Gastritis is an inflammation of the lining of your stomach. It is not a single disease but rather a group of disorders. Gastritis can "eat away" the stomach lining and cause bleeding. In some cases, gastritis does not damage the stomach lining and does not have a specific cause.

The following are symptoms of gastritis.

• Indigestion and heartburn
• Nausea
• Loss of appetite
• Abdominal pain that is often worse after eating
• Gastrointestinal bleeding (signs of this are vomiting material that looks like coffee-grounds, or having very dark stools)

The causes of gastritis include the following.

• Aspirin use
• Alcohol and tobacco use
• Serious illness
• Reflux injury (such as bile backing up into the stomach and esophagus)
• Trauma (for example, surgery, radiation, chemotherapy, severe vomiting, having swallowed a foreign object)
• Bacterial, viral, fungal, and parasitic infections
• Pernicious anemia
• Systemic disease (for example, Crohn's disease)

Your health care provider will take your medical history and conduct a physical examination. Your provider will refer you to a gastroenterologist if you need further examination, such as an endoscopy or a gastroscopy. A biopsy may be taken of the tissues of your esophagus or stomach to determine the cause of your discomfort.

Gastritis treatment depends on the cause of the problem.

• Helicobactor pylori infestation, a common bacterial cause of gastritis and ulcers, is treated with a three-drug combination for two weeks: Pepto-Bismol, metronidazole, and tetracycline (or amoxicillin if tetracycline cannot be used).
• For some types of gastritis, you must stop ingesting all irritating substances, including alcohol, tobacco, aspirin, and spicy foods.

In addition to the medications used for Helicobacter pylori infection as described, other medications that may be used to relieve symptoms of gastritis include:

• Antacids such as calcium carbonate, calcium carbonate with magnesium hydroxide, and sodium bicarbonate
• H2 blockers such as ranitidine, cimetidine, nizatidine, and famotidine
• Proton pump inhibitors such as omeprazole and lansoprazole

Nutritional and herbal support help to heal the stomach lining, fight infection, and reduce recurrence.

• Avoid dairy products, caffeine, alcohol, and sugar. Coffee, even decaffeinated, should be eliminated because it contains potentially irritating oils.
• Eliminate any known food allergens from your diet.
• Include sulfur-containing foods such as garlic, onions, broccoli, cabbage, Brussels sprouts, and cauliflower in the diet. Sulfur is the basis for forming glutathione, which provides antioxidant protection to the stomach lining. N-acetylcysteine (200 mg twice a day between meals) is also the basis for forming glutathione.
• Vitamin C (250 to 500 mg twice per day) decreases nitrosamines, substances that have been linked to stomach cancer.
• Zinc (30 to 50 mg per day) helps you heal.

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• DGL (deglycyrrhizinated licorice), 250 mg four times per day 15 to 20 minutes before meals and one to two hours after the last meal of the day, increases circulation and healing of stomach lining. This preparation is safe for people with high blood pressure or to take long-term. If you have high blood pressure, talk with your health care provider before taking any medications.
• Powders of slippery elm (Ulmus fulva) and marshmallow root (Althaea officinalis) may be taken singly or together, 1 tsp. two to three times per day, to decrease inflammation and encourage healing.
• Ginger root tea (Zingiber officinale) increases circulation and enhances digestion. Drink 2 to 3 cups per day with meals.
• For H. pylori, bismuth subcitrate (120 mg four times per day for eight weeks) may be helpful in eliminating the bacteria and reducing recurrence of gastritis. Do not use this long-term. Be sure to take it under the supervision of your health care provider, since you may still need antibiotics if the H. pylori is not gone after eight weeks.

Homeopathy may be useful as a supporting therapy. There are three remedies to consider: Nux vomica, Arsenicum album, and Lycopodium.

Acupuncture may be helpful in reducing stress and improving overall digestive function.

Therapeutic massage can reduce stress and increase your sense of well-being.

Return to your health care provider if your symptoms do not get better or if they get worse.

Do not ignore potentially life-threatening symptoms such as vomiting blood or blood in your stool. Be sure to see your health care provider regularly, and call him or her if there is any change in your symptoms. If you are pregnant, nutritional guidelines and herbal support are safe, but talk with your health care provider before taking any medicine or supplements. Do not take bismuth subcitrate if you are pregnant.

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