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In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the United States market because unacceptable levels of N-Nitrosodimethylamine (NDMA), a probable carcinogen, were present in some ranitidine products. People taking prescription ranitidine should talk with their doctors about safe alternatives before stopping the drug. Anyone taking OTC ranitidine should stop taking the drug and talk with a healthcare professional about alternatives. Instead of bringing ranitidine products to a drug take-back site, dispose of them according to the product’s instructions or by following the FDA’s guidance.

Gastritis is an inflammation of the stomach lining that can cause abdominal pain and bloating. Possible causes include bacteria and some autoimmune conditions.

Gastritis can come on suddenly, causing noticeable symptoms that may quickly resolve without treatment. Chronic gastritis, however, may go unnoticed. Without treatment, it can also lead to complications over time.

Helicobacter pylori bacteria are the most common cause of gastritis worldwide. In other cases, the inflammation is due to irritation, which might result from the use of alcohol or nonsteroidal anti-inflammatory drugs (NSAIDs), for example.

Chronic gastritis is a common problem. In fact, sources estimate that more than 50% of people worldwide have it to some degree. This is an important public health concern, as the condition is linked with complications such as stomach ulcers and stomach cancer.

This article looks at the symptoms, causes, and treatments associated with gastritis and provides tips about what to eat and what to avoid to help ease the symptoms.

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One person with gastritis may have no noticeable symptoms, while another may have severe symptoms.

Typically, people report a sharp, stabbing, or burning pain in the upper-center or upper-left abdomen. The pain often radiates to the back.

Other common symptoms include bloating and nausea. When gastritis causes vomiting, the vomit may be clear, yellow, or green.

Some symptoms of severe gastritis include:

A person needs urgent medical attention for any of the following symptoms:

Gastritis occurs when the protective lining of the stomach weakens, allowing digestive juices to damage it. This leads to inflammation.

Gastritis can be chronic, developing slowly and lasting for a long time, or acute, developing and resolving quickly.

The condition can also be erosive or nonerosive. Erosive gastritis is severe and causes the stomach lining to wear down. It may come on suddenly or develop over time. Nonerosive gastritis, on the other hand, causes changes to the stomach lining rather than a gradual breakdown.

There are also subtypes. For example, acute stress gastritis is erosive, and it develops in response to changes due to critical illness.

Some potential causes of gastritis may include the following.

H. pylori bacteria

Most commonly, gastritis is due to H. pylori bacteria. Around 35% of people in the U.S. have these bacteria in their bodies.

Irritating substances

Reactive gastritis, which is caused by irritants, is also relatively common. It affects around 15% of people in the U.S.

NSAIDs such as ibuprofen (Advil) and some other common pain relief drugs can cause stomach irritation and gastritis. NSAIDs represent the most common cause of stomach ulcers.

Some other irritants that may be responsible for this issue include alcohol and bile.

Autoimmune conditions

Autoimmune conditions can lead to gastritis. For example, in people with autoimmune atrophic gastritis, the immune system attacks the stomach lining.

Damage to the stomach

Physical trauma or damage to the stomach lining can also lead to gastritis.

For example, a person who has undergone surgery to remove part of their stomach may develop postgastrectomy gastritis, which causes the lining to degenerate.

The mechanisms behind this issue are still unclear, but postgastrectomy gastritis may stem from increased acid reflux, reactions from the vagal nerve, or a reduction in the number of acids triggered by hormones.

Other causes

Dietary factors do not usually cause gastritis, but food allergies and celiac disease can contribute to it.

Some types of gastritis that stem from other issues include:

  • Infectious gastritis not caused by H. pylori: Viruses and fungi can cause gastritis in people with immune conditions or other long-term illnesses.
  • Radiation gastritis: When the abdomen has exposure to radiation, it can irritate the stomach lining.
  • Eosinophilic gastritis: This can result from an allergic reaction.
  • Ménétrier disease: This is rare. It involves the development of thick folds and cysts on the stomach wall.

Some people, including older adults and individuals with compromised immune function, are more likely to develop gastritis.

Many health issues and factors such as smoking can also increase the risk of developing this condition.

Some risk factors for gastritis include:

Other infections that can increase the risk of gastritis include tuberculosis and syphilis.

H. pylori can spread in many different ways. For example, contaminated food, water, or cutlery may play a role.

Chronic gastritis can increase the risk of other gastrointestinal conditions, including stomach ulcers, or peptic ulcers, and bleeding in the stomach.

Certain types of gastritis, including autoimmune atrophic gastritis and H. pylori gastritis, can reduce the body’s ability to absorb iron from the blood. Autoimmune atrophic gastritis can also affect vitamin B12 absorption, which can lead to anemia.

In addition, having H. pylori gastritis may slightly increase the risk of developing stomach cancer.

The following can help a doctor diagnose gastritis:

  • conducting a physical examination
  • taking the person’s medical history and noting their current symptoms
  • checking for the presence of H. pylori using blood, breath, or stool testing
  • performing endoscopy
  • performing electrocardiography

In some cases, a doctor can diagnose gastritis with X-rays of the esophagus, stomach, and small intestine. They might refer to these X-rays as an upper gastrointestinal series or a barium swallow.

The doctor may also request:

  • evaluations of kidney and liver function
  • a test for anemia
  • gallbladder and pancreas function tests
  • pregnancy tests

If these are inconclusive, the doctor may perform upper endoscopy. This involves inserting a thin, flexible, illuminated tube down through the mouth and throat and into the stomach to perform a visual examination.

Although diet and nutrition do not typically cause gastritis, alcohol, food allergies, and some supplements can contribute to it.

Making dietary changes is not a main treatment of gastritis, except when gastritis stems from celiac disease or food allergies.

That said, some people find that eating certain foods helps with their symptoms, and doing so may also help the body get rid of H. pylori bacteria.

Foods to eat and avoid

Eating fewer foods that can irritate the stomach — such as spicy, acidic, or fried foods — may help manage gastritis, as can eating smaller, more frequent meals.

Get some diet tips for gastritis and stomach ulcers here.

The best approach depends on the cause of the condition and whether it is acute or chronic.

Treatment may involve a range of medications, including:

  • Antibiotics: A single course of antibiotics can often directly treat H. pylori. A doctor may prescribe clarithromycin (Biaxin) and metronidazole (Flagyl).
  • Proton pump inhibitors: Omeprazole (Prilosec) or lansoprazole (Prevacid), for example, can block the production of acid and aid healing.
  • H2 blockers: These drugs, which include famotidine (Pepcid), can decrease acid production.
  • Antacids: These medications can neutralize stomach acid. Many are available for purchase online.
  • Coating agents: Sucralfate (Carafate) and misoprostol (Cytotec) can coat and protect the stomach lining.
  • Antinausea medications: Several antinausea drugs are available for purchase online.

Combining the right medications with the recommended dietary changes is the surest way to help relieve gastritis.

Home remedies

In addition to making dietary changes and trying the above treatment options, some people may also benefit from natural remedies that they can try at home. This could include using probiotics, supplements, and herbal teas.

Some people may also find that techniques to reduce stress, such as meditation and yoga, are useful ways to help ease symptoms.

Learn more about natural remedies for gastritis here.

Scientists have yet to fully explore the many issues that may cause gastritis. Because some causes remain unknown, it may be impossible to prevent the issue.

However, a person can try to reduce their risk by:

  • maintaining good hand hygiene and eating well-cooked foods
  • avoiding medications that can irritate the stomach
  • avoiding smoking and consuming alcohol

Gastritis is inflammation of the stomach lining, and infection with H. pylori bacteria is the most common cause.

If a person does not receive treatment, gastritis can lead to complications, such as stomach ulcers or vitamin deficiencies. Untreated gastritis may also increase the risk of developing stomach cancer.

Depending on the cause of the inflammation and whether it is acute or chronic, treatment may involve OTC or prescription medications, antibiotics, and dietary changes.