person pouring alcohol in a glass

How To Treat Alcoholic Gastritis And When To Seek Medical Help

Alcoholic gastritis is an inflammation of the stomach lining caused by alcohol use. Untreated alcoholic gastritis can lead to several serious health complications, so it is vital that you seek treatment quickly.

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Understanding Alcoholic Gastritis

First, we will discuss the mechanism of gastric inflammation, symptoms, and diagnostic criteria to differentiate alcoholic gastritis from other gastric issues.

Over time, consuming too much alcohol can irritate and erode your stomach lining and cause gastritis symptoms.

Gastritis can be an asymptomatic illness, meaning it does not cause any symptoms, or it may cause the following symptoms:

  • A burning, gnawing ache in your stomach that may better or worsen after eating.
  • Constant pain between your navel and ribs
  • Belching and hiccuping
  • Bloated or full feeling in your stomach that worsens when you eat
  • Blood in your feces or vomit, which may be coming from bleeding in the stomach lining
  • You experience fatigue and shortness of breath when you exercise if you have anemia (too few red blood cells) and gastritis. Bleeding in the stomach can cause anemia.
  • Loss of appetite
  • Nausea
  • Vomiting

However, other issues can cause these symptoms, so a doctor must diagnose and treat them.
In order to determine if you have alcoholic gastritis, your doctor will do a physical exam and ask you about your health history and personal habits, such as how much and how often you drink.

Your doctor may also perform some of the following tests:

  • A blood test – A blood test is used to look for gastritis-causing bacteria and signs of anemia.
  • A breath test – A breath test is used to check for gastritis-causing bacteria. You will need to drink a special clear liquid and then breathe into a bag that is quickly sealed and tested to determine if the bacteria broke down the liquid in your stomach.
  • A stool test – A stool test will allow your doctor to check for blood or gastritis-causing bacteria in your feces. If there is blood in your stool sample, it could indicate bleeding in your stomach or intestine linings.
  • An upper endoscopy – To do an upper endoscopy, your doctor will guide an endoscope (a thin, lighted tube with a camera at one end) down your throat to check your duodenum (the upper part of your small intestine), esophagus (the tube leading from your throat to your stomach), and stomach. They may also remove some tissue for lab tests.
  • An X-ray of your upper gastrointestinal (GI) tract – An X-ray of your upper GI tract will capture images of your duodenum, esophagus, and stomach. To prepare for the X-ray, you will need to drink a liquid called barium, which helps show details from the scan.

Your history and test results will help your doctor determine if you have gastritis, whether or not your alcohol use is a contributing factor, and what treatment is most appropriate.

Differentiating Alcoholic Gastritis from Other Gastric Issues

Drinking too much alcohol is not the only potential cause of gastritis. Gastritis can be acute (meaning it comes on suddenly and is severe) or chronic (long-lasting).

  • Helicobacter pylori (H. pylori) bacterial infection can cause either acute or chronic gastritis.
  • Another common cause of acute gastritis is the excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Stomach ulcers may cause chronic gastritis.

Lifestyle Modifications

If you are diagnosed with alcohol-related gastritis, there are lifestyle modifications that can help you manage this condition, such as alcohol cessation, dietary changes, and managing stress and anxiety.

Alcohol Cessation

Quitting or cutting back on the amount and frequency of your alcohol consumption is key to treating alcohol-induced gastritis because it directly addresses the cause of your condition.

Strategies for quitting alcohol include:

  • Talk to your doctor to devise a plan for how to take care of yourself.
  • Set a goal, such as a date to quit drinking, and share it with someone you trust so they can help you stay motivated and accountable.
  • Manage alcohol cravings by distracting yourself, using mindfulness or visualization, and/or taking medications like naltrexone or gabapentin.
  • Identify and manage triggers that make you want to drink alcohol.
  • Schedule new activities and hobbies to keep yourself busy.
  • Reach out to your support network or go to therapy.
  • Recognize that relapses are common and that you can always get back to your goal.
  • Celebrate milestones and pay attention to what worked and what didn’t work in your journey.

Dietary Changes

Changing your diet can help you manage alcoholic gastritis symptoms.

Foods and drinks that can reduce flare-ups of alcohol-related gastritis include:

  • Applesauce
  • Bananas
  • Barley, brown rice, and quinoa
  • Beans and legumes
  • Boiled or scrambled eggs
  • Broiled or steamed fish
  • Broths and clear soups
  • Fresh berries
  • Ginger, peppermint, or turmeric tea
  • Low-fat dairy products
  • Melons
  • Oatmeal and porridge
  • Skinless poultry
  • Squash and other root vegetables
  • Steamed cabbage and cauliflower
  • Whole grain bread and pasta

Foods and drinks to avoid include:

  • Alcohol
  • Baked goods like cakes and cookies
  • Chocolate
  • Citrus fruit and juices
  • Coffee and tea
  • Corn, cornmeal, or polenta
  • Cream soups, gravy, salsa, and sauces
  • Fast foods, including pizza
  • Fried foods
  • Full-fat dairy products
  • Garlic, onions, and peppers
  • Packaged snacks and potato chips
  • Peanut butter and other nut butter
  • Processed or smoked meats
  • Red meat
  • Spicy foods
  • Sweet carbonated beverages
  • Tomatoes and tomato sauce or juice

Managing Stress and Anxiety

Stress and anxiety have a direct impact on gastric health. Stress activates your body’s fight-or-flight response and delays stomach emptying, leading to indigestion, heartburn, and nausea. Stress and anxiety are also common triggers that make people want to drink alcohol.
However, there are many things you can do to reduce stress and anxiety, such as getting more exercise, meditating, and spending time in nature.

Medical Treatments

There are also medical treatments for alcoholic gastritis available, such as medications for symptom relief, prescription medications, and endoscopy and surgical interventions.

Over-the-counter medications for symptom relief of alcoholic gastritis include antacids, proton pump inhibitors, and H2 blockers.

Antacids like Tums neutralize stomach acid but do not block stomach acid production. They work quickly, but the effects do not last longer than two hours.

Proton pump inhibitors (PPIs) like Nexium and Prilosec work by blocking the production and release of stomach acid. PPIs must be taken for 14 days, so they are not intended for immediate symptom relief because they may take one to four days to reach full effectiveness.

Histamine-2 blockers (H2 blockers) like Pepcid reduce the amount of stomach acid by blocking the histamine receptors in your stomach that produce and trigger the release of stomach acid. H2 blockers take effect in 15-30 minutes, and the effects last for up to 12 hours.

Suppose over-the-counter medications are not working well enough, or you are struggling to quit drinking alcohol. In that case, your doctor may prescribe you medications like cytoprotective agents or medications for alcohol dependence.

Cytoprotective agents protect the gastric mucosa from injury in ways other than by inhibiting or neutralizing gastric acid.[1] Examples of cytoprotective agents include aluminum-containing antacids, colloidal bismuth, and sucralfate.

The Food and Drug Administration (FDA) has approved three medications for alcohol dependence. They are acamprosate, disulfiram, and naltrexone.

  • Acamprosate increases abstinence rates and reduces relapse rates.
  • Disulfiram has significant adverse effects and compliance difficulties, and there is an absence of evidence that it is effective in decreasing relapse rates, increasing abstinence rates, or reducing cravings.
  • Naltrexone increases abstinence rates and reduces cravings and relapse rates.

The anticonvulsant topiramate and several serotonergic agents, such as fluoxetine and ondansetron, are not FDA-approved to treat alcohol dependence. Still, they may help decrease drinking while increasing abstinence rates.

Endoscopy and Surgical Interventions

Treatment of alcoholic gastritis sometimes involves endoscopy and surgical interventions.
Surgery is necessary to treat gastritis only if you have acute necrotizing gastritis or phlegmonous gastritis. Surgery to resect the affected area is often the most effective treatment for acute necrotizing gastritis.

Suppose your doctor suspects that you have bleeding in your upper GI tract. In that case, they will need to do an endoscopy in order to rule out angiomatous malformations, bleeding ulcers, erosions, and malignant transformation.

Potential complications of upper endoscopy include allergic reactions to the sedative, bleeding or infection in your digestive tract, and tearing (perforation) in the digestive tract lining. However, this procedure is necessary to help your doctor determine that you do not have any other medical conditions that may be causing your symptoms, such as cancer.

Natural Remedies and Complementary Therapies

In addition to other alcoholic gastritis treatments we have discussed, natural remedies and complementary therapies like herbal supplements and probiotics can also help relieve symptoms.

Ginger and turmeric are both rhizomes (root stalks) that can relieve pain. The pain-relieving active ingredients in ginger are the phytochemicals gingerols and shogaols. Ginger can help treat and prevent the growth of H. pylori bacteria and may help protect the lining of your stomach.

Turmeric has anti-inflammatory properties that can help improve gastric issues. You can make tea with ginger or turmeric, add ginger or turmeric to food and drinks, or take supplement pills.

Slippery elm contains a substance called mucilage that becomes a slick gel when it is mixed with water. This gel coats and soothes the intestines, mouth, stomach, and throat when ingested. Slippery elm also has cytoprotective properties, as it increases mucus secretion in the GI tract. You can take slippery elm capsules, lozenges, or tablets or make slippery elm tea.

Alcoholic gastritis disrupts the delicate balance of healthy bacteria in the gut microbiome, but taking probiotics can help reverse this damage.[2]

Managing Complications

Alcoholic gastritis can cause complications such as ulcers and bleeding, anemia, and malnutrition, but we will discuss how to manage them here.

Ulcers do not always cause symptoms, but possible signs and symptoms of an ulcer include:

  • Abdominal pain
  • Belching
  • Bloating or a feeling of fullness
  • Heartburn
  • Nausea
  • Vomiting

The first signs of a slow-bleeding ulcer are symptoms of anemia. An ulcer that is bleeding heavily may cause black and sticky stool, bloody vomit that has the consistency of coffee grounds, or dark red or maroon blood in your stool. Rapid or heavy bleeding from an ulcer can be life-threatening. You should seek immediate medical attention if you experience any of these symptoms.

Ulcers and bleeding usually require emergency surgery.

Anemia is a low red blood cell count or low levels of hemoglobin caused by decreased production of red blood cells, impaired function of red blood cells, or increased destruction of red blood cells. One effect of anemia is a decrease in your cells’ ability to transport oxygen to organs and tissues.

There are many different types of anemia. Macrocytic anemia is caused by deficiencies in B vitamins and folate resulting from excessive alcohol consumption.

Treatment for macrocytic anemia involves replacing vitamin B or folate levels through diet and/or supplementation and treating the underlying cause of the anemia.[3]

The symptoms of alcoholic gastritis can cause you to experience decreased appetite. Over time, eating less can lead to weight loss and malnutrition. This negatively impacts your health and recovery, but there are solutions to help you overcome malnutrition resulting from alcoholic gastritis.

Nutritional support supplies nutrients in ways other than by orally consuming food. Methods may include using a feeding tube (enteral nutrition) or an intravenous catheter (parenteral nutrition).

When to Seek Professional Help

This section will cover warning signs, the importance of early intervention, and consulting a gastroenterologist.

Warning Signs

As we have discussed, alcoholic gastritis can cause life-threatening complications like cancer and bleeding ulcers. It is vital to seek treatment immediately, especially if your symptoms worsen.

Importance of Early Intervention

Early intervention is key in preventing worsening alcoholic gastritis and avoiding potentially life-threatening complications.

Consulting a Gastroenterologist

If you suspect that you may have alcoholic gastritis, you should be seen by a gastroenterologist. A gastroenterologist is a doctor who specializes in treating digestive health issues.

Preventing Alcoholic Gastritis

Next, we will outline strategies for prevention, education, and awareness, as well as available support networks and available resources.

Strategies for prevention include:

  • Eating small meals
  • Managing stress
  • Not drinking alcohol at all or only in moderation
  • Not eating acidic, fatty, fried, or spicy foods
  • Not taking aspirin or other NSAIDs
  • Reducing your caffeine intake
  • Quitting smoking
  • Waiting until two to three hours after you eat before you lie down
  • Washing your hands to avoid contracting an H. pylori bacterial infection

Alcoholic gastritis is very common in people who drink regularly over a period of years, but educating people and making them aware of the warning signs, causes, and complications of alcoholic gastritis can help with prevention.

Support Networks and Resources

Quitting alcohol is the best thing you can do to prevent or treat alcoholic gastritis. Many support networks and resources are available for people who need help to stop drinking. Examples include Alcoholics Anonymous (AA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

Last Words

Alcoholic gastritis is inflammation of the stomach lining caused by excessive alcohol consumption. This condition is common among people who drink heavily. Left untreated, it can lead to serious, life-threatening complications such as cancer and internal bleeding, so it is important to seek treatment quickly.

If you are diagnosed with alcoholic gastritis, it can be treated, but you will need to stop drinking alcohol. If you abuse alcohol but do not have alcoholic gastritis, stopping drinking can ensure you will never get this condition in the first place.

Quitting alcohol and recovering from alcoholic gastritis is possible with the help of a good support system of friends, family, doctors, and community resources.

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