What foods and drinks should be avoided in gastritis?

Foods and Drinks to Avoid in Gastritis

Patients with gastritis should strictly avoid alcohol, coffee/tea (limit to 3 cups/day maximum), carbonated beverages, spicy foods, fatty/fried foods, citrus fruits, chocolate, and foods high in simple sugars, while also limiting acidic foods and adopting smaller, more frequent meals. 1, 2

Primary Dietary Irritants to Eliminate

Beverages

• Alcohol must be limited or eliminated entirely as it is a well-established gastric irritant that directly damages the gastric mucosa 1
• Coffee and tea should be restricted to maximum 3 cups per day, as caffeine stimulates acid production and can worsen symptoms 3
• All carbonated beverages should be avoided, including fizzy drinks and sodas, as they increase gastric distension and reflux 3, 1, 2

Foods That Trigger Acid Production and Irritation

• Spicy foods should be eliminated as they are consistently identified as gastric irritants across multiple guidelines 3, 1, 4
• Fatty and fried foods must be avoided as they slow gastric emptying and worsen symptoms 3, 1, 2
• Chocolate should be eliminated as it reduces lower esophageal sphincter pressure and promotes reflux 1, 2
• Citrus fruits and acidic foods (including tomato products) should be limited or avoided as they may precipitate heartburn and worsen gastric irritation 3, 1, 2

Processed and High-Sugar Foods

• Simple sugars and high glycemic index foods should be reduced, as they can trigger rapid gastric emptying and worsen symptoms 5
• Processed meats and foods high in salt should be limited 1
• Artificial sweeteners like sorbitol should be avoided, particularly if diarrhea is present 3

Specific Food Categories to Limit

Vegetables and Fruits

• Raw vegetables, particularly cruciferous vegetables (broccoli, cauliflower, cabbage), should be avoided during acute symptoms as they increase gas and bloating 3, 5
• Limit fresh fruit to 3 portions per day (approximately 80g each) to avoid excessive fructose intake 3
• Avoid citrus pith and persimmons as these can form phytobezoars in the stomach 3, 2

Protein Sources

• Red meat should be limited and replaced with lean proteins like chicken, turkey, or fish 3, 1, 2

High-Fiber Foods

• Insoluble fiber (such as bran, whole-meal flour, and high-fiber breads) should be reduced or avoided during symptomatic periods 3
• Resistant starch found in processed or recooked foods should be limited 3

Optimal Eating Patterns

Meal Timing and Frequency

• Eat 4-6 smaller, more frequent meals throughout the day rather than 3 large meals to reduce gastric distension 1, 5
• Avoid eating within 2-3 hours before bedtime to prevent nighttime reflux 2
• Have regular meals and avoid missing meals or leaving long gaps between eating 3

Eating Behaviors

• Take small bites and chew food thoroughly in a relaxed manner 3, 2, 5
• Separate liquids from solids during meals by abstaining from drinking 15 minutes before and 30 minutes after meals to reduce gastric distension 1, 2, 5
• Eat slowly to reduce the risk of reflux 2

Foods to Emphasize (What TO Eat)

• Cooked vegetables are better tolerated than raw vegetables 3
• Lean proteins (poultry, fish) should form the basis of protein intake 3, 1
• Whole grains in moderation (not high-fiber varieties during acute symptoms) 1
• Legumes at least twice weekly once symptoms are controlled 1
• Drink at least 8 cups of fluid per day, preferably water or non-caffeinated herbal teas 3

Critical Caveats

The most common pitfall is assuming all patients benefit from identical dietary restrictions - while the above recommendations provide a framework, symptom triggers can vary between individuals 1. However, the core irritants (alcohol, caffeine, carbonated beverages, spicy foods, fatty foods) should be avoided universally in gastritis patients.

Research shows that 58% of chronic gastritis patients report their symptoms are directly related to dietary factors, with irregular mealtimes, irregular meal sizes, and eating too fast being the most problematic habits 4. The strongest dietary associations with symptoms include irregular meal sizes, barbecues, snacks, salty foods, and sweets 4.

For patients with severe atrophic gastritis or autoimmune gastritis, acid suppressant medications are contraindicated as these patients already have achlorhydria (absence of stomach acid) 6. In these cases, the dietary approach focuses on mechanical prevention of reflux rather than acid reduction 6.