Erosive gastritis is a condition where your stomach lining becomes inflamed and develops sores or erosions. Unlike regular gastritis, erosive gastritis involves actual damage to the stomach lining that can be seen during an endoscopy.
This condition can cause uncomfortable symptoms and may lead to complications if left untreated. The good news is that several effective treatments are available.
Table of Contents
What Causes Erosive Gastritis?
Understanding what causes erosive gastritis can help you prevent it or manage it better.
NSAIDs (Pain Medications)
One of the most common causes is taking non-steroidal anti-inflammatory drugs (NSAIDs). These are common pain medications like aspirin and ibuprofen. Research shows that NSAIDs can cause erosive gastritis and bleeding (1).
Studies have found that aspirin causes more stomach damage than some other pain medications. In one study, 7 out of 14 people developed stomach erosions after taking aspirin for just one week (2).
H. pylori Infection
H. pylori is a type of bacteria that can live in your stomach. The infection rate varies, with about 30% of people with erosive gastritis having this bacteria (3).
Interestingly, research has shown that H. pylori bacteria is found in higher amounts in stomach erosions compared to healthy stomach tissue (4).
Other Causes
Erosive gastritis can also develop in people who are critically ill or under severe stress. This includes people with major bleeding from conditions like esophageal varices (5).
Symptoms of Erosive Gastritis
The symptoms of erosive gastritis can vary from person to person. Some people have no symptoms at all.
Common symptoms include:
- Stomach pain or discomfort
- Nausea
- Heartburn
- Bloating
- Vomiting
- Bleeding (vomiting blood or black stools)
Research shows that symptoms often don’t match what doctors see during an endoscopy. You might have severe symptoms with mild erosions, or no symptoms with significant damage (6).
How Is Erosive Gastritis Diagnosed?
The main way doctors diagnose erosive gastritis is through an endoscopy. This is a procedure where a thin, flexible tube with a camera is inserted through your mouth to look at your stomach lining.
During the endoscopy, doctors can see the erosions (sores) in your stomach lining. They may also take small tissue samples (biopsies) to check for H. pylori infection or other problems.
Treatment Options
Several effective treatments are available for erosive gastritis. The best treatment for you depends on what’s causing your condition and how severe it is.
Acid-Blocking Medications
Medications that reduce stomach acid can help heal erosions and relieve symptoms.
Proton Pump Inhibitors (PPIs): Fexuprazan is a newer type of acid blocker that has shown good results. In studies, it improved erosions in about 58-66% of patients after 2 weeks (7).
H2 Blockers: Medications like ranitidine, cimetidine, and nizatidine also reduce stomach acid. Cimetidine has been shown to heal erosions in about 80% of patients after six weeks (8). Nizatidine combined with rebamipide has been shown to improve erosions in 62% of patients (9).
Pirenzepine: This medication reduces stomach acid by a different mechanism. Studies show it can heal erosions in about 78% of patients after six weeks (8).
Mucoprotective Agents
These medications help protect and heal your stomach lining.
Rebamipide: This medication helps reduce inflammation and protect the stomach lining. Studies show it can improve symptoms and reduce erosions better than other mucoprotective agents (10).
CKD-495: A newer medication made from cinnamon extract has shown promising results. It improved erosions in about 56% of patients, which was better than the standard treatment (11).
Sucralfate: This medication coats the stomach lining and helps it heal. It has been used as a standard treatment for erosive gastritis. Studies comparing it to other treatments show it can improve erosions in about 40% of patients (12).
Gefarnate: This gastroprotective agent has shown good results for erosive gastritis. Research found it improved erosions in 72% of patients, which was significantly better than sucralfate (12).
DA-9601/DA-5204: These plant-based medications have been shown to improve erosions in about 42% of patients after 2 weeks of treatment (13).
Prostaglandin Medications
If your erosive gastritis is caused by NSAIDs, prostaglandin medications can be particularly helpful.
Misoprostol: This medication can help heal erosions caused by NSAIDs. In one study, it significantly reduced symptoms and improved the stomach lining appearance (3). Another study showed misoprostol was clearly superior to placebo for treating NSAID-induced stomach lesions (14).
Rioprostil: Another prostaglandin that can prevent NSAID-related stomach damage. It has been shown to reduce erosions from 67% to 17% when taken with NSAIDs (15). Studies show rioprostil leads to greater healing of the stomach lining compared to placebo in patients taking NSAIDs (16).
Newer Treatments
Research continues to find new treatments for erosive gastritis.
Traditional Chinese Medicine: Huazhuo Jiedu formula, a traditional Chinese medicine preparation, has shown better results than standard treatment in improving symptoms and healing erosions in patients with chronic erosive gastritis (17).
Magnetic Field Therapy: A small pilot study found that magnetic field exposure may help reduce symptoms of erosive gastritis by about 56% (18).
Free Radical Scavengers: Medications like allopurinol may help heal NSAID-related erosions by reducing harmful molecules called free radicals (1).
Sulfhydryl-containing Agents: Cysteine and methylmethionine sulfonium chloride (MMSC) have been shown to help with NSAID-induced erosive gastritis bleeding. These agents helped heal erosions in about 88-89% of patients compared to 65% with standard treatment (19).
Foods to Avoid with Erosive Gastritis
While the research studies don’t specifically mention foods to avoid, general dietary recommendations for erosive gastritis typically include avoiding foods that can irritate your stomach lining.
Common trigger foods include:
- Spicy foods
- Acidic foods (citrus fruits, tomatoes)
- Coffee and caffeinated beverages
- Alcohol
- Fatty or fried foods
- Chocolate
- Carbonated beverages
These foods can increase stomach acid production or directly irritate the stomach lining. However, everyone is different, and you may find that some of these foods don’t bother you while others do.
Prevention Strategies
You can take steps to reduce your risk of developing erosive gastritis or prevent it from coming back.
Limit NSAID Use
If possible, avoid or limit your use of NSAIDs. When you do need them:
- Take the lowest effective dose
- Use them for the shortest time possible
- Take them with food
- Consider alternative pain medications like acetaminophen
Research shows that acetaminophen doesn’t cause stomach erosions like NSAIDs do (2).
Manage H. pylori Infection
If you have H. pylori infection, getting it treated may help prevent erosive gastritis. Your doctor can test for this bacteria and prescribe antibiotics if needed.
Lifestyle Changes
Some lifestyle changes may help protect your stomach:
- Don’t smoke
- Limit alcohol consumption
- Manage stress through relaxation techniques
- Eat smaller, more frequent meals
- Avoid lying down right after eating
Treatment for Bleeding Erosive Gastritis
If you have bleeding from erosive gastritis, you need immediate medical treatment.
Intravenous Medications: For acute bleeding, intravenous acid-blocking medications may be used. Studies have shown that intravenous ranitidine can be helpful for bleeding erosive gastritis (20).
Vasopressin: In severe cases with massive bleeding, medications that constrict blood vessels may be used. One study found that intra-arterial vasopressin was more effective than standard therapy for controlling bleeding from erosive gastritis (5).
When to See a Doctor
You should see a doctor if you have:
- Persistent stomach pain
- Nausea or vomiting that doesn’t go away
- Blood in your vomit or stools
- Unexplained weight loss
- Difficulty swallowing
Early treatment can prevent complications and help you feel better faster.
Living with Erosive Gastritis
Many people with erosive gastritis can manage their condition successfully with treatment and lifestyle changes.
Treatment effectiveness varies between people. Some studies show improvement rates ranging from 40% to 78% depending on the medication used (8).
It’s important to:
- Take your medications as prescribed
- Follow up with your doctor regularly
- Make recommended dietary changes
- Monitor your symptoms
Conclusion
Erosive gastritis is a treatable condition that affects your stomach lining. While it can cause uncomfortable symptoms and complications if left untreated, many effective treatments are available.
The key is to identify what’s causing your erosive gastritis and work with your doctor to find the right treatment. Whether it’s avoiding NSAIDs, treating H. pylori infection, or using protective medications, you can heal your stomach lining and feel better.
Remember that treatment takes time. Most studies show improvement after 2-8 weeks of treatment. Be patient and consistent with your treatment plan.
If you think you might have erosive gastritis, don’t wait to see a doctor. Early diagnosis and treatment can prevent complications and help you get back to enjoying life without stomach pain.