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Allergist

Gastritis: Treatment & Management

<div> <h2 align="LEFT" class="western" style="margin-top: 0cm; margin-bottom: 0cm; border: none; padding: 0cm; font-weight: normal; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font style="font-size: 13pt"><span style="background: transparent"><em><font size="3"><span style="font-style: normal"><b><img alt="" src="/netcat_files/userfiles/137/loginappphoto.png" />Introduction</b></span></font></em></span></font></font></font></h2> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Gastritis is an inflammation of the stomach lining. Many things can cause gastritis. Most often the cause is infection with the bacteria </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Helicobacter pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">, which also causes stomach ulcers. An autoimmune disorder, a backup of bile into the stomach, or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also cause gastritis. In some cases, the stomach lining may be "eaten away," leading to sores (peptic ulcers) in the stomach or first part of the small intestine. Gastritis can occur suddenly (acute gastritis) or gradually (chronic gastritis). In most cases, gastritis does not permanently damage the stomach lining.</font></font></font></p> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Signs and Symptoms</font></font></font></h2> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">The most common symptoms of gastritis are stomach upset and pain. Other possible symptoms include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Indigestion (dyspepsia)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Heartburn</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Abdominal pain</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Hiccups</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Loss of appetite</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Nausea</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Vomiting, possibly of blood or material that looks like coffee grounds</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Dark stools</font></font></font></p> </li> </ul> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Causes</font></font></font></h2> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Gastritis can be caused by infection, irritation, autoimmune disorders (where the body's immune system mistakenly attacks the stomach), or backflow of bile into the stomach (bile reflux). Gastritis can also be caused by a blood disorder called pernicious anemia.</font></font></font></p> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Infections can be caused by:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Bacteria (usually </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Helicobacter pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Virus (including herpes simplex virus)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Parasite</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Fungus</font></font></font></p> </li> </ul> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">A number of things can cause irritation, including:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Long-term use of NSAIDs, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). Up to 20% of people who chronically use NSAIDs develop gastric problems.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Alcohol use</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Cigarette smoking</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Chronic vomiting</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Coffee and acidic beverages</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Too much stomach acid (such as from stress)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Eating or drinking caustic or corrosive substances (such as poisons)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Trauma (for example, radiation treatments or having swallowed a foreign object)</font></font></font></p> </li> </ul> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Other causes for gastritis are very rare. These include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Systemic disease (for example, Crohn disease)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Sarcoidosis</font></font></font></p> </li> </ul> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Risk Factors</font></font></font></h2> <ul> <li> <p style="margin-bottom: 0cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3"><span style="background: transparent">Infection with <i>H. pylori</i></span></font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Acquired immunodeficiency syndrome (AIDS)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Any condition that requires relief from chronic pain using NSAIDS, such as chronic low back pain, fibromyalgia, or arthritis</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Alcoholism</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Cigarette smoking</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Older age</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Herpes simplex virus or cytomegalovirus</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Inflammatory bowel disease</font></font></font></p> </li> </ul> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Diagnosis</font></font></font></h2> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Several tests can be used to make a diagnosis. These include endoscopy of the stomach, where a thin tube with a light and a camera on the end is inserted down your throat into your stomach. This allows the doctor to see into your stomach and take samples (called a biopsy) from the lining if needed. The laboratory tests you may need will depend on the cause of your gastritis. Your doctor may use a stool test to check for the presence of blood, or your doctor may take a sample of tissue, called a biopsy, from your esophagus or stomach. A breath test or a biopsy may detect </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">.</font></font></font></p> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Prevention</font></font></font></h2> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Making lifestyle changes, such as avoiding the long-term use of alcohol, NSAIDs, coffee, and drugs, may help prevent gastritis and its complications (such as a peptic ulcer). Reducing stress through relaxation techniques, including yoga, tai chi, and meditation, can also be helpful.</font></font></font></p> <h2 class="western" style="margin-top: 0.66cm; margin-bottom: 0.37cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Treatment</font></font></font></h2> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Treatment of gastritis depends on the cause of the problem. Some cases of gastritis may resolve by themselves over time, or be relieved when you stop drinking alcohol, smoking cigarettes, or taking NSAIDs. You may need to change your diet, although doctors now know that a bland diet is not required. If your gastritis is due to </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3"> infection, your doctor will prescribe antibiotics.</font></font></font></p> <h3 class="western" style="margin-top: 0.58cm; margin-bottom: 0.26cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Lifestyle</font></font></font></h3> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">The treatment for gastritis that is caused by irritants is to stop using them. These include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Alcohol</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Tobacco</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Acidic beverages, such as coffee (both caffeinated and decaffeinated), carbonated beverages, and fruit juices with citric acid</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">NSAIDS, such as aspirin and ibuprofen. Switch to other pain relievers (like acetaminophen).</font></font></font></p> </li> </ul> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">These steps may also help:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Eat a fiber-rich diet.</font></font></font></p> </li> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Foods containing flavonoids like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may stop the growth of </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori.</font></font></font></em></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Avoid high-fat foods. In animal studies, high-fat foods increase inflammation in the stomach lining.</font></font></font></p> </li> </ul> <h3 class="western" style="margin-top: 0.58cm; margin-bottom: 0.26cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Medications</font></font></font></h3> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">If you have </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">, you will probably be prescribed three medications. Doctors commonly use "triple therapy," to treat H. pylori-related gastritis and ulcers, including a proton pump inhibitor to reduce acid production and two antibiotics. Bismuth salicylate (Pepto Bismol) may be used instead of the second antibiotic. This drug, available over the counter, coats and soothes the stomach, protecting it from the damaging effects of acid.</font></font></font></p> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Some of the same drugs used for non-</font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3"> gastritis as are used for symptoms (like indigestion) due to ulcers:</font></font></font></p> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Antacids</font></font></font></strong></p> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Available over the counter, they may relieve heartburn or indigestion but will not treat an ulcer. Antacids may block medications from being absorbed and thereby decrease the medicine's effectiveness. Doctors recommend taking antacids at least 1 hour before or 2 hours after taking medications. Ask your pharmacist or doctor for more information. Antacids include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Aluminum hydroxide (Amphojel, AlternaGEL)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Magnesium hydroxide (Phillips' Milk of Magnesia)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Calcium carbonate (Rolaids, Titralac, Tums)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Sodium bicarbonate (Alka-Seltzer)</font></font></font></p> </li> </ul> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H2 blockers</font></font></font></strong></p> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Reduce gastric acid secretion. They include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Cimetidine (Tagamet)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Ranitidine (Zantac)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Nizatidine (Axid)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Famotidine (Pepcid)</font></font></font></p> </li> </ul> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Proton pump inhibitors</font></font></font></strong></p> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Decrease gastric acid production. They include:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Esomeprazole (Nexium)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Lansoprazole (Prevacid)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Omeprazole (Prilosec)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Pantoprazole (Protonix)</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Rabeprazole (AcipHex)</font></font></font></p> </li> </ul> <h3 class="western" style="margin-top: 0.58cm; margin-bottom: 0.26cm; border: none; padding: 0cm; line-height: 0.26cm; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Nutrition and Dietary Supplements</font></font></font></h3> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Doctors used to recommend eating bland foods with milk and only small amounts of food with each meal. Researchers now know that such a diet is not required to treat gastritis or ulcers.</font></font></font></p> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Following these nutritional tips may help reduce symptoms:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may inhibit the growth of </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Eat antioxidant-rich foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Eat foods high in B vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Avoid refined foods, such as white breads, pastas, and sugar.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Eat lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Use healthy oils, such as olive oil.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Reduce or eliminate trans fatty acids, found in commercially-baked goods, such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Avoid beverages that may irritate the stomach lining or increase acid production including coffee (with or without caffeine), alcohol, and carbonated beverages.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Drink 6 to 8 glasses of filtered water daily.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Exercise at least 30 minutes daily, 5 days a week.</font></font></font></p> </li> <li> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Identify and eliminate food allergies.</font></font></font></p> </li> </ul> <p style="margin-bottom: 0.34cm; border: none; padding: 0cm; line-height: 130%; orphans: 1; background: transparent;"> <font color="#000000"><font face="Tahoma, sans-serif"><font size="3">The following supplements may help with digestive health:</font></font></font></p> <ul> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">A multivitamin daily</font></font></font></strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.</font></font></font></p> </li> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Omega-3 fatty acids</font></font></font></strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">, such as fish oil, may help decrease inflammation. Fish oil may increase the risk of bleeding. If you take aspirin or other anticoagulants (blood thinners), talk to your doctor before taking fish oil.</font></font></font></p> </li> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Probiotic supplement</font></font></font></strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3"> (containing </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Lactobacillus acidophilus</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">). Probiotics or "friendly" bacteria may help maintain a balance in the digestive system between good and harmful bacteria, such as </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">. Probiotics may help suppress </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3"> infection, and may also help reduce side effects from taking antibiotics, the treatment for an </font></font></font><em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">H. pylori</font></font></font></em><font color="#000000"><font face="Tahoma, sans-serif"><font size="3"> infection. Some probiotic supplements need to be refrigerated for best results. People who have weakened immune systems, or who are taking immune-suppressive drugs, should take probiotics only under the direction of their physician.</font></font></font></p> </li> <li> <p style="margin-bottom: 0cm; background: transparent; border: none; padding: 0cm; line-height: 130%; orphans: 1"> <strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">Vitamin C</font></font></font></strong><font color="#000000"><font face="Tahoma, sans-serif"><font size="3">. Studies show that pharmacological doses of vitamin C may improve the effectiveness of H. pylori-eradication therapy. Speak with your physician about what dose might be appropriate for you.</font></font></font></p> </li> </ul> <p align="LEFT" style="margin-bottom: 0cm; border: none; padding: 0cm; orphans: 1; background: transparent;">  </p> </div> <div> <br /> <img alt="" src="/netcat_files/userfiles/137/23252431.jpg" style="width: 392px; height: 696px;" /></div>
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