For the past few months I’ve been dealing with gastritis and gastric pain, which has put a real dent in my mood, productivity, and general quality of life. I’m recovering, slowly, but this is one of the tougher health challenges I’ve faced.
My gastritis started after a “tummy bug” … some kind of viral or bacterial infection. The more acute symptoms resolved after a few weeks, but despite dietary changes (giving up coffee, booze, and spicy food), I was left with nagging gastric pain. The pain was rarely severe, but it was constant enough to be distracting. My mood worsened, my anxiety increased, and my sleep was often interrupted by burning or even stabbing sensations in my stomach. I tried a number of natural remedies (including turmeric and black seed, both of which have traditionally been used to treat gastritis and ulcers), but nothing was helping much. I’d had similar bouts of stomach pain after a stomach bug in the past, but they’d resolved on their own within a couple weeks, and the pain hadn’t kept me up at night. Time to see the doc’.
My doctor didn’t think I had ulcers, since I had no signs of bleeding, my appetite was reasonably good, and no severe nausea or vomiting. She diagnosed gastritis (inflammation/irritation of the stomach) and recommended a two-week course of omeprazole (a proton pump inhibitor that reduces stomach acid). I took her advice, and the drug helped significantly. But when I stopped taking the omeprazole, the stomach pain gradually returned, eventually becoming worse than before. I tried a number of additional home remedies, including raw cabbage juice, Manuka honey, raw garlic, and Pepto Bismol. Some seemed to help a little, but I was still experiencing significant pain and interrupted sleep.
At that point my doctor recommended an eight-week course of omeprazole, which I was reluctant to try because of possible side effects. Complete suppression of stomach acid can lead to poor absorption of many nutrients (especially calcium, magnesium, and B12) as well as gut dysbiosis and potential gut infections. I requested a blood test for H. pylori (the bacteria often responsible for stomach ulcers and gastritis), but the antibody test came back negative.
I knew the antibody test wasn’t 100% accurate–there was a still a chance that H. pylori was responsible for my stomach problems. But a more likely scenario was that my gastritis was triggered by a combination of factors: the stomach bug, a month of vacation that may have weakened my stomach lining in the first place (timezone changes, lots of rich food, lots of coffee and wine), and a number of stressful situations that I let get to me.
My Healing Approach
I resumed taking the proton pump inhibitor as my doctor recommended, but after a few weeks of feeling only marginally better, I decided to take matters into my own hands and design my own healing regimen. At that point I’d done so much reading on ulcers, gastritis, h. pylori, acid-blocking medications, and prostaglandins that I felt I possibly knew more than my doctor on that particular topic.
I gradually reduced my omeprazole dose to 5mg (a quarter of a pill), taken thirty minutes before dinner, in a vitamin gel capsule to partially serve the function of the enteric coating. Tapering helped prevent the PPI acid rebound I experienced the first time I’d used omeprazole. That, plus 400mg slippery elm right before bed, and I could usually sleep through the night without any stomach pain.
I started taking two chewable DGL (deglycyrrhizinated licorice) tablets twenty minutes before each meal to help soothe and protect my stomach lining.
I drank ginger tea (made with slices of fresh ginger) after meals to reduce stomach acid.
I increased my intake of linoleic acid (from walnuts, sunflower seeds, and low-oleic safflower oil). My diet had previously been very low in this essential fatty acid, which is a precursor to prostaglandin E2 (which protects and rebuilds the stomach lining). Increasing linoleic acid can increase gastric PGE2 expression in human subjects. Lower levels of linoleic acid in adipose tissue are also associated with higher ulcer risk.
I ate a healthful, high nutrient diet, with plenty of vegetables (especially broccoli and cabbage, both of which have gastroprotective properties), protein (mostly from eggs and fish), healthful fats, gluten-free starches, and low-acid fruit.
Though it’s often recommended for gastritis sufferers to avoid acidic foods and beverages, I found that a combination of 100% cranberry juice and 100% pomegranate juice could significantly reduce stomach pain in many cases. I’m not sure why, but it may be that some fruit acids may increase mucin secretion in the stomach, which is protective against stomach acid. I wouldn’t recommend this for GERD sufferers. Acidic juice with or after a meal can increase reflux, and fruit acids may be strong enough to activate any pepsin (a powerful digestive enzyme usually activated by stomach acid) that might have splashed up into the esophagus (some people find that a low-acid diet combined with PPIs for a couple months can heal gastritis).
I took 1000mg of mastic gum on an empty stomach each morning for one month. I’m not sure if this helped or not, but some research supports the use of mastic gum for reducing stomach pain, healing ulcers, and fighting h. pylori infection.
I increased my vitamin/mineral intake, especially vitamin C (buffered, as calcium ascorbate), vitamin A, vitamin D, a high quality multi-vitamin, and zinc carnosine. Not megadoses of anything, but enough to prevent deficiency in case I’ve been absorbing nutrients less efficiently.
I stopped drinking water with meals, but increased water intake first thing in the morning, and in-between meals.
I ate four smaller meals a day instead of three big ones. I also took a break from intermittent fasting.
I added probiotics and kept eating probiotic foods, though I’m not sure they helped.
I tried to reduce stress by doing things I enjoy, not taking on too many extra responsibilities, and meditating more. High levels of stress can irritate the stomach in two ways, both via cortisol:
- Via the production and recycling of bile from the gallbladder (which can wash back into the stomach)
- Via reducing levels of prostaglandins (specifically PGE2) which protect and rebuild the stomach lining
There are many more supplements and cures that I tried. Some may have helped a little, while others may have slowed down my healing process. Many anti-inflammatory foods and supplements which protect the stomach against acute injury in the short-term may actually slow down the healing process in the long-term. The stomach needs the “inflammatory” prostaglandin PGE2 and enzyme COX-2 to heal, as well as the angiogenesis process to rebuild injured tissue. Natural anti-inflammatories such as turmeric, black seed, green tea, and many herbs won’t hurt a healthy stomach (and may reduce the risk of cancer and other diseases), but higher doses of natural anti-inflammatories may slow down tissue repair in the stomach and intestines.
My stomach lining is far from 100% recovered. I’m still taking 5mg omeprazole at night, and I often have a warm or tight sensation in my upper abdomen. But the sharp pain is mostly gone, and at this point I feel like I have my life back. I’ve gained back the weight and muscle I lost, I can eat most foods, I can exercise strenuously, and I can work for fairly long stretches without being distracted by stomach pain. Most nights I sleep pretty well. I’m still abstaining from alcohol except for a sip here and there, and the only coffee I’m drinking is a low-acid decaf variety (from Healthwise–it’s not bad). I’m also feeling calmer, happier, more energetic, and cautiously optimistic about my chances for a full recovery.
If you’ve been through something similar and recovered, please let me know how you did it in the comments.
Wish me luck in my continued healing process!