From the Guidelines
Management of severe gastritis requires a comprehensive approach targeting both symptom relief and underlying causes, with the most recent and highest quality study 1 suggesting that eradication of H. pylori infection is crucial in preventing gastric cancer and peptic ulcer disease. Initial treatment includes proton pump inhibitors (PPIs) such as omeprazole 40mg daily or esomeprazole 40mg daily for 4-8 weeks to reduce stomach acid production. For H. pylori-associated gastritis, triple therapy is essential: a PPI plus two antibiotics (typically amoxicillin 1g twice daily and clarithromycin 500mg twice daily) for 14 days, as recommended by the most recent study 1. Some key points to consider in the management of severe gastritis include:
- Discontinuation of NSAIDs, alcohol, and smoking which can worsen inflammation
- Use of antacids like aluminum hydroxide/magnesium hydroxide for quick symptom relief between PPI doses
- Dietary modifications, such as eating smaller, more frequent meals and avoiding spicy foods, caffeine, and acidic items
- Consideration of hospitalization for IV fluids, parenteral PPIs, and monitoring in severe cases, especially if bleeding is present
- Follow-up endoscopy after treatment to confirm healing, particularly in cases with suspicious lesions or persistent symptoms, as suggested by 1 and 1. It is also important to note that the prevalence of H. pylori infection has steadily declined in more affluent countries due to improvements in sanitation, standards of living, and housing, as reported in 1. However, the risk of gastric cancer remains high in certain populations, and eradication of H. pylori infection is crucial in preventing this disease, as highlighted in 1. Overall, the management of severe gastritis requires a comprehensive approach that takes into account the underlying causes of the disease, as well as the latest evidence-based treatments, such as those recommended in 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Management Options for Severe Gastritis
The management of severe gastritis often involves a combination of medication and treatment of the underlying cause. Some of the management options include:
- Medications to reduce inflammation and heal the stomach lining, such as proton pump inhibitors (PPIs) like omeprazole 2 and lansoprazole 3, 4
- Antib antibiotics to treat Helicobacter pyli (H. pyli) infection, which is a common cause of gastritis 5, 6, 3, 4
- Avoidance of irritants like nonsteroidal anti-inflammatory drugs (NSAIDs) and cigarettes, which can exacerbate gastritis 5
Treatment of H. pyli Infection
Treatment of H. pyli infection typically involves a combination of antibiotics and a PPI. The combination of omeprazole, amoxicillin, and clarithromycin is a common regimen against H. pyli 5. Eradication of H. pyli can lead to resolution of gastritis and may induce partial regression of pre-existent gland loss 6.
Role of Proton Pump Descriptors
Proton pump descriptors (PPIs) like omeprazole and lansoprazole have been shown to be effective in reducing inflammation and healing the stomach lining in patients with severe gastritis 2, 3, 4. They also have antibacterial activity against H. pyli and can interfere with the cellular immune response to infection 4.