Treatment of Gastritis and Colitis – The Best Medications and Effective Treatment Methods

At Town Hospital we see cases of gastritis daily, ranging from mild to severe. The symptoms may be bothersome and intermittent or persistent and affect your quality of life. This guide gives you a comprehensive picture: What is gastritis? What are its causes? How do we distinguish between acute and chronic? When should you visit a doctor? And what are the best treatment and prevention methods according to the cause?

Important note: The following information is educational and is not a substitute for consulting a doctor. Do not start or stop any medication without consulting a specialist.

What Is Gastritis?

Gastritis is inflammation and irritation that affects the stomach lining (Mucosa). It may be:

• Mild with no obvious symptoms,
• or moderate/severe with pain, heartburn, bloating, and nausea,
• and it may appear suddenly (acute) or persist for long periods (chronic).

Gastritis is considered a complication or result of multiple factors, the most common being: infection with Helicobacter pylori bacteria (the stomach bacteria H. pylori).

The Difference Between Acute and Chronic Gastritis

Acute Gastritis

• Starts suddenly and is often temporary.
• It may improve within days to a week by avoiding irritants and with appropriate treatment.
• Neglecting it may lead to ulcers or bleeding in rare cases.

Chronic Gastritis

• Develops gradually and lasts months or years.
• It may cause atrophy in the stomach lining and affect the production of acid and enzymes.
• It may result in vitamin B12 deficiency and pernicious anemia, and is considered a risk factor for some stomach diseases in the long term.

Causes of Gastritis and Risk Factors

Most Prominent Causes

1. Bacterial infection with H. pylori (stomach bacteria).
2. Overuse of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin.
3. Alcohol and smoking.
4. Bile reflux from the duodenum into the stomach.
5. Autoimmune inflammation (the body attacks the stomach lining).
6. Viral/fungal infections and systemic conditions (such as sarcoidosis, eosinophilic).
7. Radiation therapy or major injuries/surgeries.

Factors That Increase the Likelihood

• Chronic stress, eating irregular meals, spicy or fatty foods frequently.
• Family history of stomach disorders.
• Advanced age (weakening of the stomach's mucosal protection over time).

Symptoms of Gastritis

Symptoms may not appear in some patients (especially with H. pylori), but the common ones are:

• Pain/heartburn in the upper abdomen (in the middle or on its left side) and may extend to the back.
• Bloating, nausea, vomiting (clear/yellow/green).
• Early fullness, loss of appetite, belching.

Signs of Severity That Require Urgent Care

• Bloody or dark vomit, black or bloody stool.
• Severe abdominal pain, dizziness/fainting, excessive sweating, palpitations, shortness of breath.
• Chest pain or fever accompanied by abdominal pain.

If the symptoms are sudden and severe → it is often acute. And if they are long-term → it is more likely chronic.

When Should I See a Doctor?

• Persistence of indigestion/pain for more than a week despite dietary modification and simple antacids.
• Warning symptoms (bloody vomit, black stool, unexplained weight loss, difficulty swallowing, fever with abdominal pain).
• Recurrence of symptoms or failure of home treatments.

Note: Stomach pain is not always gastritis; it may be irritable bowel syndrome or an ulcer or acid reflux… Proper diagnosis is important.

Possible Complications

• Peptic ulcer (stomach/duodenum) which may be accompanied by bleeding.
• Anemia (iron or B12 deficiency) especially with H. pylori or autoimmune.
• Atrophic gastritis which weakens acid and enzyme secretion.
• Long-term risk to the stomach lining in some chronic cases.

How Do We Diagnose Gastritis at Town Hospital?

We start with a medical history and clinical examination, then we choose from the following tests according to the case:

1. Tests for stomach bacteria:
2. • Urea breath test, or stool, or blood (the most accurate: breath/stool).
3. General stool test: to detect infection or bleeding.
4. Upper endoscopy: direct viewing of the stomach lining and taking a biopsy when needed.
5. Barium X-ray: in limited scenarios.

The choice of test is individual according to age, symptoms, the patient's medications, and risk signs.

Treatment Options (Depending on the Cause)

1) H. pylori Infection (Stomach Bacteria)

• The goal: eradicating the bacteria through a combination of antibiotics + a proton pump inhibitor (PPI), and bismuth salts may be added.
• The common duration: 10–14 days according to the doctor's protocol and the region's antibiotic sensitivity.
• After completion, we perform a confirmatory test to ensure recovery (usually after 4 weeks of stopping antibiotics and 2 weeks of stopping the PPI).

2) Inflammation Caused by NSAID Medications/Irritants

• Stopping the cause (or safer alternatives under the doctor's supervision).
• Proton pump inhibitors to reduce acid and accelerate healing.
• Lifestyle and diet modification.

3) Autoimmune Inflammation

• Treating anemia with vitamin B12 (often injections) and/or iron.
• Periodic follow-up of vitamin and hemoglobin levels, and an appropriate dietary plan.

4) Medications to Relieve Symptoms (According to the Doctor's Assessment)

• Proton pump inhibitors (PPIs): reduce acid secretion and help heal the lining.
• H2 blockers: reduce acid by a mechanism different from PPIs.
• Bismuth salts: may be used with antibiotics in specific protocols.
• Antacids: for quick, short-acting relief after meals.

Avoid random use of medications. Doses and durations are determined by the doctor based on your condition, age, other medications, and drug allergies.

Lifestyle and Diet: What Helps?

There is no "home recipe" that always cures the root cause, but lifestyle modification relieves symptoms and accelerates recovery.

Practical Guidelines

• Smaller, more frequent meals instead of two/three large meals.
• Avoid what triggers your symptoms (monitor individual sensitivity), and they often include:
  • Very fatty foods, fried foods, spicy foods, and strong spices.
  • Coffee, carbonated drinks, and large doses of tea.
  • Alcohol and smoking.
• Try gentler options for the stomach:
  • Light starches (rice/toast/boiled potatoes), vegetable soup, yogurt (if it doesn't bother you), non-acidic fruits (banana/cooked apple).
• Do not lie down immediately after eating; leave 2–3 hours.
• Manage stress: adequate sleep, moderate physical activity, breathing exercises.
• Consult your doctor about iron/B12 supplements if there is a proven deficiency.