Acute and chronic gastritis (inflammation of the stomach) are common. Typical complaints include nausea, feeling of fullness and epigastric pain. Acute gastritis heals after a few days, whereas with chronic gastritis, the symptoms persist for weeks. In addition to treating the cause, if that's possible, adequate nutrition that covers the nutritional needs and spares the stomach is important. Dietary supplements can be useful in the treatment of chronic gastritis.
- In the event of gastritis, light, light food is recommended: Low-fat, high-carbohydrate food. Hard-to-digest foods are to be avoided.
- Coffee, alcohol and smoking put additional strain on the stomach.
- A gluten-free diet only makes sense if you have celiac disease at the same time.
- The cause of gastritis should be treated if possible.
- Vitamin B12 substitution is important for atrophic gastritis.
How is gastritis classified?
A distinction is made between acute and chronic gastritis. In acute gastritis, the gastric mucosa reacts to an incompatible inflammation with the production of increased gastric acid. Nausea, abdominal pain and a feeling of fullness result. After a few days, the symptoms subside, and in more persistent cases, drugs that inhibit the production of stomach acid can aid healing.
Chronic gastritis, in which the symptoms last longer, is divided according to the underlying cause: Type A gastritis is an autoimmune issue. This means that the immune system is directed against the body's own cells in the gastric mucosa. It destroys the parietal cells that produce the stomach acid as well the intrinsic factor that is necessary for the uptake of vitamin B12. Type B gastritis involves the bacterium Helicobacter pylori. Type C gastritis is attribued to the gastric mucosal-damaging effect of noxae, e.g. alcohol, reflux of bile acids or medicinal side effects.
|Acute inflammation of the stomach||Chronic inflammation of the stomach|
|Reaction e.g. to stress, heavy or spoiled food, alcohol excess; Overproduction of stomach acid; Improvement of its own accord after a few days, but transition into chronic gastric mucosal inflammation is possible||Type A: Autoimmune mediated destruction of gastric acid and intrinsic factor producing parietal cells.|
|Type B: The cause is an infection with the Helicobacter pylori bacterium. The bacterium reduces the production of protective gastric mucus. The gastric mucosa is insufficiently protected from the effects of stomach acid.|
|Type C: Chemical noxae as the cause of gastritis. Alcohol, medication or biliary reflux damage the stomach lining|
Table 1: Overview of the different forms of gastritis
Do you have to follow certain nutritional rules if you have gastritis?
There is no precise regulation as to what a good diet should look like for gastritis. It is important that the stomach is not additionally burdened with food that is difficult to digest, high in fat or with a large number of additives.
The stomach can be relieved by choosinglight food. The following carbohydrate-rich, low-protein and low-fat dishes are considered easy to digest: oats, steamed vegetables with the exception of cabbage, mild fruits with little acidity and lean poultry. The dishes should be eaten in small portions and only gently seasoned. Lean natural dairy products can be eaten depending on individual tolerance. Drinks such as coffee and alcohol stimulate gastric acid production even further and should be avoided. Table 2 gives an overview of easy and difficult to digest foods. Nutrition counseling, for example via our online service Cara Care, can help those affected to select suitable meals and to develop a tolerated diet.
|Food group||Difficult to digest||Easy to digest|
|Breat||Coarse whole grain breads, fresh breads and rolls||Breads made from finely ground flours, rusks|
|Grain||Individual variations||Oats, semolina, rice, cereal flakes after tolerance|
|Bakery products||Fried and greasy baked goods and cakes with cream or cream||Baked goods made from light yeast dough, fruit cake without cream, dry biscuits|
|Potatoes||Potato pancakes, French fries||Boiled and jacket potatoes|
|Vegetables||Cabbage, radish, radish, beans, legumes, mushrooms, peppers||Fennel, carrots, green leafy vegetables, zucchini|
|Fruit||Fruits such as cherries, apricots; unripe fruit||Bananas, apples, pears, citrus fruits after tolerance|
|Milk and dairy products||Full fats and cream products, strong cheeses||Lean milk products, mild cheese according to individual tolerance|
|Meat||Fatty and smoked sausages, fatty meat (duck, pork neck), roast, bacon||Lean meat, especially poultry, lean beef; low-fat preparation method important; lean ham|
|Fish||Fat fish (eel, salmon, herring)||Lean freshwater and saltwater fish (trout, plaice)|
|Eggs||Hard-boiled eggs, fatty egg dishes, mayonnaise||Poached and soft-boiled eggs according to individual tolerance|
|Fats and oils||Greasy foods, butter, lard||Cold-pressed vegetable oils in small quantities|
|Spices||Hot spices (chilli, curry, onion, garlic)||Mild dried herbs, caraway seeds, fennel, turmeric, pepper (moderate)|
|Beverages||Black coffee, peppermint tea, ice-cold and carbonated drinks, undiluted fruit juices, lemonade, cola||Mild herbal teas with fennel, anise, caraway, chamomile tea, diluted juice spritzers, no ice-cold drinks, mild milk coffee and green tea according to tolerance|
|Food||Frying, deep-frying, breading||Steam, cook in foil, cook in the oven, grill without fat|
Table 2: Well and poorly tolerated food
How should meals be spread throughout the day?
If you are experiencing gastritis, your stomach should be protected as much as possible. Five smaller meals a day is optimal. Meals should be ingested without hassle and chewed well to aid the digestive process.
How can dishes that are gentle on the stomach be prepared?
When looking for recipes for gastric food, qualified nutritional advice can be helpful. Light porridge such as warm oatmeal or semolina porridge, which can be served with unsweetened compote, is particularly gentle on the stomach. Oatmeal is recommended for gastritis, as experience has shown that this dish is particularly gentle on the gastric mucosa. Half a cup of finely ground oatmeal is boiled with 1.5 cups of water. The oatmeal is left on the stove for about ten minutes so that it can swell. A small pinch of salt can also be added. The internet offers numerous recipe ideas. Recipes for porridge, semolina porridge and similar dishes can be found using a search engine.
Does a gluten-free diet make sense for chronic gastritis?
Patients with chronic gastritis who are also affected by celiac disease should follow a gluten-free diet. A sub-form of gastritis, lymphocytic autoimmune gastritis, often occurs together with celiac disease. With a gluten-free diet, both celiac disease-related symptoms and symptoms from lymphocytic gastritis are reduced. Patients who do not have celiac disease get no additional benefits from a gluten-free diet.
What should special attention be paid to with atrophic gastritis?
In atrophic gastritis, the gastric acid-producing cells, which also produce the intrinsic factor, are destroyed. The intrinsic factor is used to absorb vitamin B12 from food. This can only be taken up together with the intrinsic factor in the terminal ileum. People with atrophic gastritis must therefore substitute vitamin B12 in the form of high-dose food supplements or as an injection under the skin. Otherwise they develop a vitamin B12 deficiency. The substitution should be checked by a doctor to rule out a deficiency. Long-term vitamin B12 deficiency leads to anemia and damage to the nervous system.
The rest of the diet should be designed according to individual tolerance.
What are the recommendations for type B and type C gastritis?
In addition to a stomach-friendly diet for type B gastritis, treatment of the Helicobacter pylori bacterial infection is essential. The therapy consists of a combined antibiotic administration and a drug that inhibits stomach acid production.
If there is type C gastritis, the triggering agent has to be identified, i.e. the substance that causes gastritis. This can be medication, smoking or alcohol. Other causes, such as the backflow of bile into the stomach, are also possible. If possible, the cause should be remedied. The triggering medication should be discontinued if this is medically justifiable. Alternatively, you can switch to products that are easier on the stomach. If this is not possible, additional stomach protection can be prescribed. Smoking and alcohol consumption should be discontinued.
Adam, Olaf (Hrsg.): Ernährungsmedizin
in der Praxis – Band 2: Kap. 4/3.2, S. 2-5, Loseblattwerk, Spitta Verlag GmbH & Co KG 2007, Balingen
Tusch-Harke, M., & Beer, A. M. (2012). Sprechstunde Naturheilkunde-Gastritis. MMW-Fortschritte der Medizin, 154(17), 30., online: https://www.ncbi.nlm.nih.gov/m/pubmed/23088031/, accessed on April 3, 2018
Müller, H., Rappel, S., Volkholz, H., & Stolte, M. (2001). Die lymphozytäre Gastritis–eine seltene Erkrankung der Magenschleimhaut. Der Pathologe, 22(1), 56-61., online: https://link.springer.com/article/10.1007/s002920000434, accessed on April 3, 2018