Unveiling Effective Gastritis Treatments: A Comprehensive Review

Gastritis is a prevalent ailment, especially after taking some treatments which trigger inflammation in the stomach mucosa. Gastritis is just that. It features inflammation in the stomach and encompasses many conditions that induce swelling, which can be only found in a specific area of the stomach or the entire organ.

Gastritis can be divided into acute and chronic, depending on how long you have endured the symptoms. Acute gastritis has symptoms that are not serious enough to cause your health to be in jeopardy, but they can be very uncomfortable and reduce your quality of life. Chronic gastritis is a condition that affects your body for an extended period, which makes it more difficult to heal and has long-term consequences in some cases, such as stomach cancer when it is triggered by Helicobacter pylori infections.

Gastritis symptoms include nausea, vomiting, cramps, diarrhea, bloating, loss of appetite, and weight loss. If you experience any of these symptoms, it is best to visit your doctor immediately. The doctor will determine if you have acute or chronic gastritis and give you treatment for each. In this article, we’re going to talk about different treatment options for each.

1. Treatment of acute gastritis

Treatment basics of acute gastritis

Acute gastritis usually needs medical treatment as opposed to surgical procedures. The only case when surgical procedures are recommended is in case of acute necrotizing gastritis and phlegmonous gastritis, which are not the most common ailments.

In some cases, gastritis is associated with gastrointestinal tract bleeding, which manifests with hematemesis, melena, and a decrease in hemoglobin levels. In such cases, a stomach and duodenal ulcer should be ruled out, and doctors should investigate the possibility of stomach cancer.

Most instances of acute gastritis are quickly relieved with short-term over-the-counter drugs such as antacids and sucralfate, which work in mild and moderate cases. However, these patients should also keep in mind long-term changes in their habits and lifestyle, such as avoiding smoking and reducing caffeine intake and nonsteroidal anti-inflammatory drugs.

Medical care for acute gastritis

Different medications and treatment options exist for acute gastritis, but there is no specific therapy and treatment protocol, and medical care depends on the patient’s symptoms and underlying disease. The only specific therapy and medical care are for cases triggered by Helicobacter pylori infections.

A significant highlight of medical care for acute gastritis is the use of ranitidine, which was very popular until December 2019. During that time, the FDA announced that this drug should be recalled from the market because it was found to be contaminated with a carcinogenic molecule. The total withdrawal of ranitidine was made effective by April 2020. Since then, the number of medications available for acute gastritis has been reduced.

H. pylori eradication therapy in acute gastritis

As mentioned previous, one of the only treatment options standardized and made into a protocol for acute gastritis is Helicobacter pylori eradication. This treatment is usually made with a triple or quadruple therapy that includes bismuth, a proton-pump inhibitor, tetracycline, and nitroimidazole. Another option is using clarithromycin, amoxicillin, and a proton-pump inhibitor.

There are many variations of the same treatment. Sometimes your doctor can prescribe concomitant therapy with two antibiotics. In other cases, they can prescribe sequential treatment with one antibiotic for the first week and the other in the second week. There is even a type of hybrid therapy. However, they all last 10 to 14 days.

It is essential to highlight that the nitroimidazole molecule of choice is usually metronidazole. Tinidazole is not usually used to prevent drug resistance. Other antibiotics can be used, including levofloxacin.

Other treatment considerations

Gastritis treatment usually does not need to escalate and rarely requires hospitalization. But in some cases, fluids and electrolytes are necessary to correct an imbalance. This is particularly important when patients are vomiting very frequently.

It is also essential to detect the trigger of gastritis and discontinue using medications and lifestyle elements that may contribute to the disease. Patients taking low-dose aspirin should talk to their doctors to search for an alternative if they experience very frequent episodes of dyspepsia and gastritis symptoms.

Another important consideration with gastritis treatment is the interaction between proton pump inhibitors and the drug clopidogrel, which is antiplatelet therapy. With proton pump inhibitors, clopidogrel may decrease its activity and trigger heart problems. In such cases, pantoprazole is usually recommended because it has limited interaction with clopidogrel.