Treatment Approaches for Chronic Non-Atrophic Gastritis

Chronic non-atrophic gastritis, also known as chronic superficial gastritis, is a type of chronic gastritis characterized by inflammation of the gastric mucosa caused by various factors. The clinical symptoms are often non-specific, and diagnosis typically relies on endoscopic examination and histological biopsy. Mild, inactive forms of this condition are commonly found in the gastric mucosa of many adults and can be considered a normal physiological immune response, usually not requiring pharmacological intervention. However, for patients with more pronounced symptoms, treatment should focus on several key areas.

Identifying and Addressing Underlying Causes

Eliminating contributing factors is crucial in managing chronic non-atrophic gastritis. Patients should treat infection sources in the nasal, oral, and pharyngeal regions, quit smoking, and avoid alcohol consumption. Dietary recommendations include consuming soft, easily digestible foods while avoiding overly coarse or spicy meals. Additionally, foods with strong seasonings and medications that irritate the stomach should be avoided. For Helicobacter pylori (H. pylori)-associated gastritis, a combination of antibiotics, proton pump inhibitors (PPIs), and bismuth compounds is often prescribed. In cases of duodeno-gastric reflux, digestive aids and prokinetic agents may be used. Autoimmune-related inflammation may warrant corticosteroid therapy, while deficiencies in mucosal nutrition can be addressed with multivitamin supplements to enhance gastrointestinal health.

Pharmacological Treatment Options

1. Eradication of H. pylori

One of the primary steps in treating this condition is eliminating H. pylori infection, which is known to contribute to chronic gastritis. This is typically achieved through a combination of antibiotics and acid-suppressing medications.

2. Mucosal Protective Agents

Medications such as sucralfate tablets or suspension (1.0g taken orally 3–4 times daily, one hour before meals and at bedtime) help protect the stomach lining. Bismuth subsalicylate (110–120mg four times daily, taken 30 minutes before meals and at bedtime) can also be effective, although it should not be used for more than eight weeks. Another option is teprenone (50mg four times daily, taken 30 minutes before meals and at bedtime), which also has a recommended usage limit of eight weeks.

3. H2 Receptor Antagonists

Drugs like ranitidine, famotidine, and cimetidine are effective in reducing gastric acid secretion. For patients unable to take oral forms, intravenous administration may be considered.

4. Prokinetic Agents

Medications such as domperidone, mosapride citrate, and itopride hydrochloride can help improve gastric motility and alleviate symptoms like bloating and delayed gastric emptying.

Patient Education and Lifestyle Modifications

Adopting a balanced and diverse diet is essential for managing chronic non-atrophic gastritis. Avoiding picky eating habits and ensuring adequate nutrient intake can support overall digestive health. Patients should steer clear of moldy or spoiled foods and limit consumption of smoked, salted, or nitrate-rich items. Instead, a preference for fresh, natural foods is recommended. It's also important to avoid irritating foods such as highly spiced dishes and to limit long-term alcohol consumption and smoking. Maintaining a positive mental outlook and getting sufficient rest are also key components of effective disease management.

Conclusion

Chronic non-atrophic gastritis can be effectively managed with a combination of lifestyle changes, targeted medication, and professional medical supervision. However, it is important to consult with a licensed healthcare provider before starting any treatment regimen. Self-medication is discouraged, as individual responses to therapy may vary, and accurate diagnosis is essential for successful outcomes.