Treatment of Gastritis & Gastropathy

How do doctors treat gastritis and gastropathy?

Your doctor will recommend treatments based on the type of gastritis or gastropathy you have and its cause. Treating gastritis and gastropathy can improve symptoms, if present, and lower your chance of complications.

H. pylori gastritis

Doctors treat Helicobacter pylori (H. pylori) gastritis with a combination of medicines to kill
H. pylori bacteria. These medicines most often include

• two or more antibiotics
• a proton pump inhibitor (PPI)
• in some cases, bismuth subsalicylate

Your doctor may avoid prescribing antibiotics you’ve taken in the past because the H. pylori bacteria may have developed antibiotic resistance to those antibiotics.

If you are given medicines, take all doses exactly as your doctor prescribes. If you stop taking your medicine early, some bacteria may survive and reinfect you. In other words, H. pylori bacteria may develop antibiotic resistance.

To find out if medicines have worked, your health care professional may recommend testing you for H. pylori at least 4 weeks after you’ve finished taking medicines.⁴ If you still have an H. pylori infection, your doctor may prescribe a different combination of antibiotics and other medicines to treat the infection. Making sure that all of the H. pylori bacteria have been killed is important to prevent further complications of the infection.

Reactive gastropathy

If long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) leads to reactive gastropathy, your doctor may recommend that you stop taking NSAIDs, take a lower dose, or take a different medicine for pain. Doctors may also recommend taking a PPI along with NSAIDs to prevent or treat reactive gastropathy and its possible complications.

If bile reflux is causing reactive gastropathy, doctors may prescribe ursodiol, a medicine that contains bile acids and can help heal the stomach lining, or surgery to stop flow of bile into the stomach.

Autoimmune gastritis

If you have autoimmune gastritis, your doctor may recommend iron, folic acid, and vitamin B12 supplements to prevent pernicious anemia. If autoimmune gastritis leads to pernicious anemia, doctors may recommend vitamin B12 injections to treat this condition.

For safety reasons, talk with your doctor before using dietary supplements, such as vitamins, or any complementary or alternative medicines or medical practices.

Acute erosive gastropathy

For patients with severe injuries or critical illness, doctors may prescribe medicines that reduce stomach acid such as PPIs, H2 blockers, or sucralfate (Carafate) to prevent or treat stress gastritis.

If an irritating substance is causing acute erosive gastropathy, treatment includes removing contact with the substance. Doctors may also prescribe PPIs or H2 blockers to reduce stomach acid.

If acute erosive gastropathy causes severe bleeding in the stomach, doctors may treat the bleeding during upper GI endoscopy or with surgery in severe cases.

Gastritis or gastropathy due to other causes

To treat gastritis or gastropathy due to other causes, doctors may prescribe medicines to treat the underlying cause or improve symptoms. Doctors may recommend diet changes if gastritis is related to celiac disease or food allergies.