For most cases of gastritis, over-the-counter antacids or acid reducers will ease symptoms within days. The right choice depends on how severe your symptoms are, how long they’ve lasted, and what’s causing the inflammation in the first place. Options range from simple antacids you can pick up today to prescription antibiotics for bacterial infections, along with dietary changes that make a real difference.
Antacids for Quick Relief
Antacids like Tums, Rolaids, and Maalox neutralize the acid already sitting in your stomach. They work within minutes, which makes them useful when you need fast relief from burning or discomfort after eating. The tradeoff is that they wear off quickly, usually within one to three hours, so they’re better for occasional flare-ups than ongoing symptoms.
If you find yourself reaching for antacids multiple times a day for more than two weeks, that’s a sign you need something stronger or should look into what’s driving the inflammation.
H2 Blockers: A Step Up
H2 blockers reduce the amount of acid your stomach produces rather than just neutralizing what’s there. Famotidine (sold as Pepcid) is the most widely available option over the counter. These medications work by blocking the signal that tells your stomach cells to release acid. Relief takes 30 to 60 minutes to kick in but lasts significantly longer than antacids, typically 6 to 12 hours.
H2 blockers are a solid middle ground if antacids alone aren’t cutting it. They’re generally well tolerated and can be taken daily for short stretches while your stomach heals.
Proton Pump Inhibitors for Stronger Acid Suppression
Proton pump inhibitors, or PPIs, are the most powerful acid reducers available. Over-the-counter versions include omeprazole (Prilosec) and esomeprazole (Nexium). Unlike antacids, PPIs don’t provide instant relief. They take one to four days to reach full effect because they work by shutting down the tiny acid-producing pumps in your stomach lining.
PPIs are particularly useful when gastritis has progressed to erosions or small ulcers, since dramatically lowering acid gives damaged tissue time to repair. Over-the-counter PPIs are labeled for 14-day courses, and most guidelines recommend not self-treating beyond that without professional guidance. Long-term PPI use has been associated with reduced absorption of certain nutrients, so using the lowest effective dose for the shortest time makes sense.
Bismuth Subsalicylate
Pepto-Bismol (bismuth subsalicylate) works differently from acid reducers. It coats irritated stomach tissue and has mild antibacterial properties. It can help with the nausea, burning, and upset stomach that come with gastritis. Bismuth is also a key component of prescription regimens used to treat H. pylori infections, so it pulls double duty as both a comfort measure and a therapeutic agent.
Prescription Treatment for H. Pylori
If your gastritis is caused by H. pylori, a bacterial infection found in roughly half the world’s population, acid reducers alone won’t fix the underlying problem. You’ll need antibiotics to clear the infection.
The current recommended approach from the American College of Gastroenterology is a 14-day course of four medications taken together: a PPI, tetracycline, metronidazole, and a bismuth compound. This combination, called quadruple therapy, replaced the older three-drug regimen because H. pylori has developed widespread resistance to clarithromycin, one of the antibiotics previously used. The older triple therapy is now specifically recommended against unless lab testing confirms the bacteria are still sensitive to it.
For people who don’t respond to the first round, alternative regimens exist using different antibiotic combinations. Your doctor will typically confirm the infection is gone with a follow-up breath test or stool test a few weeks after treatment.
Dietary Changes That Help
What you eat won’t cure gastritis, but it can significantly reduce how much your stomach hurts while it heals. The goal is to avoid foods that trigger more acid production or directly irritate inflamed tissue.
Foods that commonly make gastritis worse include:
- Coffee (regular and decaf), alcohol, and caffeinated drinks
- Citrus fruits, tomato-based sauces, and orange or grapefruit juice
- Spicy seasonings like chili powder, black pepper, and curry
- Fried foods, fast food, and high-fat meats like bacon, sausage, and salami
- Chocolate, whole milk, and full-fat dairy
Foods that tend to be easier on an inflamed stomach:
- Low-acid fruits and vegetables like apples, melons, pumpkins, and carrots, cooked without added fat
- Whole grains including oatmeal, brown rice, and whole-wheat bread
- Lean proteins like skinless chicken, turkey, fish, eggs, and beans
- Healthy fats from olive oil and canola oil in moderate amounts
- Herbal teas (except peppermint and spearmint, which can relax the valve at the top of your stomach and worsen symptoms)
High-fiber foods in general tend to be easier to digest and may help relieve symptoms. Eating smaller, more frequent meals instead of large ones also keeps acid production lower throughout the day.
Probiotics as a Supplement
Certain probiotic strains show promise as an add-on to standard gastritis treatment, particularly when H. pylori is involved. Lactobacillus reuteri has been shown to inhibit H. pylori from colonizing the stomach lining and produces a natural antimicrobial compound active against the bacteria. In clinical practice, L. reuteri supplements have been used alongside antibiotic therapy to improve treatment effectiveness and reduce side effects like diarrhea and bloating that antibiotics often cause.
Probiotics aren’t a standalone treatment for gastritis, but they can support recovery, especially during and after a course of antibiotics that disrupts your gut bacteria.
Slippery Elm and Other Herbal Options
Slippery elm bark is one of the more commonly used herbal remedies for stomach irritation. When mixed with water, it forms a gel-like substance that coats and soothes the lining of the digestive tract. A typical dose is about one tablespoon of the powdered bark mixed into tea or water, up to three times daily. It’s available as capsules, lozenges, or loose powder.
Chamomile and ginger teas are also popular choices for calming an upset stomach, though the evidence behind them is less robust than for conventional treatments. These can be reasonable comfort measures alongside more targeted therapy.
Symptoms That Need Prompt Attention
Most gastritis responds well to the approaches above, but stomach lining inflammation can sometimes progress to erosions or ulcers that bleed. Signs of stomach bleeding include black or tarry stools, vomit that looks like coffee grounds, red blood in vomit or stool, feeling lightheaded or unusually tired, and unexplained abdominal pain. These symptoms warrant immediate medical evaluation, as bleeding from the stomach can become serious quickly.
Gastritis that persists beyond a few weeks despite treatment, or that keeps coming back, often has an identifiable cause like H. pylori, regular use of anti-inflammatory painkillers (ibuprofen, aspirin, naproxen), or an autoimmune condition. Identifying and addressing that root cause is what ultimately resolves the problem rather than just managing symptoms with acid reducers indefinitely.