Gastritis

What is Gastritis?

Gastritis is inflammation of the stomach lining (the gastric mucosa), and the diagnosis rests on finding inflammation in a tissue sample taken during endoscopy.^[1] It is grouped by how quickly it develops (acute or chronic), by what the tissue looks like under the microscope, and by cause.^[1]

A related term is gastropathy, which means damage to the lining without much inflammation. The two can overlap.^[1]

Common symptoms

The most common symptoms are upper abdominal pain or burning, nausea, bloating and feeling full early in a meal.^[1] Many people with chronic gastritis have no symptoms at all, so the condition is often found only when a doctor looks for another reason.^[2]

Long-standing atrophic gastritis can also interfere with absorbing vitamin B12, iron and other nutrients.^[2]

Causes and risk factors

Infection with Helicobacter pylori, usually acquired in childhood, is the main cause of chronic gastritis worldwide.^[2] Other causes include aspirin and other NSAIDs, heavy alcohol use, an autoimmune attack on the stomach lining, and bile reflux.^{[1, 3]} Gastritis from severe physical stress, such as critical illness, is a separate form.^[4]

How it is diagnosed and treated conventionally

Diagnosis combines endoscopy, a biopsy examined under the microscope, and testing for H. pylori.^{[1, 5]} Treatment depends on the cause. If H. pylori is present it is treated with a course of prescribed medicines, and if an NSAID is responsible, stopping or changing it is the key step.^[3] Acid-lowering medicines such as proton pump inhibitors are the usual first-line way to ease symptoms and help the lining heal.^[3]

Chronic atrophic gastritis needs ongoing medical follow-up. A meta-analysis of 23 studies found it was linked to about a fourfold higher risk of stomach cancer, which is why a doctor's diagnosis and surveillance matter.^[6]

Why Gastritis calls for a whole-person approach

Gastritis is not one disease with one cause. An infection, a medicine, the immune system and the way the stomach reacts to stress can all play a part, and the symptoms people feel do not always match what the endoscope shows.

Medical treatment targets the cause. Complementary care is aimed at the symptoms and the factors around them, and it is not a substitute for finding and treating the cause.

Infection and chronic inflammation

H. pylori colonizes the stomach for decades and drives continuing inflammation of the lining. Over years this can progress to atrophy and, in some people, to precancerous change.^{[2, 5]}

Medicines and alcohol

Aspirin and other NSAIDs, which people often take for pain elsewhere in the body, are a leading cause of stomach injury.^[3] This is one reason we ask for a full medicine list. Treating pain with other methods may sometimes reduce the need for an NSAID, but that decision belongs to you and your prescriber.

Physical stress and the nervous system

The stomach lining protects itself against its own acid, and acute illness can disrupt that barrier and cause erosive gastritis.^[4] Stress, worry and low mood are also common alongside long-term upper digestive symptoms. In a meta-analysis of 16 trials in functional dyspepsia (a related condition with symptoms but no visible damage), acupuncture lowered anxiety and depression scores on most scales, although the certainty was low or very low and one scale showed no difference from placebo.^[7]

Nutrition

Chronic atrophic gastritis can reduce absorption of B12, iron and other nutrients, so blood tests and diet quality deserve attention.^[2]

Acupuncture for Gastritis

What the research shows

The evidence that acupuncture helps gastritis is limited. A 2026 review of 55 randomized trials in chronic atrophic gastritis, involving 5,311 patients, found serious weaknesses: almost none used allocation concealment or blinding, none were prospectively registered, and the outcomes measured varied widely.^[8] The authors called for better-designed trials and a standard set of outcomes.^[8]

One example is a Chinese trial of 88 patients with chronic atrophic gastritis. After two months, symptoms improved more in the acupuncture and acupuncture-plus-moxibustion groups than in the control group, and the combined group also showed improvement in biopsy findings (glandular atrophy and intestinal metaplasia) compared with its own starting point.^[9] The trial was small, and its findings need confirmation in blinded studies before they can be relied on.

For related symptoms, a Cochrane review of 7 trials (542 people) of acupuncture for functional dyspepsia found low or very low quality evidence and could not say whether acupuncture works better or is safer than other treatments.^[10] Evidence for functional dyspepsia is not evidence for gastritis, since the two are different conditions.

How acupuncture may work

Most mechanism research is in animals. A review of 30 animal studies lists changes in gene expression in the stomach lining, effects on anti-inflammatory substances, increased vagal nerve activity and changes in how brain regions communicate.^[11] These are proposed explanations from animal work and do not show that acupuncture heals inflamed stomach tissue in people.

What treatment involves

Treatment uses fine, sterile, single-use needles placed at points on the abdomen, arms, legs and back, usually left in place for about 20 to 40 minutes. Moxibustion, the warming of points with burning mugwort, is sometimes added in traditional practice. A course is several visits, with reassessment along the way.

Serious problems from acupuncture are rare. In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, soreness or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[12] Tell the practitioner first if you have a bleeding disorder, take blood thinners, are pregnant, or have a pacemaker (relevant to electroacupuncture).

Ayurvedic medicine for Gastritis

The Ayurvedic view

Ayurveda describes burning, sour, acidic stomach complaints under the name Amlapitta. In this traditional framework it is linked to aggravated Pitta, the principle associated with heat and digestion, and to weak digestive fire (agni). These are traditional categories for choosing treatment, not biomedical diagnoses.

Therapies that may be used

Care is chosen for the individual and traditionally combines:

• Regular meal times and a diet that avoids very spicy, sour, fried and heavy foods
• Stress-reducing routines and steady sleep hours
• Herbs traditionally used for Pitta-type digestive complaints, prescribed individually
• Pitta-pacifying cleansing therapies from Panchakarma, only where traditionally appropriate and medically sensible

Panchakarma procedures are not appropriate during pregnancy, acute illness or frailty, with active stomach bleeding or a known ulcer, or before symptoms have been medically assessed.

What the research shows

The research on Ayurveda for gastritis is very limited. A 30-day open-label pilot study of 30 people with endoscopic gastritis, given an Ayurvedic suspension called Amlapitta Mishran, reported lower endoscopy scores and symptom scores with no adverse events.^[13] It had no placebo or comparison group, so it cannot show that the product caused the improvement. We found no systematic reviews or placebo-controlled trials of Ayurvedic treatment for gastritis.

Turmeric (curcumin) has been studied more often, as a food or supplement. A randomized trial in people with H. pylori gastritis found that adding curcumin to standard triple therapy for 8 weeks improved inflammation scores and the eradication rate compared with triple therapy alone.^[14] This was a single trial, and curcumin was an addition to medical treatment, not a replacement.

Herbal medicine for Gastritis

Herbs and formulas that have been studied

Most research is on Chinese herbal formulas for chronic atrophic gastritis. A review of 12 trials found that the herbs used most often included white peony (Paeonia lactiflora), Atractylodes, Pinellia, tangerine peel, Codonopsis, Salvia miltiorrhiza (dan shen) and Coptis.^[15] A Korean formula, Yukgunja-tang, has also been reviewed.^[16] Foods and food-derived products studied in gastritis include garlic, turmeric, red pepper, broccoli sprouts, cranberry juice, honey and probiotics.^[17]

What the research shows

The evidence is limited and the studies are mostly of low quality. A meta-analysis of 16 studies (1,673 participants) found Chinese herbal medicine gave better overall clinical efficacy and some symptom scores than routine drug treatment, with no clear difference for acid regurgitation or loss of appetite. The authors said more rigorous research is needed.^[18] A meta-analysis of 12 trials in atrophic gastritis found that adding Chinese herbs to standard treatment gave better clinical response.^[15]

A 2025 meta-analysis of 22 trials of Yukgunja-tang found it improved the overall clinical response rate when added to Western medicine, with moderate certainty for that combination and low or very low certainty for several other results.^[16] A review of food-based therapies found 28 clinical studies with a high risk of bias and called for more rigorous trials.^[17] None of these studies show that herbs reverse atrophy or prevent stomach cancer.

Safety and herb-drug interactions

Herbs are active substances and can interact with medicines. Reports describe extra bleeding when warfarin or aspirin was combined with herbs including dan shen, garlic and ginkgo.^[19] That matters in gastritis, because gastric lining injury can itself bleed. Anyone taking blood thinners or NSAIDs needs a practitioner's review before using herbs.

Tell us if you have liver disease, because some herbs are hard on the liver. In one study, about one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic.^[20] Herbs should come from tested sources and be prescribed individually. Tell us if you are pregnant or breastfeeding, or have kidney disease. A herbal preparation applied to the skin (transdermal medication therapy) is also available, but we are not aware of trials of it for gastritis.

Translating traditional medicine into modern biological language

The links drawn here are interpretation, not equivalence. Chinese medicine describes many chronic stomach complaints as a pattern of spleen-stomach deficiency with cold, or of liver qi disharmony in which stress disturbs digestion. Researchers studying this care look at things that loosely parallel this picture: inflammatory signaling, nerve activity along the vagus nerve, and how the brain and gut communicate.^{[11, 15]}

Ayurveda's aggravated Pitta and weak agni describe burning discomfort and poor digestion. No study has shown that a dosha or agni corresponds to a specific biological process in the stomach.

How this care fits with your medical care

Integrative care for gastritis is complementary. Keep your physician or gastroenterologist, and do not stop or change prescribed medicines without your prescriber. We do not diagnose gastritis or its cause, and we do not test for or treat H. pylori. Persistent upper abdominal symptoms should be medically evaluated first.

Please bring your diagnosis, endoscopy and biopsy reports, any H. pylori test results, a full list of medicines and supplements (including NSAIDs and aspirin), and recent blood tests such as B12 or iron.

When to seek urgent medical care

Some stomach symptoms point to bleeding, an ulcer or another serious cause that needs prompt medical care.^[3]

• Vomiting blood or material that looks like coffee grounds
• Black, tarry or bloody stools
• Severe or sudden abdominal pain, or a rigid, tender abdomen
• Repeated vomiting or being unable to keep fluids down
• Trouble swallowing, or unintended weight loss
• Dizziness, fainting, a racing heart or unusual paleness

If any of these occur, call 911 or go to the nearest emergency department.