What is the recommended diet and treatment for managing gastritis?

Gastritis Diet Management

For patients with gastritis, dietary management should focus on individualized food choices that avoid trigger foods, with emphasis on consuming small, frequent meals, avoiding irritants like alcohol and spicy foods, and incorporating anti-inflammatory foods. 1

Dietary Recommendations

Foods to Include:

• Consume 5 portions of vegetables and fruits daily, varied in color and type 1
• Include whole grains as a significant component of the diet 1
• Incorporate legumes at least twice weekly 1
• Choose lean proteins such as chicken or turkey over red meat 1
• Consider oat beta-glucans with high molar mass, which have shown beneficial effects in reducing mucosal damage in chronic gastritis 2

Foods to Avoid:

• Limit or eliminate alcohol consumption, which is a common gastric irritant 1, 3
• Reduce intake of spicy foods, which can trigger symptoms in many gastritis patients 3
• Avoid foods that may precipitate reflux such as coffee, chocolate, and fatty foods 1
• Limit acidic foods that may precipitate heartburn (citrus, carbonated drinks) 1
• Reduce consumption of processed meats and foods high in salt and sugar 1

Eating Habits:

• Eat smaller, more frequent meals (4-6 meals/day) rather than large meals 1
• Avoid eating too quickly, as this is reported by 53% of gastritis patients to worsen symptoms 3
• Maintain regular mealtimes, as irregular eating patterns are associated with increased symptoms 3
• Avoid late meals and wait 2-3 hours after eating before lying down 1
• Separate liquids from solids during meals to reduce gastric distension 1

Symptom-Specific Dietary Adjustments

For Stomachache and Gastric Distention:

• Avoid irregular meal sizes and mealtimes 3
• Limit restaurant dining which is associated with these symptoms 3
• Reduce consumption of meats, barbecue, fried foods, sour foods, sweets, and salty foods 3

For Reflux Symptoms:

• Elevate the head of the bed for patients troubled with heartburn or regurgitation when recumbent 1
• Weight loss should be advised for overweight or obese patients 1
• Consider a reduced-carbohydrate diet, which has shown to decrease symptoms in some patients 4

Gender-Specific Considerations:

• For male patients, particular attention should be paid to limiting alcohol, barbecue, and spicy foods, which are strongly associated with symptom exacerbation 3
• For female patients, limiting sweet foods may be especially important as they are associated with all symptoms 3

Medical Treatment

Pharmacological Options:

• Proton pump inhibitors (PPIs) are more effective than histamine 2 receptor antagonists (H2RAs) for acid suppression 1
• For short-term treatment, H2RAs like ranitidine can be used at 150 mg twice daily for gastritis symptoms 5
• Antacids can be given as needed for pain relief 5

Monitoring and Follow-up:

• Monitor for vitamin and mineral deficiencies (B12, iron, calcium, magnesium, zinc) in patients with severe atrophic gastritis 6
• Assess for H. pylori infection, which is the main cause of chronic gastritis globally 6

Common Pitfalls to Avoid

• Assuming all patients benefit from the same dietary restrictions; dietary modifications should be tailored to individual symptom triggers 1
• Neglecting the importance of eating habits (speed, regularity) which significantly impact symptoms 3
• Overlooking potential nutritional deficiencies in severe or long-standing gastritis 6
• Focusing solely on medication without addressing dietary factors, when 58% of patients report symptom correlation with diet 3