The Best Medications for Managing Chronic Gastritis

Chronic gastritis is a condition characterized by long-term inflammation of the stomach lining. In many cases, especially in China, it often presents as pangastritis primarily affecting the antrum, with atrophy of the gastric glands and intestinal metaplasia being key pathological features in later stages. Treatment strategies are typically tailored to each individual's specific symptoms. Here are the most effective medication approaches based on symptom presentation:

1. Acid Reflux or Gastric Erosion with Bleeding

For individuals experiencing acid reflux or gastrointestinal bleeding due to gastric erosion, proton pump inhibitors (PPIs) or H2 blockers are commonly prescribed to reduce stomach acid production. Additionally, mucosal protective agents such as sucralfate or bismuth compounds may be used to shield the stomach lining from further damage.

2. Bloating, Nausea, or Vomiting

Patients suffering from bloating, nausea, or vomiting may benefit from prokinetic agents such as metoclopramide or domperidone. These medications help accelerate gastric emptying and improve digestive tract motility, thereby relieving discomfort.

3. Stomach Cramps and Pain

When abdominal pain or cramping occurs, antispasmodic drugs like hyoscine butylbromide can provide relief by relaxing the smooth muscles of the gastrointestinal tract, reducing spasms and associated pain.

4. Pernicious Anemia

In cases where chronic gastritis leads to pernicious anemia due to vitamin B12 deficiency, supplementation with vitamin B12 (via injection or oral high-dose supplements) and folic acid is essential to correct the deficiency and support red blood cell production.

5. Helicobacter pylori Infection

If Helicobacter pylori (H. pylori) infection is detected, a triple or quadruple eradication therapy regimen is typically recommended. This usually includes a proton pump inhibitor combined with two or three antibiotics such as clarithromycin, amoxicillin, or metronidazole for 10–14 days.

Lifestyle and Dietary Adjustments Are Crucial

While medication plays a vital role in symptom management, long-term recovery and prevention of recurrence depend heavily on lifestyle modifications. Avoiding irritants such as alcohol, spicy foods, and nonsteroidal anti-inflammatory drugs (NSAIDs), along with adopting a balanced diet rich in fruits, vegetables, and lean proteins, can significantly improve gastric health. Stress reduction techniques like mindfulness, yoga, or regular exercise also contribute to better outcomes.

Managing chronic gastritis effectively requires a combination of targeted medication and healthy lifestyle choices. Always consult with a healthcare provider to determine the best treatment plan for your specific condition.