The right treatment for gastritis depends on what’s causing it, but most people get relief by reducing stomach acid with over-the-counter medications while the stomach lining heals. Proton pump inhibitors (PPIs) are the most effective acid reducers available without a prescription, and they’re the foundation of nearly every gastritis treatment plan. Beyond medication, what you eat, what you stop taking, and whether you have a bacterial infection all shape how quickly you recover.
Over-the-Counter Acid Reducers
Three classes of medication reduce stomach acid, and they work at different speeds and strengths. Antacids like calcium carbonate (Tums) and magnesium hydroxide (Milk of Magnesia) neutralize acid that’s already in your stomach. They work within minutes but wear off quickly, making them useful for short bursts of relief rather than sustained healing.
H2 blockers work differently. Your stomach produces acid when a chemical messenger called histamine binds to receptors on the cells lining your stomach wall. H2 blockers occupy those receptors first, preventing the signal from getting through. Famotidine (Pepcid) is the most widely available H2 blocker and provides moderate acid suppression for 8 to 12 hours per dose.
PPIs are the strongest option. They shut down the acid-producing pumps in your stomach cells directly, cutting acid output by roughly 90%. Omeprazole (Prilosec) and esomeprazole (Nexium) are both available over the counter. Unlike antacids, PPIs take a day or two to reach full effect, but they provide the deepest and longest-lasting acid reduction. For active gastritis, a PPI taken once daily before breakfast is typically the most effective OTC choice.
Treatment for H. pylori Infection
About half of all chronic gastritis cases are caused by Helicobacter pylori, a bacterium that burrows into the stomach lining and triggers ongoing inflammation. You can’t treat this with acid reducers alone. Killing the bacteria requires a combination of antibiotics and an acid suppressor, taken together for 14 days.
The current recommended first-line treatment from the American College of Gastroenterology is a four-drug regimen: a PPI twice daily, bismuth (the active ingredient in Pepto-Bismol) four times daily, plus two antibiotics, tetracycline and metronidazole. This approach replaced the older three-drug regimen built around the antibiotic clarithromycin, which is no longer recommended unless lab testing confirms the bacteria are sensitive to it. Antibiotic resistance made clarithromycin-based therapy unreliable for too many patients.
A newer alternative pairs a stronger acid suppressor called vonoprazan with high-dose amoxicillin. This simpler two-drug regimen is gaining traction because it’s easier to follow and appears effective even against some resistant strains. Your doctor will choose a regimen based on your allergy history and whether you’ve tried treatment before. The key point: H. pylori won’t go away on its own, and leaving it untreated keeps the inflammation going indefinitely.
Stop What’s Causing the Damage
NSAIDs are the other major cause of gastritis. Ibuprofen (Advil), naproxen (Aleve), and aspirin all carry a black box warning about serious gastrointestinal events, including bleeding, ulceration, and perforation of the stomach lining. If you’re taking one of these regularly and develop gastritis, stopping the NSAID is often the single most effective step.
For pain relief while your stomach heals, acetaminophen (Tylenol) is the safest substitute. It works through a different mechanism and is far less likely to irritate the stomach lining. If you need to stay on an NSAID for a condition like arthritis, your doctor may add a daily PPI to protect your stomach, or switch you to a COX-2 selective inhibitor, which carries a lower risk of stomach damage.
Alcohol and smoking both slow healing and worsen inflammation. Cutting them out during an active flare gives the stomach lining a much better chance of recovering.
Foods That Help and Foods That Hurt
Diet won’t cure gastritis, but it can dramatically affect how you feel day to day. The general principle is simple: eat bland, low-acid, low-fat foods and avoid anything that increases acid production or directly irritates inflamed tissue.
Foods that tend to promote healing include:
- High-fiber choices: whole grains, oats, beans, and chickpeas
- Low-acid fruits: bananas, melons, and apples
- Cooked vegetables: carrots, spinach, zucchini, leafy greens, and mashed pumpkin
- Lean proteins: skinless chicken, fish, and eggs
- Soft, bland staples: rice, boiled potatoes, soft pasta, cottage cheese, and avocados
- Soothing liquids: broth, chamomile tea, and caffeine-free teas
Foods and drinks to avoid during a flare:
- Acidic foods: tomatoes, citrus fruits, and fruit juices
- Irritants: coffee, alcohol, carbonated drinks, and spicy foods
- High-fat and fried foods: these increase inflammation in the stomach lining
- Pickled and heavily processed foods
Eating patterns matter too. Research shows that people with gastritis symptoms tend to eat at irregular times, skip meals, snack heavily, and eat inconsistent portions. Smaller, more frequent meals spread throughout the day keep your stomach from producing large surges of acid at once.
Supplements and Natural Options
A few natural substances show some promise for gastritis, though none replace conventional treatment. Deglycyrrhizinated licorice (DGL) is a modified form of licorice root with the blood-pressure-raising compound removed. Small studies suggest it may help protect the stomach lining from NSAID damage, and it’s available as chewable tablets. Colostrum, the early form of breast milk sold as a supplement, has also shown some protective effects in preliminary research.
Probiotics may play a supporting role, particularly when taken alongside antibiotic treatment for H. pylori. One analysis found that combining certain Lactobacillus and Bifidobacterium strains with standard antibiotic therapy pushed eradication rates from about 74% up to 92-96%. Probiotics won’t clear the infection on their own, but they may improve the odds that antibiotics succeed while reducing side effects like diarrhea.
Other supplements sometimes recommended for stomach health, like slippery elm, have little to no scientific evidence behind them for gastritis specifically.
Prescription Medications for Severe Cases
When over-the-counter PPIs aren’t enough, prescription-strength versions at higher doses are the next step. Your doctor may also prescribe sucralfate, a medication that works differently from acid reducers. Instead of lowering acid production, it forms a physical coating over damaged areas of the stomach lining, shielding them from acid while they heal. Sucralfate needs to be taken on an empty stomach to work properly.
For people who must continue taking NSAIDs, a prescription medication called misoprostol can be added to reduce the risk of stomach ulcers and bleeding. It replaces a protective substance that NSAIDs deplete from the stomach lining.
Warning Signs That Need Immediate Attention
Most gastritis responds well to the treatments above, but certain symptoms signal bleeding in the stomach and require urgent medical care. These include black or tarry stools, red or maroon blood in your stool, vomit that contains red blood or looks like coffee grounds, and unexplained lightheadedness, fatigue, or shortness of breath combined with abdominal pain. These symptoms can indicate that gastritis has progressed to an ulcer or erosion that’s actively bleeding.