Preventing and relieving gastritis through diet

Gastritis refers to inflammation of the inner membrane (mucosa) that lines the stomach wall. This inflammation can be acute (transient) or chronic. There are different types of gastritis/gastritis, such as eosinophilic gastritis, lymphocytic gastritis, collagenous gastritis, etc. These are specific to certain pathologies (Crohn's disease, Biermer's disease, etc.). Being rarer, this article only addresses chronic gastritis not following an autoimmune disease.

In 90% of cases, gastritis is due to Helicobacter pylori. Helicobacter pylori is a Gram-negative flagellate bacterium. Its particularity is to resist acidity, so it naturally thrives in the stomach, a very acidic environment. Man is a natural reservoir ofHelicobacter pylori (it is found in 50% of humans). The infection with Helicobacter pylori is not obligatory, it can be passing through. Sometimes it attaches to the stomach wall and secretes an enzyme “urease”. Urease converts urea into ammonia (plus CO₂). In excess and over the long term, ammonia disrupts and damages gastric cells, promoting inflammation. Other factors accentuate the attack on the gastric mucosa. Such as inappropriate consumption of alcohol, tobacco, prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) or excessive stress.

There gastritis is asymptomatic, we are rarely aware of its presence. There is therefore a lot of confusion between the symptoms of gastroesophageal reflux and ulcer pain. However, if gastritis becomes complicated, certain disorders may appear: abdominal discomfort, nausea, vomiting, dyspepsia, anorexia, etc. Due to the absence of warning signs, the diagnosis of gastritis is only made after analysis of the gastric tissue by biopsy.

Approximately 10% of chronic gastritis develop into an ulcer disease, and in 2% of cases, into stomach cancer. This is why the IARC (international center for research against cancer) has classified Helicobacter pylori among Group 1 carcinogens (proven carcinogen).

Medical care takes care to exclude the causes of gastritis (alcohol, tobacco or NSAIDs) and prescribe antibiotics if infection by Helicobacter pylori is confirmed (urea breath test). An adequate diet can also be suggested to support the protection of the stomach.

Diet plays a preventive role in gastritis. Indeed, it seems obvious to avoid the compound which alone causes gastric irritation, that is to say:

• The alcohol : alcohol is one of the main risk factors for gastritis. It irritates the gastric mucosa. This long-term irritation disrupts the functioning of gastric cells. This disorganization accelerates cell death and limits cell renewal. All this promotes the inflammatory state.

Conversely, certain compounds participate in the bacterial and inflammatory protection of the stomach, these are:

• Flavonoids : they represent a very diverse class of polyphenolic compounds in plants. Flavonoids are divided into 14 different groups and do not all have the same benefits. However, many flavonoids are gastroprotective, particularly pro-anthocyanidins. The latter limit the membership ofHelicobacter pylori (HP) on the gastric mucosa, by competition effect. Thus, their presence disrupts the proliferation of HP. Other flavonoids would also be beneficial in cases of gastritis, such as quercetins and rutins (flavonol subgroup), cathechins (flavanol subgroup)... Generally speaking, flavonoids can claim to fight against the development of HP by harming its growth or contributing to the body's protection system (anti-oxidant, immune system, anti-inflammatory, etc.).

• Antioxidants : oxidative stress corresponds to an imbalance between the oxidant/antioxidant balance in favor of an excess of free radicals. Free radicals degrade the genetic material of cells, which accelerates their death. Oxidative stress contributes to maintaining the inflammatory state. Antioxidant nutrients neutralize free radicals or contribute to the functioning of antioxidant enzymes. We find vitamins (E, C and B2), trace elements (copper, iron, manganese, selenium and zinc), phytonutrients (carotenoids, polyphenols, terpenes, isocyanates, phytic acid, etc.) and cysteine. .

• Omega 3 : omega-3 polyunsaturated fatty acids are involved in the process of resolving inflammation. Indeed, alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are precursors of anti-inflammatory metabolites (resolvins, protectins, maresins, etc.).

• Curcumin : curcumin is an active pigment present in turmeric. Its anti-inflammatory role is widely recognized: it disrupts the inflammatory metabolic pathway (COX-2, LOX, NF-κB and JAK/STAT), which reduces the production of pro-inflammatory compounds. In addition, curcumin is thought to block the shikimate pathway, an essential pathway for the production of aromatic amino acids in bacteria. This interaction is unfavorable for the development ofHelicobacter pylori. Others literature reviews also note promising antimicrobial activity of curcumin against Helicobacter pylori. Nevertheless, other evidenceare necessary to confirm the bacteriostatic/bactericidal power of curcumin.

When gastritis is diagnosed, the role of the mucous membrane is weakened. The mucous membrane serves as adornment to the stomach, that is to say, it protects it from acids and digestive enzymes. Without it, the stomach self-digests. Therefore, it seems important to moderate the intake of constituents capable of accentuating gastric aggression, such as :

• Sugar, Salt and Lipids (in excess!) : these nutrients are not harmful as such, it is the excess that is unfavorable. Indeed, foods/meals that are too sweet, salty or too fatty stimulate stomach activity. This results in hypersecretion of hydrochloric acid (HCl) and longer than normal gastric emptying. However, the protection of the stomach against hydrochloric acid and digestive enzymes is failing, which maintains inflammation of the mucosa.

• The i'sdigestive ritants (in excess!) : certain substances can attack the wall of the stomach, more so if the protection of the latter is fallible. We find capsaicin, piperine, shogaol, methylxanthines and all substances with an acidic pH (less than 7). In absolute terms, these substances are not to be feared and do not aggravate gastritis. They can maintain the inflammatory state, if and only if they are consumed in excess and on an empty stomach.

Conversely, food can contribute to gastric protection, thanks to :

• Mucilages : these soluble fibers have the particularity of forming a viscous gel on contact with water. In the stomach, this gel forms a protective covering, a dressing, which keeps the contents necessary for digestion (enzymes, food, nutrients, acids, etc.) away from the stomach wall. In addition, we do not have the enzymatic material necessary to break down fibers (including mucilage), so they are insensitive to gastric enzymes. In other words, the mucilages act as a substitute mucous membrane during digestion.

• Bicarbonates : bicarbonate (HCO₃^-) has a basic pH: around 8. It has a buffering power, that is to say it neutralizes hydrochloric acid (HCl) whose pH is around 0. In fact, the acidity of hydrochloric acid comes from the proton H⁺ (H⁺ +Cl^-). By coupling it with bicarbonate (HCO₃^-), we obtain chlorine (Cl^-), water and CO₂; three components with neutral pH. Bicarbonate is an antacid which may prove necessary when gastric protection against acidity is insufficient, which is the case with gastritis.

Alcohol is a corrosive. Its presence irritates digestive cells, leading to their dysfunction. Alcohol is one of the main risk factors for developing gastritis.

We recommend you :

• to limit your consumption of alcoholic beverages: maximum one standard drink per day, and not every day.

• avoid consuming alcohol outside of meals.

Consuming foods with acidic pH (below 7) can lead to stomach inflammation. Indeed, in excess and on an empty stomach, the distribution of the stomach's protective mucus can be imperfect, which makes the already weakened stomach vulnerable. To protect the stomach, it is therefore wise not to consume these foods in isolation.

We recommend you :

• not to consume acidic foods on an empty stomach: citrus fruits, pineapples, acidic apples, tomatoes (and its derivatives), unripe fruits, red fruits.

• to limit vinegared foods: vinegar, pickles and all pickled vegetables, etc.

In excess and on an empty stomach, strong spices can support inflammation of the gastric mucosa. This effect comes from their “pungent” chemical components, such as capsaiin, piperine, (6)-shogaol, etc. However, an in vitro study suggests that capsaiin inhibits (in a dose-dependent manner) the growth ofHelicobacter pylori. Further studies are needed to confirm this benefit in humans. Especially since capsaicin is rarely consumed alone, outside of meals. This may explain the contradictory results between studies.

We recommend you :

• to favor sweet spices: vanilla, star anise, turmeric, nutmeg, saffron, cardamom, etc.

• reduce the consumption of strong spices: paprika, pepper, chilli, ginger, horseradish, etc.

• to limit strong condiments: mustard, hot, smoked, sour or acidic sauces, etc.

In excess, sugar stimulates the secretion of hydrochloric acid by parietal cells (cells specialized in the secretion of Hcl) and slows gastric emptying. These two effects increase the vulnerability of the stomach to acidity and digestive work, which is not preferable in the face of gastritis.

We recommend you :

• not to consume sugary products outside of meals.

• to reduce the consumption of confectionery (candies, chocolates, fruit paste, etc.) and sugary drinks.

In excess, salty foods promote hypersecretion of hydrochloric acid and slow gastric emptying. Indeed, a high concentration of sodium in the chyme (contents of the stomach) requires greater gastric work to try to rebalance the sodium concentrations. It is therefore preferable to spread sodium intake over the day to support the recovery of the stomach.

We recommend you :

• to limit foods rich in salt: dried seaweed, condiments (olives in brine, salty soy sauce, pickles), stock cube, etc.

• not to salt your preparations.

• limit yourself to one portion of cheese per day (30 g).

• to consume a maximum of 50 g of cold meats per week.

• to consume a maximum of one baguette per day.

• avoid prepared meals, industrial preparations and canned foods.

• to favor soft butter.

• to opt for home cooking.

• to use spices, aromatic herbs and salt substitutes (potassium salt, gomasio, etc.).

Fat increases gastric work. Indeed, the passage of chyme towards the duodenum is conditioned by various factors. These factors depend on the permeability of the pylorus (opening between the stomach and the duodenum) which includes the lipid concentration in the chyme. The fattier a meal, the longer gastric emptying will take. Thus, foods that are too fatty slow down gastric emptying by increasing the work of the stomach. In addition, they promote the production of hydrochloric acid in the stomach: a factor favorable to irritation of the already vulnerable stomach (inflammation of the mucosa).

We recommend you :

• to limit the cheeses richest in fat: Beaufort, Comté, Parmesan, Ossau Iraty, Gruyère, cheddar, etc.

• limit sauces and fried foods.

• consume a maximum of 50 g of cold meats per week: rillettes, dry sausages, pâtés, sausages, etc.

• avoid excessive consumption of butter (maximum 20 g per day), crème fraîche (maximum 60 g crème fraiche with 30% fat, or 120 g crème fraîche with 15% fat per day) and margarine (maximum 20 g per day). day).

• to consume a maximum of one meat in sauce per week: pot au feu, blanquette of veal, paupiettes, beef bourguignon, etc.

Coffee, tea and chocolate contain methylxanthines (caffeine or theine, theophylline and theobromine) which, in excess, are irritating substances for the gastric epithelium. In addition, coffee stimulates the production of hydrochloric acid, which supports its irritant power.

We recommend you 

• to limit tea and coffee drinks: two cups per day maximum, not on an empty stomach.

• Avoid excess consumption of caffeine-producing foods (dark chocolate, energy drinks, guarana powder, cola-based soda, etc.).

There licorice appears as the food of first attention to gastritis. Indeed, a scientific study carried out in vitro indicates that the isoflavans (glabridin and glabrene) found in licorice inhibit the growth ofHelicobacter pylori. Additionally, another study indicates that saponins (glycyrrhizic acid) have bactericidal activity. Isoflavans and saponins are subgroups of flavonoids. In other words, licorice contributes to bacterial protection.

The big strong point Licorice comes from its richness in mucilage. It therefore also contributes to the protection of the stomach by forming a protective layer. Finally, licorice would participate in digestion, which would facilitate gastric work.

Caution : people suffering from high blood pressure should avoid excessive consumption of licorice, due to the hypertensive power of a deglycyrrhizinated extract.

We recommend you to consume at least one licorice-based herbal tea per day.

Blueberries and cranberries have proanthocyanidins. This particular type of flavonoid would be effective in inhibiting the adhesion of HP to the stomach wall. Bacteria are then more likely to be eliminated naturally when the stomach empties.

Please consider that these are not miracle products! They cannot claim to eradicate an infection alone. Helicobacter pylori. They may simply claim to contribute to preventive protection and recurrence of infection.

We recommend you :

• two standard glasses of cranberry juice (if possible organic), every day, for two months (quantities observed on different scientific study protocols).

• to regularly eat fresh blueberries and cranberries.

• to consume 25 g of dried cranberries or dried blueberries per day.

THE turmeric is recognized for its active ingredient: curcumin. Curcumin is a powerful anti-inflammatory. Turmeric can therefore claim to participate in the resolution of stomach inflammation. In addition, a study observes an attack on the development ofHelicobacter pylori in the presence of curcumin, which would benefit the resolution of the infection.

We recommend you :

• to sprinkle turmeric regularly on your preparations, at the end of cooking.

• to consume golden milk (or golden latte), once or twice a week.

The powders of Psyllium and of Konjac are rich in soluble mucilaginous fiber. In fact, per serving, we find respectively 12.6 g and 1.8 g of soluble fiber. These soluble fibers form a gel on contact with water. In the stomach, this gel forms a protective dressing.

Attention, psyllium and konjac should not be consumed daily. These powders cause malabsorption, which can aggravate the nutritional deficiencies already present during gastritis (gastritis are pathologies with a high risk of nutritional deficiency).  

We recommend you enrich your diet with Psyllium or Konjac, 2 to 3 times a week.

Foods rich in bicarbonate neutralize stomach acid. This effect helps protect the stomach from acidity. Normally, the stomach is capable of self-protection, but during gastritis, the mucous membrane has difficulty fulfilling its protective role.

Caution: bicarbonated waters are also high in sodium. The antacid effect added to the significant intake of sodium disrupts the natural pH of the stomach in the long term. Bicarbonate waters should not be taken systematically.

We recommend you to occasionally consume bicarbonated water. The waters richest in bicarbonate are: St Yorre, Vichy Celestins, Arvie, Rozana, Badoit and Quézac.

THE linseed and the chia seeds are interesting in cases of gastritis for three reasons. First of all, they are rich in alpha-linolenic acid (omega-3), with 2.5 g and 2.7 g of alpha-linolenic acid respectively for a serving of seed (15 g). In addition, they are rich in mucilage (soluble fibers): on contact with a liquid, they swell. Finally, there is a wide range of antioxidant micronutrients: copper, manganese, zinc, etc.

We recommend you consume 15 g of ground flax seeds or chia seeds per day.

Oily fish are among the foods richest in omega-3: alpha-linolenic acid (ALA), EPA and DHA. These are our main sources of EPA and DHA. For 100 g of fatty fish, there is on average 0.2 g of ALA and 2.5 g of EPA and DHA in 100 g.

Oily fish are also full of antioxidants: vitamin E, iron, copper, manganese, zinc, etc.

We recommend you to compose two meals based on fatty fish per week: sardines, mackerel, bluefin tuna, salmon, trout, herring, etc.

Nuts and vegetable oils contribute to rebalance the omega-3/omega-6 ratio by the interesting presence of alpha-linolenic acid (omega-3), an anti-inflammatory. Also, they are vectors of vitamin E, a powerful antioxidant. For nuts, we also find other antioxidant trace elements, such as zinc or copper.

We recommend you :

• to consume 15 g of nuts per day. Walnut kernels are the nuts richest in omega-3.

• to consume three tablespoons of vegetable oil rich in raw omega-3 daily. Vegetable oils rich in omega-3 are flaxseed oil, chia oil, soybean oil, rapeseed oil and even hemp oil. 

• Ensuring good food hygiene : Gastritis is largely caused by a bacterial infection. It is transmitted orally, via contaminated food or contaminated water. Therefore, remember to wash your plants well before consumption.

• Favor gentle cooking: many micronutrients degrade during cooking (vitamins, saponins, omega-3, certain flavonoids). To benefit from their benefits, please favor short cooking (steam, wok, en papillote) and, possibly, opt for raw consumption.

• Split your meals and avoid meals that are too large : the stomach corresponds to an important stage of digestion. However, digestion is impaired in cases of gastritis (nutritional deficiencies are more recurrent), it seems important not to overload it. Therefore, it is preferable to opt for several small, balanced meals to facilitate your recovery and promote the absorption of nutrients.

• Opt for a curegreen clay : green clay lines the stomach and acts as a natural gastric dressing. As a result, it contributes to gastric protection. Orally, ingest a glass of clay water (supernatant from the green clay mixture in a glass of water after a few hours of break), before meals. The treatment lasts a maximum of three weeks. If taking medication, please seek medical advice before use.

• Pay attention to food temperatures : the stomach is already sensitive, it is recommended to avoid foods and liquids that are too hot or too cold. The temperature of the meal also affects the recovery of the gastric mucosa.

• Limit or even stop smoking: tobacco is a significant risk factor for developing gastritis.

• Improve stress management: Stress can stimulate the acid secretion of the stomach, favoring the occurrence of gastritis. In addition, stress promotes vulnerability to infections. Helicobacter pylori. When gastritis is encouraged by episodes of stress, we then speak of nervous gastritis. Different techniques can be useful to deal with anxieties: meditation, sophrology, yoga, physical activity, olfactotherapy, cardiac coherence, etc.

• Avoid all self-medications : this seems obvious, but we would like to point out that no medication is without danger. For gastritis, taking an antacid (proton pump inhibitor (PPI)) benefits the development ofHelicobacter pylori. Please contact a healthcare professional before taking any medication.