Gastritis
Understanding inflammation of the stomach lining and how to manage it
Last reviewed: February 2026
🔴 What is Gastritis?
Gastritis is inflammation, irritation, or erosion of the stomach lining (mucosa). The stomach lining contains glands that produce stomach acid and an enzyme called pepsin. Normally, a thick mucus barrier protects this lining from the digestive juices. When this barrier is weakened or damaged, inflammation can occur.
Gastritis can occur suddenly (acute gastritis) or develop gradually over time (chronic gastritis). It ranges from mild irritation to severe inflammation that can lead to ulcers or, rarely, increase the risk of stomach cancer.
H. pylori
Most common cause worldwide
NSAIDs
Common cause in developed nations
Alcohol
Can erode stomach lining
Treatable
Most cases respond well
📋 Types of Gastritis
Acute Gastritis
Sudden, severe inflammation that comes on quickly. Causes include:
- NSAIDs (aspirin, ibuprofen)
- Excessive alcohol consumption
- Severe stress (major surgery, trauma, burns)
- Bacterial infections
- Bile reflux
Chronic Gastritis
Long-term inflammation that develops gradually. Main types include:
| Type | Cause | Characteristics |
|---|---|---|
| Type A (Autoimmune) | Immune system attacks stomach cells | Affects body of stomach; can lead to B12 deficiency and pernicious anemia |
| Type B (Bacterial) | H. pylori infection | Most common type worldwide; affects antrum primarily |
| Type C (Chemical) | NSAIDs, bile reflux, alcohol | Chemical irritation of stomach lining |
Other Forms
- Erosive gastritis: Causes erosions (shallow breaks) in the stomach lining
- Atrophic gastritis: Stomach lining thins and loses gland function
- Metaplastic gastritis: Stomach cells change type (intestinal metaplasia)
⚡ Causes of Gastritis
Most Common Causes
- H. pylori infection: Bacteria that live in the stomach lining; affects about 50% of world's population
- NSAIDs: Aspirin, ibuprofen, naproxen—especially with regular use
- Alcohol: Irritates and erodes the stomach lining
- Stress: Severe physical stress from surgery, injury, burns, or critical illness
Other Causes
- Bile reflux: Backup of bile from small intestine into stomach
- Autoimmune conditions: Body attacks its own stomach cells
- Other infections: Viral, fungal, or parasitic (more common in immunocompromised)
- Radiation therapy: To upper abdomen
- Crohn's disease: Can involve stomach
- Allergic reactions: Food allergies (eosinophilic gastritis)
Risk Factors
- Regular NSAID use
- Heavy alcohol consumption
- Smoking
- Older age (stomach lining thins with age)
- Autoimmune diseases
- HIV/AIDS or other conditions affecting immunity
- Severe stress or critical illness
🔍 Symptoms of Gastritis
Gastritis symptoms can vary from person to person. Some people have no symptoms at all.
Common Symptoms
- Gnawing or burning pain in upper abdomen (epigastric pain)
- Nausea and sometimes vomiting
- Feeling full quickly after eating (early satiety)
- Bloating in upper abdomen
- Indigestion (dyspepsia)
- Loss of appetite
- Belching
Symptoms That May Indicate Complications
- Vomiting blood or material that looks like coffee grounds
- Black, tarry stools (melena)
- Severe abdominal pain
- Unexplained weight loss
- Symptoms that don't improve with treatment
Seek emergency care if you have: Vomiting blood, black tarry stools, or severe abdominal pain. These may indicate bleeding from the stomach.
🩺 Diagnosis
Diagnostic Tests
| Test | Purpose |
|---|---|
| Upper Endoscopy (EGD) | Visualize stomach lining; take biopsies; most accurate diagnostic test |
| H. pylori Tests | Breath test, stool test, or blood test to detect H. pylori |
| Blood Tests | Check for anemia, H. pylori antibodies, or autoantibodies |
| Stool Test | Check for blood in stool (occult blood) or H. pylori |
| Biopsy | Examine tissue for inflammation, H. pylori, or precancerous changes |
💊 Treatment
Treatment depends on the cause and severity of gastritis.
General Treatment Approaches
For H. pylori-Related Gastritis
Triple or quadruple therapy combining:
- PPI (omeprazole, pantoprazole)
- Two or more antibiotics (clarithromycin, amoxicillin, metronidazole)
- Treatment duration: typically 10-14 days
- Follow-up testing to confirm eradication
For NSAID-Related Gastritis
- Stop or reduce NSAID use if possible
- Switch to acetaminophen (paracetamol) for pain
- PPIs to heal stomach and protect if NSAIDs must continue
- Consider COX-2 selective NSAIDs (less stomach irritation)
Medications
| Medication Type | Examples | Action |
|---|---|---|
| PPIs | Omeprazole, Pantoprazole, Esomeprazole | Strongly reduce stomach acid production |
| H2 Blockers | Famotidine, Ranitidine | Reduce acid production (less potent than PPIs) |
| Antacids | Tums, Mylanta, Maalox | Neutralize existing acid; quick but short relief |
| Cytoprotective agents | Sucralfate, Bismuth | Protect stomach lining |
| Antibiotics | Clarithromycin, Amoxicillin, Metronidazole | Kill H. pylori bacteria |
🥗 Diet and Lifestyle Management
Foods to Avoid or Limit
- Spicy foods
- Acidic foods (citrus, tomatoes)
- Fried and fatty foods
- Alcohol
- Coffee and caffeinated beverages
- Carbonated drinks
- Processed and packaged foods
Foods That May Help
- High-fiber foods (fruits, vegetables, whole grains)
- Low-fat proteins (chicken, fish, tofu)
- Probiotic-rich foods (yogurt, kefir)
- Non-acidic vegetables
- Ginger (anti-inflammatory properties)
- Turmeric (anti-inflammatory)
- Honey (may have antibacterial properties)
Lifestyle Recommendations
- Eat smaller, more frequent meals
- Avoid eating 2-3 hours before bedtime
- Quit smoking (irritates stomach lining)
- Limit or avoid alcohol
- Manage stress through relaxation techniques
- Avoid NSAIDs if possible; use alternatives
- Maintain a healthy weight
- Stay well-hydrated with water
- Chew food thoroughly and eat slowly
⚠️ Potential Complications
If left untreated, gastritis can lead to:
- Peptic ulcers: Open sores in stomach lining
- Bleeding: Erosions can bleed, causing anemia
- Atrophic gastritis: Loss of stomach gland function
- Pernicious anemia: B12 deficiency from autoimmune gastritis
- Stomach cancer: Increased risk with chronic H. pylori infection or autoimmune gastritis
Most cases of gastritis improve quickly with treatment and don't lead to complications. The key is proper diagnosis and treatment of the underlying cause.
❓ Frequently Asked Questions
How long does gastritis take to heal?
Acute gastritis may improve within days to weeks once the cause is removed. Chronic gastritis takes longer—typically 2-8 weeks of treatment for significant improvement. H. pylori treatment usually takes 10-14 days of antibiotics, but the stomach lining may take several more weeks to fully heal. Following your treatment plan and dietary recommendations helps speed recovery.
Can I drink coffee with gastritis?
Coffee can worsen gastritis symptoms because it stimulates acid production and can irritate an already inflamed stomach lining. It's generally recommended to avoid or significantly limit coffee during active gastritis. Some people find they can tolerate small amounts of low-acid coffee once healed, but this varies individually.
Is gastritis the same as an ulcer?
No, but they're related. Gastritis is inflammation of the stomach lining. An ulcer is an open sore that goes deeper into the lining. Gastritis can lead to ulcers if left untreated. They share similar causes (H. pylori, NSAIDs) and treatments (PPIs, antibiotics for H. pylori). Endoscopy can distinguish between them.
Can stress cause gastritis?
Severe physical stress (surgery, trauma, burns, critical illness) can cause "stress gastritis." Psychological stress alone doesn't directly cause gastritis but can worsen symptoms, increase acid production, and lead to behaviors (eating poorly, drinking more alcohol, taking more NSAIDs) that do cause gastritis.
Do I need to be tested for H. pylori?
Testing is recommended if you have symptoms of gastritis or ulcers, especially if the cause isn't obvious (like NSAID use). Testing is also recommended before starting long-term NSAID therapy and for people with a family history of stomach cancer. If you test positive, treatment can eradicate the infection and significantly improve outcomes.