From the Guidelines
The recommended treatment for gastritis is triple therapy, consisting of a proton pump inhibitor (PPI) plus two antibiotics, for 10-14 days, as this approach has been shown to achieve high cure rates and improve patient outcomes, as noted in the most recent study 1. The treatment for gastritis depends on its cause, but typically includes acid-reducing medications such as PPIs like omeprazole (20-40mg daily) or pantoprazole (40mg daily) for 4-8 weeks. H2 blockers such as famotidine (20mg twice daily) may also be used. For Helicobacter pylori-induced gastritis, the most effective treatment is triple therapy, which includes a PPI plus two antibiotics, commonly amoxicillin 1g twice daily and clarithromycin 500mg twice daily, for 10-14 days, as supported by recent studies 1. Antacids like aluminum hydroxide or magnesium hydroxide can provide quick symptom relief. Lifestyle modifications are essential and include:
- avoiding trigger foods (spicy, acidic, fatty)
- avoiding alcohol, NSAIDs, and tobacco
- eating smaller, more frequent meals
- using stress reduction techniques to help manage symptoms. These treatments work by either neutralizing stomach acid, reducing acid production, eliminating H. pylori infection, or removing irritants that damage the stomach lining, allowing the inflamed gastric mucosa to heal and preventing complications like ulcers or bleeding, as discussed in 1. It is also important to note that the management of H. pylori infection is evolving, and the use of antimicrobial stewardship is becoming increasingly important to reduce the emergence and spread of antimicrobial resistance, as highlighted in 1.
From the FDA Drug Label
The current recommended adult oral dosage of ranitidine tablets USP for ... Benign Gastric Ulcer: The current recommended adult oral dosage is 150 mg twice daily Treatment of active, benign gastric ulcer. Most patients heal within 6 weeks and the usefulness of further treatment has not been demonstrated.
The recommended treatment for gastritis (specifically benign gastric ulcer) is ranitidine 150 mg twice daily.
- The treatment duration is typically 6 weeks.
- Antacids should be given as needed for relief of pain. 2 2
From the Research
Treatment for Gastritis
The treatment for gastritis, particularly when associated with Helicobacter pylori infection, typically involves a combination of medications to eradicate the bacteria and reduce stomach acid.
- The standard treatment regimen often includes a high-dose proton-pump inhibitor (PPI) such as omeprazole, along with antibiotics like amoxicillin, clarithromycin, and metronidazole 3.
- The choice of antibiotics may depend on factors like resistance patterns and patient allergies, with options including fluoroquinolones, tetracycline, and doxycycline 3, 4.
- PPIs like omeprazole have been shown to be effective in reducing gastric acid secretion and, when used in combination with antibiotics, can improve healing and prevent complications and recurrences of gastric or duodenal ulcers 5, 6.
- The duration of treatment can vary, but typically ranges from 7 to 14 days, with longer treatment durations sometimes resulting in higher eradication rates 3, 7.
- Factors like smoking and the severity of histological gastritis can influence treatment outcomes, with smokers and those with more severe gastritis potentially requiring alternative or extended treatment regimens 4.
Treatment Regimens
Different treatment regimens have been studied, including:
- Triple therapy with a PPI, amoxicillin, and clarithromycin, which has been shown to be effective in eradicating H. pylori in about 70-80% of cases 3, 4.
- Quadruple therapy with a PPI, amoxicillin, clarithromycin, and metronidazole, which may be more effective in cases where there is resistance to clarithromycin 3.
- Sequential treatment with amoxicillin followed by clarithromycin and metronidazole, which has been shown to be effective in some studies 3.
Proton Pump Inhibitors
PPIs like omeprazole, lansoprazole, and pantoprazole have been widely used in the treatment of H. pylori infection and gastritis.