Gastritis treatments
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Gastritis Treatments: A Comprehensive Overview
Conventional Pharmacological Treatments for Gastritis
Proton Pump Inhibitors, Histamine H2 Receptor Inhibitors, and Antacids
Gastritis, characterized by inflammation of the gastric mucosa, is commonly treated with proton pump inhibitors (PPIs), histamine H2 receptor inhibitors, and antacids. These medications are effective in reducing stomach acid and alleviating symptoms but are associated with various side effects, prompting the exploration of alternative treatments 1.
Nitrofurans for Bacterial Gastritis
For gastritis associated with Campylobacter pylori, nitrofurans such as furazolidone and nitrofurantoin have shown efficacy in reducing bacterial colonization and inflammation. However, a significant relapse rate has been observed, indicating the need for continuous or additional treatment strategies 2.
Alternative and Complementary Treatments
Food-Based Therapies
Recent studies have explored the use of food and food-derived products as alternative treatments for gastritis. Clinical trials have evaluated the efficacy of garlic, turmeric, red peppers, broccoli sprouts, cranberry juice, honey, oils, and probiotics. While promising, these studies often have a high risk of bias, and more rigorous clinical trials are needed to confirm their effectiveness 1.
Herbal Preparations
Chaihu-Shugan-San (CSS), a traditional herbal preparation, has been found to be more effective than conventional chemotherapy in treating various types of chronic gastritis, with no reported adverse events. However, the quality of the existing studies is low, necessitating further high-quality clinical trials 3. Similarly, Jian-Wei-Qu-Tong Pills (JWQTP) and Shen-ling-bai-zhu san (SLBZS) have shown potential in treating chronic non-atrophic gastritis and chronic gastritis, respectively, through various molecular mechanisms, including anti-inflammatory and antioxidative pathways 789.
Nutritional Supplements
The combination of wheat peptides and fucoidan (WPF) has demonstrated protective effects against chronic superficial gastritis. WPF not only reduced gastric mucosal damage but also improved gut microbiota composition and gastrointestinal symptoms, suggesting its potential as a nutritional alternative for managing chronic gastritis 4.
Targeted Therapies for Specific Gastritis Types
Bismuth-Containing Quadruple Therapy for H. pylori-Related Gastritis
A 10-day bismuth-containing quadruple therapy has proven more effective than traditional triple therapy in eradicating H. pylori and improving symptoms of chronic gastritis. This regimen significantly enhances eradication rates and reduces dyspeptic symptoms, making it a superior first-line treatment option 5.
Zeaxanthin for Stress-Induced Gastritis
Zeaxanthin, a non-provitamin A carotenoid, has shown gastroprotective effects against stress-induced gastritis in animal models. It reduces oxidative stress, inflammation, and histopathological changes, highlighting its potential as a therapeutic agent for stress-related gastric conditions 6.
Netazepide for Autoimmune Chronic Atrophic Gastritis
Netazepide, a gastrin/cholecystokinin 2 receptor antagonist, has been effective in reducing and even eradicating gastric neuroendocrine tumors in patients with autoimmune chronic atrophic gastritis. Continuous treatment is necessary to prevent tumor regrowth, and progress can be monitored through biomarkers 10.
Conclusion
The treatment landscape for gastritis is diverse, ranging from conventional pharmacological approaches to innovative alternative therapies. While traditional medications remain effective, their side effects and limitations have spurred interest in food-based therapies, herbal preparations, nutritional supplements, and targeted treatments. Continued research and high-quality clinical trials are essential to validate these alternative treatments and integrate them into standard care practices for gastritis.
Sources and full results
Most relevant research papers on this topic
Use of food and food-derived products in the treatment of gastritis: A systematic review
Food-based therapies show potential as alternative treatments for gastritis, but more rigorous clinical studies are needed to confirm these results.
Systematic ReviewNitrofurans in the treatment of gastritis associated with Campylobacter pylori. The Gastrointestinal Physiology Working Group of Cayetano Heredia and The Johns Hopkins Universities.
Nitrofurantoin and furazolidone effectively reduce or clear Campylobacter pylori colonization in antral gastritis, but relapse is common within 6 weeks.
RCT
Highly CitedChaihu-Shugan-San, an oriental herbal preparation, for the treatment of chronic gastritis: a meta-analysis of randomized controlled trials.
Chaihu-Shugan-San (CSS) shows potential in treating chronic gastritis with no serious side-effects, but more full-scale, randomized, double-blind, placebo-controlled clinical trials are needed to confirm its therapeutic benefit.
Meta-AnalysisThe combination of wheat peptides and fucoidan protects against chronic superficial gastritis and alters gut microbiota: a double-blinded, placebo-controlled study
The combination of wheat peptides and fucoidan (WPF) effectively reduces chronic superficial gastritis progression and improves gut microbial profile, potentially benefiting the lower gastrointestinal tract.
RCT
Rigorous JournalTen-day bismuth-containing quadruple therapy is effective as first-line therapy for Helicobacter pylori-related chronic gastritis: a prospective randomized study in China.
Ten-day bismuth-containing quadruple therapy is more effective than omeprazole-based triple therapy as first-line therapy for patients with H. pylori-induced chronic gastritis in China.
RCT
Large Human TrialA novel gastroprotective effect of zeaxanthin against stress-induced gastritis in male rats targeting the expression of HIF-1α, TFF1 and MMP-9 through PI3K/Akt/JNK signaling pathway.
Zeaxanthin effectively reduces stress-induced gastritis in rats by promoting antioxidant and anti-inflammatory effects, mainly through regulating MMP-9 and HIF-1 signaling pathways.
RCT
Animal StudyThe efficacy and safety of Jian-Wei-Qu-Tong Pills for the treatment of chronic non-atrophic gastritis (spleen and stomach qi deficiency with damp-heat stasis syndrome): study protocol for a phase II, randomized controlled trial
The Jian-Wei-Qu-Tong Pills (JWQTP) show potential in treating chronic non-atrophic gastritis with spleen and stomach qi deficiency and damp-heat stasis syndrome, offering an alternative treatment option for these patients.
RCT
Very Rigorous JournalChinese herbal formula shen-ling-bai-zhu-san to treat chronic gastritis: Clinical evidence and potential mechanisms
SLBZS may be useful in treating chronic gastritis, but long-term effects and specific clinical mechanisms remain unclear.
Meta-AnalysisRigorous JournalTreatment of Chronic Gastritis with Traditional Chinese Medicine: Pharmacological Activities and Mechanisms
Traditional Chinese medicine (TCM) improves chronic gastritis through various molecular mechanisms, including inhibition of Helicobacter pylori infection, alleviation of oxidative stress, and repair of gastric mucosa.
Literature ReviewNetazepide, a gastrin/cholecystokinin‐2 receptor antagonist, can eradicate gastric neuroendocrine tumours in patients with autoimmune chronic atrophic gastritis
Netazepide, a gastrin/cholecystokinin 2 receptor antagonist, can potentially eradicate type 1 gastric neuroendocrine tumors in patients with autoimmune chronic atrophic gastritis.
Non-RCTRigorous Journal