Gastritis Symptoms: What Is Gastritis and How Is It Treated?

What causes gastritis?

Several factors can damage or irritate the stomach lining:

• Helicobacter pylori (H. pylori) infection: This bacterial infection is one of the most common causes of gastritis worldwide. H. pylori weakens the protective mucus layer lining the stomach, allowing acid to damage the underlying tissue. Eradicating H. pylori is central to healing H. pylori-related gastritis and preventing ulcer recurrence 1Ref 1Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC (2024).ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.H. pylori as a cause of gastritis and peptic ulcer disease; recommended antibiotic-based eradication regimens and their role in healing gastritis and preventing ulcer recurrence.
• NSAIDs (non-steroidal anti-inflammatory drugs): Frequent use of aspirin, ibuprofen, or naproxen can irritate and erode the stomach lining by inhibiting prostaglandins that protect the mucosa 2Ref 2National Institute of Diabetes and Digestive and Kidney Diseases (2022).Peptic Ulcers (Stomach or Duodenal Ulcers).Distinction between gastritis and peptic ulcer; NSAID and H. pylori as shared causes; role of endoscopy in diagnosis and the spectrum of mucosal damage.
• Alcohol: Heavy or regular alcohol use is a well-known cause of gastric irritation and acute gastritis.
• Autoimmune gastritis: The immune system mistakenly attacks the stomach lining's acid-producing cells; this form is associated with vitamin B12 deficiency and pernicious anemia.
• Stress-related changes: Severe physiological stress (from major surgery, burns, or critical illness) can cause acute gastritis.
• Bile reflux: Bile flowing backward from the small intestine into the stomach.

What does gastritis feel like?

The symptoms of gastritis are often described as:

• A dull, gnawing, or burning discomfort in the upper abdomen (between the navel and breastbone)
• Nausea, sometimes with vomiting
• A feeling of fullness after eating only a small amount
• Bloating or belching
• Loss of appetite

Some people have gastritis confirmed on endoscopy without any symptoms at all. In cases where the stomach lining erodes into an ulcer, pain can be more severe and eating may temporarily either relieve or worsen it 2Ref 2National Institute of Diabetes and Digestive and Kidney Diseases (2022).Peptic Ulcers (Stomach or Duodenal Ulcers).Distinction between gastritis and peptic ulcer; NSAID and H. pylori as shared causes; role of endoscopy in diagnosis and the spectrum of mucosal damage.

How is gastritis different from a peptic ulcer?

Gastritis and peptic ulcers exist on a spectrum — both involve damage to the stomach lining, and H. pylori can cause both 1Ref 1Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC (2024).ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.H. pylori as a cause of gastritis and peptic ulcer disease; recommended antibiotic-based eradication regimens and their role in healing gastritis and preventing ulcer recurrence2Ref 2National Institute of Diabetes and Digestive and Kidney Diseases (2022).Peptic Ulcers (Stomach or Duodenal Ulcers).Distinction between gastritis and peptic ulcer; NSAID and H. pylori as shared causes; role of endoscopy in diagnosis and the spectrum of mucosal damage. The key differences:

• Gastritis is inflammation of the lining without a break in the tissue surface
• A peptic ulcer is an actual sore (erosion) in the lining, either in the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer)

Ulcer pain tends to be more localized and can have a distinctive pattern — for example, duodenal ulcer pain sometimes improves briefly after eating (because food buffers acid) and then returns a few hours later. Endoscopy is the only definitive way to distinguish them 2Ref 2National Institute of Diabetes and Digestive and Kidney Diseases (2022).Peptic Ulcers (Stomach or Duodenal Ulcers).Distinction between gastritis and peptic ulcer; NSAID and H. pylori as shared causes; role of endoscopy in diagnosis and the spectrum of mucosal damage.

How is gastritis diagnosed and treated?

Diagnosis

A primary care clinician can often assess gastritis based on your symptoms, history, and risk factors. Testing for H. pylori (with a urea breath test, stool antigen test, or blood test) is typically part of the workup 1Ref 1Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC (2024).ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.H. pylori as a cause of gastritis and peptic ulcer disease; recommended antibiotic-based eradication regimens and their role in healing gastritis and preventing ulcer recurrence. Upper endoscopy allows direct visualization and biopsy of the stomach lining, and is used when the diagnosis is uncertain or symptoms are severe or persistent 2Ref 2National Institute of Diabetes and Digestive and Kidney Diseases (2022).Peptic Ulcers (Stomach or Duodenal Ulcers).Distinction between gastritis and peptic ulcer; NSAID and H. pylori as shared causes; role of endoscopy in diagnosis and the spectrum of mucosal damage.

Treatment depends on the cause:

• H. pylori: The 2024 ACG guideline recommends antibiotic-based combination therapy — often two antibiotics plus an acid-suppressing proton pump inhibitor (sometimes called triple or quadruple therapy) — which effectively treats the infection and heals H. pylori-related gastritis 1Ref 1Chey WD, Howden CW, Moss SF, Morgan DR, Greer KB, Grover S, Shah SC (2024).ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.H. pylori as a cause of gastritis and peptic ulcer disease; recommended antibiotic-based eradication regimens and their role in healing gastritis and preventing ulcer recurrence.
• NSAID-related: Stopping or reducing NSAID use and switching to a different pain reliever with guidance from a clinician. Proton pump inhibitors (PPIs) or H2 blockers help the stomach lining recover.
• Acid suppression: PPIs or H2-receptor antagonists reduce stomach acid and allow the lining to heal regardless of cause.
• Autoimmune gastritis: Management of the underlying condition and B12 supplementation.
• Dietary and lifestyle adjustments: Reducing alcohol, avoiding foods that worsen symptoms, and eating smaller, more frequent meals can support recovery.

When should I see a clinician about stomach pain?

See a clinician if you have:

• Upper abdominal discomfort that has lasted more than a few days
• Nausea or vomiting that is disrupting your daily life
• Symptoms that are not improving with antacids
• Unintentional weight loss

A Gale primary care clinician can evaluate whether your symptoms point to gastritis, H. pylori, GERD, or something else, and can initiate testing and treatment or refer you to a gastroenterologist when appropriate.