M.D., Infectious diseases specialist, travel junkie, chocolate/coffee addict and amateur climber.
What is gastritis?
Gastritis is an inflammation of the mucosal lining of the stomach which can cause pain, nausea, vomiting as well as coughing. In order to protect us from infection, the stomach produces acid which can irritate the lining of the stomach if it is damaged. This is what causes the aforementioned symptoms.
Gastritis is a disease that can affect women, children and men of all ages. Although many different causes for gastritis exist, in almost all cases, bad lifestyle habits will greatly contribute to the severity of the symptoms and changing or reversing this can have a huge impact on your overall health.
Most people will practice these bad habits for years without any consequences and then one day, suddenly, they will notice pain or acid reflux after eating certain foods. Others are very sensitive and can experience symptoms quickly when eating something that doesn't become them. Gastritis has definitely become a civilization disease. It is the result of our stressful and unhealthy lives.
Symptoms of gastritis
- Loss of appetite
- Acid reflux
- Epigastric Pain
- Vomiting (especially after a meal)
- Morning cough
What causes gastritis?
Many factors can damage the mucosal lining of the stomach and lead to gastritis. Infections, including Helicobacter pylori (which I will talk about in more detail below), autoimmune disorders, food allergies and certain medications can all cause these symptoms on their own. However, some lifestyle factors, such as poor diet, drinking too much coffee, drinking too much alcohol or smoking can definitely worsen symptoms. All of these factors irritate the stomach lining causing more acid production which in turn irritates the stomach again. It's a vicious circle.
Possible causes of gastritis
|lifestyle associated causes||other|
Autoimmune (very rare)
Other infections (very rare)
Which foods make gastritis worse?
- Carbonated beverages
- Sweet beverages
- Black tea
- Peppermint tea
- Fruit (some are worse than others: oranges, pineapple, kiwi, banana)
- Tomatoes in every possible form
- Spicy foods
- Foods that are too salty
- Cold meals
- Too hot or too cold beverages
How is it diagnosed?
If you suffer from the symptoms mentioned above, maybe your physician has already recommended a gastroduodenoscopy. This is a simple procedure which can be performed either with local or general anaesthesia, where a tube is inserted through your mouth then into your oesophagus and finally into your stomach. Thanks to the camera at the end of the tube, the physician can examine all structures of the upper digestive tract including your stomach and the beginning of the small intestine.
For diagnostic purposes, small biopsies (little samples of tissue from the lining) can be sampled and tested for Helicobacter pylori infection, autoimmune gastritis or other pathologies. This is necessary to exclude more serious pathologies. If all reasons for your symptoms have been excluded, then the inflammation is likely caused—at least in part—by your lifestyle. Luckily, there are many things in your daily routine that you change which should significantly improve your symptoms.
Is it Helicobacter pylori?
Helicobacter pylori is a bacterium which can be found in the lining of the stomach and is associated with gastritis and stomach cancer. There are several tests to find out whether you are infected or not. The most reliable test is to examine a biopsy sampled by gastroduodenoscopy.
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Another less invasive method is the urea breath test. But it is tricky and requires a certain amount of expertise depending on the type of machine used. Another alternative is an antigen test from the stool which can also reveal a possible H. pylori infection. Finally, the blood test—which is the least reliable and clinically significant diagnostic test—detects H. pylori antibodies in the blood.
However, the gold standard remains the culture from biopsies. The advantage of a biopsy is that you can perform an antibiogram from the positive culture. This tells you which combination of antibiotics are most likely to eradicate the bacteria in your stomach.
How can you treat it?
Of course, how you treat it depends on the cause of your gastritis. Depending on the underlying issue, you might need antibiotics, antacids, immunosuppressants or surgery. But even if your gastritis is a result of infection, autoimmune disease or certain drugs, these lifestyle changes can benefit you.
You don't necessarily need to stop eating your favorite foods forever. Sometimes just changing the order of certain things in your day will do the trick. For example, eating breakfast as soon as possible after waking up in the morning is important. This way you can neutralize the acid in your stomach with food.
If you feel nausea in the morning just after waking up and have absolutely no appetite, ignore your instincts and eat something. You will feel much better. And this may come as a suprise to some, but coffee is not a substitute for breakfast. Skipping breakfast and drinking coffee instead is one of the worst things you can do.
Also, try to eat neutral and warm meals as often as possible. Eating five smaller portions at least per day is better than eating three large portions per day.
Often, a physician will recommend starting a treatment with proton pump inhibitors (PPIs), which can block the acid until the stomach lining has healed. But keep in mind that this is a symptomatic treatment and does not resolve the underlying issue. You will either need to implement some dietary/lifestyle changes or take the PPIs for the rest of your life. Since stomach acid is an important barrier against most bacteria, I do not recommend the latter.
Some final tips:
Try to do as much as possible from this list. Be very strict for two weeks and then try slowly adding back the forbidden foods.
- Try to keep a normal sleep schedule
- Never skip breakfast
- Have breakfast as soon as possible after you wake up in the morning
- Eat warm meals as often as possible
- Eat neutral foods (extremes are not good: too spicy, too salty, too sweet, too acid, too cold or too hot)
- Do not eat any acid fruit
- Do not eat tomatoes
- Try to eat wholegrain foods
- Eat smaller meals at least 5 times per day
- If you need to drink coffee or tea do this after you have eaten something (never on an empty stomach)
- Stop smoking (it's a filthy habit that will probably kill you anyway)
- Eat your last meal at least 3 hours before going to bed
- Drink a lot of water (still water)
- Try keeping a food diary to find out what foods cause you problems
- Be careful with alcohol - red wine is better than white wine
No coffee before breakfast
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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