From the Guidelines
The treatment of acute gastritis should focus on addressing the underlying cause, managing symptoms, and preventing complications, with an emphasis on discontinuing causative agents, implementing dietary modifications, and using medications such as antacids, H2 receptor antagonists, and proton pump inhibitors. For symptom relief, the following options can be considered:
- Antacids (like aluminum hydroxide or magnesium hydroxide) for immediate but short-term acid neutralization
- H2 receptor antagonists such as famotidine (20-40 mg twice daily) or ranitidine (150 mg twice daily) for 1-2 weeks
- Proton pump inhibitors like omeprazole (20-40 mg daily) or pantoprazole (40 mg daily) for 2-4 weeks in more severe cases If H. pylori infection is confirmed, quadruple therapy is recommended as first-line therapy, given the increasing antibiotic resistance, with 14-day bismuth quadruple therapy being a preferred option when susceptibility testing or regional data are not available 1. Additionally, antiemetics such as ondansetron (4-8 mg every 8 hours) may be prescribed for nausea and vomiting. It is essential to note that empiric therapy for H. pylori infections should be guided by antimicrobial stewardship principles, with consideration of local and regional antimicrobial susceptibility patterns 1. The goal of treatment is to allow the gastric mucosa to heal, reduce symptoms, and prevent complications, with most cases of acute gastritis resolving within a few days to weeks with appropriate treatment.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Guideline for Acute Gastritis
The treatment guideline for acute gastritis involves several approaches, including:
- Helicobacter pylori (H. pylori) eradication: Studies have shown that H. pylori eradication leads to resolution of gastritis and may induce partial regression of pre-existent gland loss 2.
- Proton pump inhibitors (PPIs): PPIs are effective in reducing gastric acid secretion and are used in the treatment of acid-related disorders, including acute gastritis 3, 4.
- Antibacterial agents: Combination therapy with PPIs and antibacterial agents is effective in eradicating H. pylori and reducing the risk of ulcer recurrence 3, 4.
- Symptomatic relief: Treatment with PPIs or other acid-suppressing agents can provide symptomatic relief for patients with acute gastritis 3, 4.
Considerations for Treatment
When treating acute gastritis, the following considerations should be taken into account:
- H. pylori status: Patients with H. pylori infection should be treated with a combination of PPIs and antibacterial agents to eradicate the infection 2, 3, 4.
- Acid suppression: PPIs are effective in reducing gastric acid secretion, but may increase the risk of bacterial gastroenteritis 5.
- Treatment duration: The duration of treatment with PPIs or other acid-suppressing agents should be tailored to the individual patient's needs and response to treatment 3, 4.
Specific Treatment Regimens
Specific treatment regimens for acute gastritis may include:
- Omeprazole: 20-40 mg/day for 2-4 weeks, depending on the severity of symptoms and H. pylori status 3, 4, 6.
- Lansoprazole: 30-60 mg/day for 2-4 weeks, depending on the severity of symptoms and H. pylori status 3, 4.
- Pantoprazole: 40-80 mg/day for 2-4 weeks, depending on the severity of symptoms and H. pylori status 3, 4.