What is the management (Medical Doctor's management) for gastritis?

From the Guidelines

For gastritis management, I strongly recommend assessing all individuals for H pylori infection and administering treatment if positive, as this approach has been shown to be effective in managing atrophic gastritis 1. When managing gastritis, it is essential to consider the underlying cause of the condition.

Key Considerations

• Assessing for H pylori infection is crucial, as it is a common cause of gastritis
• If H pylori infection is confirmed, treatment should be administered to eradicate the infection
• Non-serological testing modalities should be used to confirm successful eradication of H pylori 1

Treatment Approach

• Treatment of H pylori infection typically involves a combination of medications, including a proton pump inhibitor (PPI) and antibiotics such as amoxicillin and clarithromycin
• The specific treatment regimen may vary depending on the individual patient's needs and the presence of any antibiotic resistance
• Lifestyle modifications, such as avoiding spicy foods, caffeine, and acidic foods, and stopping smoking, can also help alleviate symptoms and promote healing

Medication Options

• PPIs, such as omeprazole or pantoprazole, can help reduce stomach acid production and alleviate symptoms
• Antibiotics, such as amoxicillin and clarithromycin, are used to eradicate H pylori infection
• Antacids and H2 blockers may also be used to provide symptom relief 1

From the FDA Drug Label

Omeprazole delayed-release capsules are used in adults: • for up to 8 weeks for the healing of duodenal ulcers • with certain antibiotics for 10 to 14 days to treat an infection caused by bacteria called H. pylori. • for up to 8 weeks for healing stomach ulcers.

Ranitidine tablets USP are indicated in:

1. Short-term treatment of active duodenal ulcer.
2. Maintenance therapy for duodenal ulcer patients at reduced dosage after healing of acute ulcers
3. Short-term treatment of active, benign gastric ulcer.

The management of gastritis by a Medical Doctor may include the use of proton pump inhibitors (PPIs) like omeprazole or histamine-2 (H2) blockers like ranitidine to reduce stomach acid.

• The doctor may prescribe omeprazole for up to 8 weeks for healing stomach ulcers or ranitidine for short-term treatment of active, benign gastric ulcer.
• In cases of H. pylori infection, the doctor may prescribe omeprazole with certain antibiotics for 10 to 14 days.
• The doctor will determine the best course of treatment based on the individual patient's condition and medical history 2 3.

From the Research

Medical Management of Gastritis

The management of gastritis by medical doctors typically involves the use of proton pump inhibitors (PPIs) and antibiotics to eradicate Helicobacter pylori infection, which is a common cause of gastritis.

• PPIs such as lansoprazole 4, omeprazole 5, and pantoprazole 6 have been shown to be effective in reducing gastric acid secretion and alleviating symptoms of gastritis.
• The use of PPIs in combination with antibiotics has been found to be effective in eradicating H. pylori infection and reducing inflammation in the gastric mucosa 4, 5.
• Studies have also shown that PPIs can exhibit anti-inflammatory effects and interfere with the cellular immune response to H. pylori infection, which can help to reduce the severity of gastritis 6.

Treatment Regimens

The treatment regimens for gastritis typically involve the use of PPIs and antibiotics for a period of 7-14 days.

• A study found that optimal omeprazole regimens for anti-H. pylori therapy involve administering the drug at a dosage of 40 mg/day for 7,10, or 14 days in combination with two antibacterial agents 5.
• Another study found that lansoprazole is more effective than H2-receptor antagonists in relieving ulcer pain and has a similar safety profile in the healing of gastric and duodenal ulcers 7.

Helicobacter pylori Eradication

The eradication of H. pylori infection is an important aspect of the management of gastritis.

• Studies have shown that the use of PPIs in combination with antibiotics can effectively eradicate H. pylori infection and reduce the risk of gastric cancer 8.
• A study found that H. pylori eradication leads to resolution of gastritis and may induce partial regression of pre-existent gland loss 8.