Gastritis (Stomach Pain)
What Is It and How to Find Relief
Many have suffered from gastritis at some point in their lives. You ate something that disagreed with your stomach, and it burned. You took too many aspirin on an empty stomach for a week when you were recovering from breaking your ankle, and your stomach started to ache. You consumed too much alcohol during a weekend wedding celebration, and now your stomach hurts. What are the numerous causes of gastritis, and what can be done to recover from it?
All About Gastritis
Gastritis refers to inflammation of the stomach lining, which is composed of three main layers: the epithelium, containing mucus-secreting cells that produce protective alkaline mucus; the lamina propria, a connective tissue layer with blood vessels and immune cells; and the muscularis mucosae, a thin band of smooth muscle that moves glandular secretions. The stomach lining also contains gastric glands with parietal cells that secrete hydrochloric acid, chief cells that release digestive enzymes such as pepsinogen, and mucous cells that produce mucus. All these work together to protect the stomach from self-digestion, inflammation, dysbiosis, and injury, while also aiding in the breakdown and preparation of food for absorption in the intestines.1 2 3
The stomach mucosa is composed of proteins, amino acids, minerals, lipids, and protective compounds that form a resilient barrier against acid, enzymes, and pathogens. Structural proteins such as collagen and elastin, made from amino acids like glycine, proline, and hydroxyproline, along with vitamin C, vitamin A, and minerals such as sulfur, zinc, manganese, magnesium, and copper, provide stomach submucosa strength and health. Mucins, large glycoproteins rich in carbohydrates, create the protective stomach mucus layer. Glutathione and sulfhydryl groups protect the stomach mucosal barrier from oxidative stress. These components help the stomach mucosa remain strong, self-repairing, and able to withstand the rigors of digestion.4 5 6 7 8
Growth factors such as epidermal growth factor (EGF) and transforming growth factor (TGF) support stomach lining healing, while hormones such as gastrin and somatostatin regulate acid secretion and mucosal growth. Prostaglandin E2 (PGE2), produced by cyclooxygenase (COX) enzymes, stimulates mucus and bicarbonate secretion, increases mucosal blood flow, and reduces gastric acid output, all of which strengthens the mucosal barrier. Nitric oxide, produced by nitric oxide synthase, promotes vasodilation in the stomach’s microcirculation, ensuring adequate oxygen and nutrient delivery, and supporting healthy mucus secretion.9 [10 . https://pmc.ncbi.nlm.nih.gov/articles/PMC4532093/] 10
Gastritis Causes Include:11 12 13 14 15 16 17 18 19 20 21
- Anticoagulant use (abigatran, apixaban, dabigatran, rivaroxaban, and warfarin)
- Caffeine ingestion
- Carrageenan
- Cirrhosis and liver failure (portal vein hypertension)
- Critical illness or shock (stress-induced gastritis likely caused by decreased blood flow to the stomach)
- Cysts
- Cytostatic medications (for example, mycophenolate mofetil)
- Endoscope biopsy
- Excessive alcohol consumption
- Foodborne illness and poisoning
- Food allergies (eosinophilic gastritis)
- Immune checkpoint inhibitor medications (for example, anti-PD1 medications like cemplimab, anti-PD-L1 medications like avelumab, and anti-CTLA-4 medications like imjudo)
- Infections (bacterial [H. pylori], viral, fungal, and parasitical)
- Iron supplementation (iron bisglycinate might be less irritating)
- Glucocorticosteroid use (might weaken stomach immunity, causing or worsening dysbiosis, and inhibits prostaglandin E2)
- Kidney disease and failure
- Microbial die-off
- Menetrier disease (likely caused by H. pylori dysbiosis)
- Non-steroidal anti-inflammatory COX2 inhibitors (aspirin, curcumin, ibuprofen, meadowsweet, naproxen sodium, turmeric, white willow bark), herbs, supplements, or medications, especially when taken repeatedly on an empty stomach
- Radiation (cancer therapy, excessive exposure)
- Smoking
- Stomach surgery
- Traumatic injury to the stomach
- Tumors
Gastritis Symptoms Are:22 23 24 25 26
- Abdominal pain (worsens usually immediately during/after eating)
- Anxiety
- Burning feeling within your stomach (underneath the bottom of your left rib cage, worsens usually immediately during/after eating)
- Cibophobia (fear of eating)
- Depression
- Dyspepsia (indigestion)
- Early satiety (feeling full early when eating)
- Frequent belching
- Frequent hiccups
- Gnawing feeling within your stomach (underneath the bottom of your left rib cage, worsens usually immediately during/after eating)
- Loss of appetite
- Nausea
- Pernicious anemia, which is known as a form of anemia caused by a vitamin B12 deficiency
- Pressure feeling within your stomach (underneath the bottom of your left rib cage, worsens usually immediately during/after eating)
- Sore feeling within your stomach (underneath the bottom of your left rib cage, worsens usually immediately during/after eating)
- Stomach pain (underneath the bottom of your left rib cage, worsens usually immediately during/after eating)
- Weight loss from loss of appetite
- Upper abdominal bloating
- Upper back deferred pain
- Vomiting (if your vomit is full or red blood or black blood that looks like coffee grounds and smells like, iron go to the emergency room immediately)
Diagnostic tests useful in the diagnosis of gastritis are upper abdominal X-rays, upper abdominal CT scan, endoscopy, total blood cell count testing, vitamin B12 blood serum and methylmalonic acid testing to determine pernicious anemia, H. pylori colonization tests, liver, kidney, gallbladder, or pancreatic function tests, stool sample (check for bleeding and dysbiosis), and stomach biopsy.27 28 29
What to Do to Relieve Your Gastritis
- Avoid taking bismuth, iron, and zinc on an empty stomach. If you have to ingest iron, take iron bisglycinate in divided doses with food throughout the day.
- Consume multiple small meals daily, four to five, to see if your symptoms improve. Food buffers stomach acid, so eating more frequently might help improve symptoms.
- Ingest beets or beet juice for dietary sources of nitrates, which increases the production of nitric oxide within the body when consumed.
- Look into using low-level laser therapy (LLLT) on your stomach a couple of times weekly to accelerate healing.30
- A low vitamin D blood level is associated with the development or worsening of gastritis symptoms.31
- Proper sunlight exposure can help improve symptoms. Sunlight exposure increases nitric oxide expression, especially when your stomach is exposed directly to sunlight.
- Eating spicy food might irritate the lining of your stomach, but it can also stimulate gastric mucosal production and blood flow to your stomach and can relieve pain and inflammation. Try spicy foods and see if they help or make the gastritis worse!
- Supplement with L-glutamine if you can tolerate it or consume bone broth and/or cabbage juice on an empty stomach (do not consume bone broth or cabbage if you have H2S dysbiosis or bone broth if you have histamine intolerance or MCAS).
- Talk with your doctor about switching to different medications if they are causing or worsening your gastritis, and if you must take them, discuss consuming them with food for extra protection.
- Taking basic (pH) minerals like calcium, magnesium, and potassium might irritate the lining of your stomach. You might have to take them in smaller doses throughout the day, sometimes with food, even if they neutralize stomach acid, which may worsen dysbiosis.
- Ten to twenty minutes of daily infrared and red-light LED exposure on your stomach can increase blood flow, stimulate collagen production, and accelerate healing.32
- Treat upper gut dysbiosis if it is your issue.
- Try to get seven to eight hours of sleep nightly. Proper sleep hygiene can help improve your symptoms.
- Quit consuming alcohol, caffeine, and smoking if you are.
- Remain properly hydrated.
Herbs for Gastritis – Start With the Lowest Recommended Dosages With Food to Determine Tolerance
- George’s aloe vera – consume one-ounce ten minutes before a meal twice daily.
- Lemon balm tea – consume one cup twice daily with food.
- Now slippery elm extract – mix one teaspoon well with eight ounces of water and let sit for a few minutes before consuming ten minutes before a meal once or twice daily. Do not supplement if you cannot tolerate oxalate ingestion and suffer from poor oxalate metabolism.
- Organic chamomile tea – consume one cup twice daily with food.
- Solaray marshmallow extract – one capsule twice daily ten minutes before food.
Supplements For Gastritis – Start With the Lowest Recommended Dosages With Food to Determine Tolerance
- N-acetyl glucosamine – Start with one capsule with a meal daily, and increase to two capsules with a meal, divided if needed. Use caution if you have Candida dysbiosis.
- Omega-3 fatty acids – Use caution if you are suffering from bile reflux.
- Quercetin – Quercetin may be a weak proton pump inhibitor, which could reduce stomach acid production and hinder digestion. If you can tolerate it, take it on an empty stomach away from food. I would caution against using quercetin in anyone with catechol-O-methyltransferase (COMT) enzyme deficiency, which is likely due to a genetic polymorphism and overmethylation. Supplementation of quercetin in people with COMT enzyme deficiency may cause or increase the frequency of certain symptoms, including anxiety, brain fog, mania, schizophrenia, delusions of grandeur, bipolar disorder (mania), and estrogen dominance. Finally, quercetin has been shown to possibly cause or worsen Hashimoto’s thyroiditis and hypothyroidism by interfering with thyroid cell growth, reducing iodide uptake, and decreasing the expression of the thyrotropin receptor, thyroid peroxidase, and the thyroglobulin gene. Take one capsule with food to see how you tolerate it and you can increase to two capsules daily in divided doses depending on tolerance.
- https://www.ncbi.nlm.nih.gov/books/NBK544250/ ↩
- https://www.ncbi.nlm.nih.gov/books/NBK482334/ ↩
- https://www.ncbi.nlm.nih.gov/books/NBK535425/ ↩
- https://www.sciencedirect.com/science/article/pii/S1742706124007335 ↩
- https://www.sciencedirect.com/science/article/pii/S1742706124007335 ↩
- https://www.sciencedirect.com/science/chapter/edited-volume/abs/pii/B9780323027526500122 ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7500085/ ↩
- https://pubmed.ncbi.nlm.nih.gov/10470601/ ↩
- https://pubmed.ncbi.nlm.nih.gov/8590137/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC2582807/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10341309/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11085445/ ↩
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastritis ↩
- https://pubmed.ncbi.nlm.nih.gov/37042078/ ↩
- https://www.jacionline.org/article/S0091-6749(23)00753-4/fulltext ↩
- https://www.gastrojournal.org/article/S0016-5085(20)34826-5/fulltext ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8441963/ ↩
- https://www.mayoclinic.org/diseases-conditions/gastritis/symptoms-causes/syc-20355807 ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC7105238/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3210241/ ↩
- https://www.mdpi.com/2624-5647/5/3/27 ↩
- https://www.niddk.nih.gov/health-information/digestive-diseases/gastritis-gastropathy/symptoms-causes ↩
- https://www.merckmanuals.com/home/digestive-disorders/gastritis-and-peptic-ulcer-disease/gastritis#Symptoms_v753765 ↩
- https://www.cureus.com/articles/169618-a-comprehensive-review-of-upper-gastrointestinal-symptom-management-in-autoimmune-gastritis-current-insights-and-future-directions#!/ ↩
- https://link.springer.com/article/10.1007/s11938-020-00298-8 ↩
- https://digitalcommons.library.tmc.edu/cgi/viewcontent.cgi?article=2373&context=baylor_docs ↩
- https://www.mayoclinic.org/diseases-conditions/gastritis/diagnosis-treatment/drc-20355813 ↩
- https://www.ncbi.nlm.nih.gov/books/NBK544250/ ↩
- https://www.niddk.nih.gov/health-information/digestive-diseases/gastritis-gastropathy/diagnosis ↩
- https://pubmed.ncbi.nlm.nih.gov/25916131/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6225568/ ↩
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10835098/ ↩
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The product is not effective as it used to be. It has changed! It has no longer the same ingredients and properties. I would be very grateful if you could tell us what to buy instead.
As one client has noticed on Amazon: ” you look at the ingredients before the change it had 760mg of DGL, now it only has 75mg of DGL.”
Thanx!
Also, Jarrow D-Limonene is no longer available. What else could we take to replace it?
Thanx!
How can I tell if I have gastritis, GERD or gallstones. I’ve tried conventional doctors and alternative doctors. The two alternative doctors suspect Gastritis. I was on PPI’s for years and weaned off them. I have had burning pains just to the right of my chest bone ever since and also above my right hip, I have tried treating it as gallstones for two years but I am starting to think that it is not gallstones. Gerd was something I used to have but I have not suffered from reflux for at least 3 years, at least not reflux to my throat. Unless it is still reflux but maybe doesn’t travel as far as it used it used tio? That leaves gastritis. I’ve recently started taking capsules for Slippery Elm, Marshmallow root and DGL licourice. I guess they need time, but should I add D Limonene? Am I on the right track? It’s been years and honestly the pain is ruining my quality of life. Thanks for the interesting article.
you have heartburn. have you tried digestive bitters before you eat, chewing very slowly, smaller meals and if those don’t work apple cider vinegar.
Hello sir i am suffering from lax LES and and burning sensation just below the diafram at all time for last 07 years
Plz suggest me treatment
Dont know where to start. Been diagnosed with Diverticular Disease. Have had a couple bouts of Diverticulitis. Would like to find out if i can heal this or keep under control. When i look at various diets they are all over the place some say no yogurt, apples, pears, plums, fermented foods. And others save Mediterranean Diet. Looking for diet and supplement info.
Hello,
I’m looking for some help and direction with this. I’ve had gastritis for over 4 months now, for a few years I was doing shots in my back twice am onth that contained toradol. I have been off that for almost two months now. Do you know anything about whether this could cause it and how long the recovery time may be? Can I drink coffee and alcohol if it was caused by the NSAIDS?
Thanks,
Alex
Have had Gastritis for 4 months now. So I just purchased Aloe Juice,, slippery elm, zinc carnosine, licorice chews. Can all of these be taken at the same time? I’m also concerned with zinc carnosine hurting my stomach and insomnia. What is your take? How long does it take to heal gastritis? I tested negative for H pyloric and am on Prilosec
The formula for the DGL you recommend has changed. Now only 75mg per serving! Do you recommend a new product. How about Nova Nutritions?
https://www.amazon.com/Vital-Nutrients-Nutritional-Intestinal-Vegetarian/dp/B000KYMBT4/ref=sr_1_4_s_it?s=hpc&ie=UTF8&qid=1538620982&sr=1-4&keywords=DGL+powder
hello. Ive been suffering for a number of years. I’ve been told by a NYC doc that my LES remains open during the entire examination. I was positive for barretts three years ago, but then the following two endoscopies (1 year later and then another swallow test at 18 pos post barretts) and couldn’t detect it barretts, just esophagitis. I changed my diet so that helped with some inflammation I’m guessing. I have constant dull pain around the LES area and then most nights are really difficult with reflux pain even though i’m propped up significantly. I’ll have a couple ok nights then a couple awful nights. I’m working on mediation, chewing and eating much slower and eliminating excess belly fat, which i do have. What do you suggest? over the past 3 years I’ve tried D-limonene, bitters, cold herb teas like marshmallow root, gabapentin for vegas nerve damage, enzymes, HCL, celery juice, aloe vera from the plant mixed with coconut water. grain free, dairy free, without meat, with meat. LMK if you have any advice so I can enjoy my three young children and not be afraid to go to sleep at night. Thank you!
Hi John,
Thank you for your interesting article.
There is a warning on this D-Limonene to not take it if you have gastritis: https://www.swansonvitamins.com/swanson-ultra-d-limonene-cold-pressed-orange-peel-extract-250-mg-60-sgels
I am really wanting to reduce gastritis but this makes me nervous to try it.
I would appreciate your feedback if you have time.
For some people it could irritate their stomach for a brief period of time. Taking it with zinc carnosine may protect against it.
Curious as to what route you chose after all.
Hi John,
In the context of having sibo/ yeast overgrowth with normal of even high stomach acid….what herbal antibiotics are best to use when one has gastritis? I know oregano is out for sure (ADP oregano caused my gastritis). I just found out dybiocide increase stomach acid. Is neem and garlic typically well tolerated? How about berberine (non hcl version). Atrantil is probably out because of the mint. Thoughts?
D-limonene, zinc carnosine, bismuth, clove oil mixed with extra virgin olive oil, mastic gum?
Hi
I was diagnosed with GERD a few years ago. I started taking antidepressants and it got under control. I still had to watch what I eat. Last month I had to take prednisone for an asthma attack which caused acid reflux and then it messed up my stomach. Very painful and can’t eat much. I was tested positive for H pyorli. I had to take two antibiotics and Prilosec for 10 ten days. I’m currently weaning off the PPI. Now I have some type of bile coming into my mouth constantly, heart burn and acid reflux. My GI doc thinks I have a lazy stomach, but all this started after I used prednisone. Do you think my current symptoms be from the bacteria or did the predisone just mess up my stomach? GI doc isn’t ready to do a scope yet. Just a bland diet for now.
Hi John.
Interesting comments. Three years ago I had an endoscopy for long-term unresolved issues with acid reflux. H. pylori biopsy negative. Severe esophagitis, ulcers, and gastritis, all but the gastritis resolved with 1 year of Prilosec and a bland diet. It took me a year to get off the Prilosec, and I’ve now been mostly free from reflux for only a month, thanks mainly to zinc carnosine, glutamine, and a restricted carbohydrate diet. I still have the gastritis. As I read your comment above, is it possible to assume that the gastroenterologist did not find anything but I am infected with pylori anyway? I don’t use NSAIDs. Is there a more accurate test for pylori than biopsy? I’d rather not go through that again. I’m 55, and have suffered from reflux since I was a baby.
Their is a fecal test you can do for H-pylori. I too had ulcers with no h-pylori and no NSAIDs. My functional medicine dr didn’t believe my stomach biopsy results and did the fecal test which according to him is more sensitive and shows all bacteria, fungus, and parasites in your GI tract. It also came up negative. I till maintain that my ulcers came from Ambian. My stomach starting killing when I started taking this drug. I am all better using natural protocol. I still get some silent reflux occaisionally. the zinc carnosine was a game changer, so was cabbage juice for a week. side note neurofeedback is a great alternative to sleep medications.
Have you tried probiotics? Something rang a bell when you said that you had been suffering from GERD since when you were a baby.
In France they give L. reuteri to babies to help them with this issue. But this probiotic is used in the US and some other countries to fight H. Pylori!
My husband and I were diagnosed with chronic gastritis during a gastroscopy. Ten years later it was still there, another gastroscopy confirmed it. After taking this probiotic (to relieve the SIBO-related symptoms: GERD, bloating, distention, constipation…) for a couple of months my husband’s third gastroscopy in eleven years came back negative for gastritis!
Btw, he was positive and teated for H. pilory with antibiotics before taking this probiotic. His symptoms remained. I was tested for times, biopsy, blood, breath and the results always came back negative.
Hope this helps someone… I know that my comment is somewhat late.
Thank you. I’ve doing all above protocols with no relief after more than a month. Endoscopy showed severe gastritis. Take DGL, slippery elm, marshmallow tea. Glutamine causes me insomnia and amps me up. Now on Prilosec for over a month, low fat, low avid diet. Zinc carnosine over a month. Also doing homeopathy for a week. Nat sulphuric, phosphorus and arsenicum. Still in pain
Endoscopy showed bile in my stomach and I don’t have a gallbladder…since 06. Have frequent gastritis but not like this. Have been under a lot of stress. No h pylori, no nsaids, no bad diet. Can this all be from stress? I think bile is playing a part and no one addresses that. George’s aloe seems to possibly irritate so I stopped it. Sometimes take Thorne GI encaps. I just need to get rid of this pain
Husband has stage 4 prostate cancer do I need to be healthy.
Thanks for any help
Hi John. I am thinking of trying d-limonene for the GERD I developed after taking a PPI for gastritis. The PPI caused many issues, GERD being one of them. I’m not sure if I still have gastritis or not. Is d-limonene safe to take if the gastritis is still there? Thanks for your help.
For most people use, it would coat the ulcers and reduce inflammation. Zinc carnosine may also cause relief.
Hi John,
My grandma is 70 years old, long hx of gastritis, with her gastritis she has severe anxiety she says that she feels in her gut. The ONLY thing that has helped her is Megestrol acetate…she said her anxiety is gone, she can eat again, she feels back to normal. Her doc won’t prescribe it to her anymore (something with FDA) I don’t know much about megestrol except that its a progestin. Any thoughts on what might be going on? …my thoughts are something to do with her sex hormones…low GABA? Low serotonin?
Would love your feedback.
PS, she tested negative for H. pylori
Can any of the supplements on the mild protocol cause or worsen constipation? I use to love D-limonene, and it worked wonders, but my stomach has gotten super sensitive and even that bloats me now (after stopping using it for a year or two). Could I just need time to adjust?
Yes, die off from D-limonene would increase hydrogen for a short time which would increase Archaea, increase methane production, bloating, and constipation. It could work better with time, but I would recommend talking to your doctor about trying Atrantil.