Is gastritis curable?

From the Guidelines

Gastritis is generally curable with appropriate treatment, which depends on the underlying cause and may involve a combination of antibiotics, proton pump inhibitors, and lifestyle modifications. The treatment approach has shifted towards considering H. pylori gastritis as an infectious disease, where the goal is to achieve high cure rates, similar to other infectious diseases 1. For H. pylori-induced gastritis, a standard treatment includes a combination of antibiotics, such as amoxicillin and clarithromycin, along with a proton pump inhibitor, like omeprazole, for 7-14 days 1.

Treatment Approaches

• For gastritis caused by NSAIDs, stopping the medication and taking acid-reducing medications like omeprazole typically resolves symptoms.
• Lifestyle modifications, including avoiding alcohol, spicy foods, and smoking, are also important for recovery and prevention.
• Stress reduction techniques may help with stress-induced gastritis.

Cure Rates and Treatment Outcomes

• The management of H. pylori infection is transforming, with a focus on achieving high cure rates, similar to other infectious diseases 1.
• Treatment trials will focus on actual cure rates, and comparisons will be restricted to deciding which of two highly successful therapies is best 1.
• The goal is to achieve cure rates of at least 90%, preferably ≥95%, with the use of effective antibiotics and proton pump inhibitors 1.

Chronic Forms of Gastritis

• Some chronic forms of gastritis, particularly autoimmune gastritis, may require long-term management rather than offering a complete cure.
• The healing process occurs as inflammation subsides and the stomach lining regenerates, which happens relatively quickly since stomach cells renew approximately every 3-4 days.

From the Research

Gastritis Curability

• Gastritis, particularly the type caused by Helicobacter pylori infection, can be treated and cured with the appropriate regimen of antibiotics and acid suppressive therapy 2, 3.
• The treatment typically involves a combination of drugs, including a proton pump inhibitor (PPI), amoxicillin, clarithromycin, metronidazole, and tetracycline, to eradicate the H. pylori infection 2.
• In cases where the first-line treatment fails, second-line and third-line treatments are available, including levofloxacin-amoxicillin-based triple therapy and rifabutin-based regimens 2.
• Eradication of H. pylori has been shown to prevent the progression of gastritis to more severe conditions, such as gastric cancer, especially in patients with non-atrophic gastritis 3.
• However, in patients with atrophic gastritis, the eradication of H. pylori may not prevent the progression of precancerous lesions and small invisible early cancers to overt tumors 3.

Factors Affecting Gastritis Curability

• The use of antacids and H2 receptor antagonists does not appear to increase the incidence of atrophic gastritis in patients with or without H. pylori gastritis 4.
• Long-term suppression of acid by proton pump inhibitors may increase the risk of atrophic gastritis, but this is still a topic of controversy 4, 5.
• H. pylori eradication can lead to resolution of gastritis and may induce partial regression of pre-existent gland loss, reducing the risk of gastric cancer 5.

Current Understanding and Treatment

• Chronic gastritis is a common pandemic infection that can lead to severe sequelae, such as peptic ulcer or gastric cancer 6.
• The main cause of chronic gastritis is H. pylori infection in childhood, which can result in a life-long and aggressive inflammation of the stomach mucosa 6.
• Treatment of H. pylori infection is crucial to prevent the progression of gastritis to more severe conditions, and proton pump inhibitors can be used in conjunction with antibiotics to achieve this goal 2, 5.