What diet is recommended for individuals with gastritis?

Dietary Recommendations for Gastritis

For individuals with gastritis, adopt a diet emphasizing small, frequent meals of easily digestible foods (bananas, rice, applesauce, toast), while eliminating alcohol, lactose-containing products, and high-osmolar supplements as first-line dietary management. 1

Core Dietary Principles

Meal Pattern and Eating Behavior

• Consume small, frequent meals rather than large meals to reduce gastric irritation and improve digestion 2
• Eat slowly and chew food thoroughly to minimize mechanical irritation of the gastric mucosa 2
• Drink fluids 30 minutes before or after eating, not during meals to optimize digestive function 2
• Avoid carbonated beverages to reduce gas formation and gastric distension 2

Foods to Emphasize

• Easily digestible foods form the foundation: bananas, rice, applesauce, and toast (BRAT diet components) 1
• Bananas specifically help thicken stool output and replace potassium that may be depleted 2
• Soluble fiber sources like ispaghula should be started at low doses (3-4g/day) and gradually increased to avoid bloating 1
• High-molar-mass oat beta-glucans have demonstrated beneficial effects in reducing mucosal damage and improving antioxidant parameters after 30 days of use 3

Foods and Substances to Eliminate

• Immediately eliminate alcohol, lactose-containing products, and high-osmolar supplements as first-line dietary intervention 1
• Avoid insoluble fiber sources like wheat bran, which may exacerbate symptoms 1
• Reduce or eliminate simple and complex carbohydrates, particularly refined carbohydrates and sugars, as these promote inflammation 4, 5
• Limit processed foods, red and processed meats, and foods high in saturated and trans fats 4

Anti-Inflammatory Dietary Pattern

Mediterranean-Style Approach

• Prioritize whole grains, fruits, vegetables, and healthy fats, which have been linked to reduced inflammation and lower risk of chronic gastrointestinal diseases 4
• Diets higher in fiber, vegetables, fruits, and whole grains promote beneficial gut bacteria growth and reduce gastrointestinal inflammation 4

Specific Foods with Evidence

Clinical research has evaluated several specific foods for gastritis treatment, though evidence quality varies 6:

• Garlic, turmeric, broccoli sprouts, and cranberry juice have been studied clinically 6
• Honey and specific oils show potential benefits 6
• For atrophic gastritis specifically, adenosylcobalamin-rich foods, soybeans, common wheat, dates, and barley may be beneficial 7

Important caveat: The clinical literature on specific food-based therapies presents high risk of bias and requires more rigorous validation 6

Hydration Management

• Maintain adequate fluid intake of at least 1.5 liters daily to prevent dehydration 2
• Increase fluid intake if experiencing diarrhea or vomiting 2
• Space fluid consumption away from meals as noted above 2

Probiotics and Prebiotics

• Consider probiotic-containing foods (yogurt, fermented milk, kefir) to support beneficial gut bacteria 4, 6
• Prebiotic fibers encourage growth of beneficial bacteria and may help manage inflammatory conditions 4
• These dietary components have regulatory effects on inflammatory gastrointestinal diseases 4

Advanced Dietary Interventions

Low FODMAP Diet

• Reserve low FODMAP diet as second-line therapy for persistent symptoms despite initial dietary modifications 1
• Implementation must be supervised by a trained dietitian to ensure nutritional adequacy 1
• This approach is particularly relevant when symptoms overlap with irritable bowel syndrome features 4

Controversial Approach: Acid pH Foods

One study suggests that adding acidic foods (lemon juice, fresh tomatoes) combined with carbohydrate restriction may reduce gastric acid production paradoxically and improve symptoms 5. However, this contradicts traditional gastritis dietary advice and requires cautious interpretation given limited evidence.

Critical Pitfalls to Avoid

• Do not use opioids for chronic gastritis-related pain due to addiction risk and paradoxical pain amplification 1
• Avoid exhaustive dietary restrictions that could lead to nutritional deficiencies, particularly in atrophic gastritis where vitamin B12, iron, calcium, magnesium, and zinc absorption may already be compromised 8
• Do not ignore H. pylori status, as dietary recommendations may differ based on infection presence 7
• Recognize that severe atrophic gastritis represents the highest independent risk for gastric cancer and requires medical monitoring beyond dietary management alone 8

Integration with Medical Management

• Dietary therapy works synergistically with antispasmodics (hyoscine butylbromide, dicyclomine) for symptom relief 1
• For persistent symptoms despite dietary modification, tricyclic antidepressants (starting at 10mg amitriptyline daily) are effective second-line treatments 1
• Referral to a specialist gastroenterology dietitian is warranted for patients showing dietary deficits, nutritional deficiencies, unintended weight loss, or those requesting detailed dietary modification advice 4