Dietary management for gastritis and peptic ulcer disease has limited benefit without other therapeutic measures like medication. Despite that fact that certain foods and drinks may exacerbate the pain of both gastritis and peptic ulcers, most cases are due to H.pylori infection or the long term use of NSAIDs (non-steroidal anti-inflammatory drugs). Diet therefore cannot be the solitary approach to treating and preventing either condition. Instead, the focus of diet in the management of gastritis or peptic ulcers should rather be directed at providing some symptomatic relief for the patient.
Peptic ulcers are a common complication of chronic gastritis and even if the ulcer heals, the gastritis has to be treated and managed in the long term. If conservative management is to be considered, the focus should not be solely on diet, but rather on diet AND lifestyle. While these measures may be helpful, the treatment of gastritis and peptic ulcers with medication should not be bypassed.
Foods to Avoid for Gastritis and Peptic Ulcers
Ideally, each person with gastritis or peptic ulcers should keep a food diary to monitor which foods, if any, aggravates the pain, stomach ache or abdominal discomfort. Individual irritants may vary from one person to another. While there may be no medical or scientific explanation for why one food or drink is more of an irritant than another, it is nevertheless worth avoiding so as to limit the pain and discomfort. An elimination diet is usually not necessary as most patients are well aware of the triggers.
In certain types of gastritis, like eosinophilic gastritis, elimination diets may prove effective in some cases and should therefore be followed strictly. Since this type of gastritis is immune-mediated, foods like milk and dairy products are a common irritant but will offer little or no relief in other, more common, forms of gastritis. To the contrary, milk is an alkali and may provide temporary pain relief in most cases of gastritis and peptic ulcers.
The more common foods and drinks reported to trigger or aggravate pain due to gastritis or peptic ulcers include :
- Spicy foods which contain chilli, paprika, black pepper and cayenne pepper. Other spices like cinammon may also be irritants. Curry powder which is used in most south Asian cuisines (Indian, Thai and so on) contains a combination of many of these spices.
- Vegetables and herbs like onion, horseradish, bell peppers (capsicum), peppadew and garlic.
- Processed and preserved foods, particularly meats, may also be irritants due to the preservative and spice content within these foods rather than due to the meat or vegetable it is composed of. This includes pickled foods. Certain preservatives like monosodium glutamate (MSG) are used in fresh dishes as well, like in Chinese cuisine and some fast foods.
- Caffeinated beverages like coffee, cola and tea. Certain energy drinks containing caffeine or taurine may also prove to be irritants as the stimulants within these drinks increase gastric acid secretion.
- Fruit are generally not irritants or trigger foods, however, highly acidic fruits and fruit juices like those containing oranges, lemons and grapefruit may aggravate some cases. Tomatoes and tomato juice may also prove to be an irritant in some cases.
- High-fat foods are known to stimulate gastric acid secretion and therefore aggravate gastritis or peptic ulcers.
- Alcohol is a another known irritant and while it may not have to be discontinued entirely, intake should be drastically reduced.
Certain foods that are considered to be gassy foods may also play a role, especially in a case of GERD (gastroesophageal reflux disease) and esophageal ulcers. A list of foods to avoid are outlined in the article on Gassy Stomach.
Frequent small meals throughout the day may be beneficial in avoiding the pain due to an empty stomach or shortly after large meals in a person which is common in gastritis and peptic ulcer disease.
Conservative management involves both dietary and lifestyle measures. With gastritis and peptic ulcers, lifestyle changes may often be more beneficial than dietary management.
- Cigarette smoking should be discontinued as smokers are more likely to develop these gastritis and peptic ulcers than non-smokers. The use of nicotine replacement products (NRT) may also contribute to these conditions as stimulants tend to increase gastric acid secretion.
- Stress, especially emotional stress, may stimulate gastric acid secretion.
- The use of NSAIDs should be limited or avoided altogether. In chronic inflammatory conditions this may not be possible so the dosage of the prescribed NSAID should be reduced, proton pump inhibitors should be taken simultaneously or the typ of NSAID should be switched (COX-1 to COX-2).
- Helicobacter pylori infection is a major causative factor of gastritis and peptic ulcers globally. Proper hygiene like washing hands before eating and preparing food as well as sourcing clean drinking water are important measures to prevent re-infection with H.pylori following eradication therapy. These measures however, are not a guarantee that H.pylori gastritis or peptic ulcers will not recur.
- Excessive and constant gum chewing may also increase gastric acid secretion and should be avoided in gastritis or peptic ulcer disease. Tobacco chewing and areca nut-betel leaf chewing may also be aggravating factors.