taking antacids alone. Some common demulcent supplements are slippery elm, DGL (de-glycerinated licorice), glutamine, aloe vera, okra, and marshmallow.
  4. Lifestyle Modifications: Making certain changes to your lifestyle is an important factor in effectively treating chronic gastritis:
  1. Diet: Avoiding spicy, acidic, and highly seasoned foods can help reduce irritation to the stomach lining. Eating smaller, more frequent meals can also be beneficial. If food intolerances are a contributor to the gastritis, then these foods must be tested for and removed from the diet.  
  2. Alcohol and Tobacco: Limit or avoid alcohol consumption and smoking, as they can exacerbate gastritis symptoms.
  3. Stress Management: Practicing stress-reduction techniques like meditation, yoga, and relaxation exercises can help manage symptoms.
  1. Avoiding Irritating Substances: If chronic gastritis is triggered by certain medications (such as NSAIDs or aspirin), avoiding or minimizing the use of these drugs is important. Often, we can switch to more natural anti-inflammatories that don’t negatively affect the stomach lining in patients who still need pain control.  
  2. Management of Underlying Conditions: If chronic gastritis is secondary to an underlying condition like an autoimmune disorder or a systemic disease, managing that condition effectively can help alleviate gastritis symptoms.
  3. Follow-Up and Monitoring: Regular follow-up appointments with your physician are important to monitor the progress of treatment, assess symptom improvement, and make any necessary adjustments to the treatment plan. Gastritis is a condition that should not be treated outside the care of a trained medical professional.

Dr. Katie Nuckolls is a naturopathic physician and owner of Thrive GI: Natural Digestive Medicine in Vancouver, Washington. She currently sees patients that live in Washington, Oregon, and Arizona using telemedicine. For more information, visit our contact page or schedule a free 15-minute consultation online. 

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