Gastritis and peptic ulcer disease (PUD) are two common conditions of the upper digestive tract. One may lead to the other and often both conditions may exist simultaneously. The symptoms of both gastritis and peptic ulcers are largely the same and most people are unable to differentiate between the two conditions. The treatment also involves most of the same drugs and similarly a dietary change may help with controlling and easing symptoms.
Gastritis vs Peptic Ulcers
Gastritis refers to the inflammation of the stomach lining, mainly caused by the action of gastric acid. Irritation of the stomach leads to stomach pain which is a characteristic feature of gastritis. Persistent chronic inflammation of the lining of the stomach (chronic gastritis) may lead to the formation of ulcers.
Read more on gastritis.
Peptic ulcer disease refers to topen sores in the lining of the stomach and the duodenum. Sometimes, the ulcers may also be present in the lower regions of the intestine and the esophagus. The sores in peptic ulcer disease are usually in the duodenum (first part of the small intestine).
Read more on peptic ulcer disease.
Both gastritis and peptic ulcer disease are caused by Helicobacter pylori infection and chronic use of non-steroidal anti-inflammatory drugs (commonly abbreviated as NSAIDs). Excessive alcohol consumption and cigarette smoking may also contribute to the development of these conditions.
Foods to Eat and Avoid
Certain dietary factors seem to increase the severity of the stomach pain in gastritis and peptic ulcer disease. Therefore, dietary management is an important approach in providing symptomatic relief in these conditions. However, it should be emphasized that dietary management is not a treatment for gastritis and peptic ulcer disease.
Medication and other therapeutic measures are the primary treatment modalities for both these ailments. On their own, managing diet and lifestyle factors have limited benefits in treating gastritis and peptic ulcer disease. Therefore, it should be seen as secondary supportive measures that need to be considered alongside medical therapy.
Foods to avoid in gastritis and peptic ulcer disease
A variety of foods and drinks can exacerbate symptoms such as stomach pain in patients suffering from gastritis and peptic ulcer disease. However, the exact food that may worsen abdominal pain and discomfort varies on an individual basis. Keeping a food diary will help in identifying the offending foods.
Even though there may not yet be any scientific or medical explanation for why certain foods worsen the symptoms of gastritis and peptic ulcer disease, it is best to avoid foods and drinks that are known to be irritants for most people with gastritis or peptic ulcers, such as with spicy foods.
Most patients are usually aware of the trigger foods and drinks that exacerbate their symptoms. However, in some cases, elimination diets may need to be followed to identify the offending foods. Eosinophilic gastritis is an example of a condition that can benefit from following an elimination diet.
Milk and dairy products are common offending foods in eosinophilic gastritis, which is an immune-mediated condition. However, avoiding milk and dairy products offer limited benefits in other types of gastritis. In fact, milk intake may provide temporary relief from gastric pain in many cases of peptic ulcer and gastritis. This can be attributed to the alkaline nature of milk, which can neutralize stomach acid to some extent.
Some of the foods that have been commonly reported to trigger or exacerbate abdominal pain and discomfort in gastritis and peptic ulcer disease include the following:
- Spicy foods: Foods containing paprika, black pepper, cayenne pepper and chilly are commonly associated with aggravation of gastritis and peptic ulcer symptoms. In addition, other spices like cinnamon may also cause irritation of the gastric lining. Cocktails of spices (such as the curry powder used in many south Asian cuisines) are also potent irritants of the lining of the stomach.
- Fatty foods: Consumption of foods that contain high amounts of fat can exacerbate pain in gastritis and peptic ulcer disease by stimulating secretion of gastric acid.
- Processed foods: Certain preservatives used in processed foods can cause irritation of the gastric mucosa. Preserved meats, vegetables, and pickles are some examples of such foods. Monosodium glutamate (commonly abbreviated as MSG) added to fresh food (such as Chinese fast food) can also cause gastric irritation.
- Caffeine: Caffeinated beverages such as coffee, tea, energy drinks and soft drinks can also be irritating to the gastric mucosa. Caffeine or taurine present in these drinks stimulates secretion of gastric acid.
- Vegetables and fruits: Certain natural vegetables and herbs like chili, bell peppers, garlic, onion, peppadew, and horseradish may also irritate the stomach. Foods that are highly acidic (such as lemons, oranges, and grapefruit) may also exacerbate symptoms of gastritis and peptic ulcer disease. In some cases, tomato is also found to irritate the stomach. Most fruits are, however, not irritants.
- Alcohol: Alcohol is a well-known irritant of the stomach lining and should be avoided or consumed in very small quantities.
Certain gassy foods are also thought to contribute to the severity of the symptoms of gastritis and peptic ulcer disease. This is especially the case in patients suffering from esophageal ulcers and gastroesophageal reflux disease (commonly known as acid reflux).
The foods suspected to exacerbate the symptoms of gastritis and peptic ulcer disease should either be avoided or consumed in reduced amounts. In addition, having frequent small meals throughout the day may help in preventing abdominal pain caused by the action of gastric acid on the lining of the stomach.
Lifestyle Changes for Gastritis and Peptic Ulcers
Along with dietary changes, lifestyle modifications are also considered as a part of conservative management of gastritis and peptic ulcer disease. In fact, lifestyle modifications may have a greater effect on the management of these conditions that dietary restrictions. The following are some of the lifestyle changes that may help in long-term management of gastritis and peptic ulcer disease.
- Stop smoking: Gastritis and peptic ulcer disease tend to affect smokers more often than non-smokers. Therefore, discontinuing cigarette smoking is beneficial in the long-term management of gastritis and peptic ulcer disease. However, trying to replace nicotine with another stimulant, such as in nicotine replacement therapy (abbreviated as NRT), may aggravate the symptoms. This is because the stimulants used in nicotine replacement therapy also increase gastric acid production.
- Stress management: Stress increases the production of gastric acid. Therefore, reducing stress levels may help in long-term management of the symptoms of gastritis and peptic ulcer disease.
- Restricted use of NSAIDs: Chronic NSAID usage is one of the causative factors of peptic ulcer disease. Therefore, restricting usage of NSAIDs would help in alleviating abdominal pain. In cases where NSAID therapy is unavoidable (such as in chronic inflammatory diseases), the dosages could be reduced or the type of NSAID may be changed. In addition, proton pump inhibitors should be taken along with NSAIDs to prevent increased gastric acid production.
- Avoid gum chewing: Constantly chewing gum, tobacco, and betel nut leaf increases the production of gastric acid, and may aggravate stomach pain in gastritis and peptic ulcer disease. Therefore, avoiding these things may help in alleviating the pain in these conditions.
- Maintain proper hygiene: A major cause of gastritis and peptic ulcer disease is infection with the bacteria, Helicobacter pylori (commonly abbreviated as H. pylori). Following successful medical treatment of these conditions, H. pylori reinfection may be prevented through observance of proper hygiene (such as thoroughly washing hands before eating anything, and cooking food with clean drinking water).