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 U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance.
Gastritis and duodenitis both affect the digestive tract and share the same causes, including Helicobacter pylori infection. Gastritis is inflammation of the lining of the stomach, while duodenitis is inflammation of the lining of the upper small intestine, called the duodenum.
The stomach and duodenum are close to each other in the body, and many factors affect them in comparable ways. In addition to having the same causes, the conditions share similar treatments.
It can be difficult to deal with the symptoms of gastritis and duodenitis, which are often uncomfortable. However, most cases do not cause long-term or severe complications, and both conditions are generally easy to cure.
Some cases of gastritis and duodenitis cause no symptoms, and doctors may only find and diagnose the issue while looking for other digestive disorders.
When the disorders do cause symptoms, these can vary from person to person. Typical symptoms may include:
- a painful burning sensation in the stomach
- feeling full when the stomach is empty or after eating a small amount of food
In some people, pain in the stomach will spread to the back or lower abdomen.
More severe symptoms can sometimes occur, such as internal bleeding. This may cause the stool to be sticky and very dark brown or black. It might also produce a gritty, chunky vomit that resembles wet coffee grounds.
Anyone experiencing the symptoms of internal bleeding should seek immediate medical care.
Both gastritis and duodenitis can affect people of all ages at any time. Either condition may be acute or chronic.
An acute case of gastritis or duodenitis comes on quickly and lasts for a short period before going away. Chronic inflammation in this region of the body tends to progress more slowly and last for more extended periods, sometimes months or even years.
Gastritis shares some similarities with peptic ulcers, which also cause inflammation of the stomach lining. While gastritis is a general inflammation, an ulcer is a specific eroded patch of the stomach lining.
The two conditions have many symptoms in common, but an intense, localized pain is much more likely to occur with an ulcer. A peptic ulcer also carries a higher risk of bleeding and cancer, and it can lead to stomach perforation. Doctors use a variety of techniques to diagnose each of the conditions, which will require different methods of treatment.
One of the more common causes of inflammation in the digestive tract is an infection of the bacteria H. pylori. These bacteria are often present in the digestive system and are usually harmless. However, if they grow out of control, they may take over portions of the intestine or stomach and cause inflammation and other symptoms.
Another common cause of gastritis and duodenitis is the long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs include:
- ibuprofen (Advil and Motrin)
- naproxen (Aleve)
- low-dose aspirin (Bayer)
Inflammatory bowel disease (IBD) may also cause inflammation in the stomach or duodenum. A 2012 research paper looking at reports from one laboratory found that gastritis and duodenitis unrelated to bacterial infection occurred most often in adults and children with IBD. Specific forms of IBD, such as Crohn’s disease and ulcerative colitis, may cause these conditions more frequently.
Other possible causes of gastritis and duodenitis include:
Doctors who suspect either gastritis or duodenitis are likely to order several tests to check for underlying causes. They may ask for blood or stool samples to test for an H. pylori infection.
They may also recommend a breath test, in which the patient consumes either a liquid or tablet and then breathes into a bag. The doctor will test the breath for extra carbon dioxide gas, which could signify an H. pylori infection.
In some cases, doctors may perform an endoscopy to take images of the stomach lining or duodenum. This procedure involves inserting a small tube, or endoscope, with a camera on the end of it through the mouth and down into the stomach and small intestine to investigate this area.
An endoscopy allows doctors to check for signs of inflammation, bleeding, or peptic ulcers, as well as any abnormal tissues.
During the endoscopy, the doctor may also perform a biopsy. They will use a small needle attached to the endoscope to take a sample of the tissue in the stomach or duodenum. Analyzing these tissues may help doctors make a diagnosis.
Treatment for both gastritis and duodenitis varies from person to person. The success of each treatment and the recovery time will depend on the underlying cause and whether or not the individual can follow their treatment plan.
In cases of H. pylori infection, doctors will usually recommend antibiotics as a primary treatment. This can involve one or more drugs, and treatment could take a few weeks.
Regardless of the cause, doctors are likely to recommend prescription or over-the-counter (OTC) drugs to reduce acid production in the stomach and promote healing.
Some OTC acid blockers may help reduce acid in the digestive tract, and doctors often prescribe proton pump inhibitors (PPIs). PPIs work by blocking the cells that produce acid.
Some people need to take PPIs in the long term to help manage their condition or prevent symptoms from coming back. PPIs include omeprazole (Prilosec) and esomeprazole (Nexium).
Doctors may also recommend drugs called H2-receptor blockers, especially if the person is taking NSAIDs long-term and is at risk of other issues, including ulcers. H2-receptor blockers also work on the cells of the stomach to reduce acid production. This provides time for damaged tissue to heal.
Famotidine (Pepcid) is a common H2-receptor blocker.
Doctors may also recommend that people use OTC antacids to manage their symptoms temporarily. This may be helpful for people experiencing burning stomach pains or indigestion.
If the doctor recommends specific times to take these drugs, it is vital to follow their instructions. Antacids can make it difficult or impossible for the body to absorb certain medications. Therefore, it is best to always take antacids separately from other medicines to avoid interactions.
It is also essential to note that OTC antacids are only for occasional use. Anyone experiencing symptoms, such as indigestion or burning stomach pain, which require antacids more than twice a week should see their doctor for a full diagnosis.
Antacids are available to purchase online.
Many doctors will recommend lifestyle changes to help reduce inflammation in the gut and treat gastritis or duodenitis.
Avoiding or limiting the use of alcohol and tobacco may help reduce inflammation and promote healing in the gut. These substances can make it harder for the swelling to resolve.
NSAIDs, aspirin, and other medications may also increase the risk of damage to the gut. Where these drugs are the underlying cause of gastritis or duodenitis, it may be necessary to stop taking them to let the body heal.
People who use these drugs long-term to manage symptoms of other conditions should talk to their doctor. The doctor may suggest a lower dose or recommend other drugs that could reduce the risk of damage in the stomach and intestines.
If doctors find that a person is gluten-intolerant or has celiac disease, the individual will need to remove gluten from their diet to avoid an inflammatory flare-up.
If symptoms do not improve with the use of OTC treatment, it is best to speak to a doctor.
Some symptoms and complications require immediate attention, such as:
- severe abdominal pain alongside regular symptoms
- vomit that resembles coffee grounds
- black, tar-like stool
- high fever in addition to other symptoms
Without treatment, gastritis and duodenitis may lead to other complications. An H. pylori infection may damage the cells over time, leading to scar tissue or possible cancer formation. Anyone who is not experiencing relief from their treatment should see a doctor.
When people work with doctors and adhere to their treatment plan, complications are not common. Gastritis and duodenitis often respond well to treatment and heal without issue.
Can any foods or diet plans help with gastritis and duodenitis?
People who regularly experience gastritis or duodenitis may have a specific allergen or trigger that is causing the inflammation, such as gluten for those with celiac disease. Avoiding particular foods that trigger symptoms is highly recommended.
When an allergy is not the cause of gastritis or duodenitis, it is best to avoid foods that agitate the stomach or contribute more acid. These include alcohol, fruit juice, spicy foods, and greasy, fatty, and fried foods. Foods that are low in fat and acidity but high in fiber will help alleviate symptoms.
A doctor should examine you to make an accurate diagnosis to prevent more severe damage to the stomach. They can also determine whether or not medication may resolve the issue.
Debra Sullivan, PhD, MSN, RN, CNE, COI Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.