Gastritis diet: what to avoid, what helps, and what heals it

A gastritis diet can make a sore stomach more comfortable. What it usually can’t do is make gastritis go away, because in most cases food isn’t what caused it. H. pylori infection is behind more than 90% of chronic gastritis.^[2] Other causes include anti-inflammatory painkillers, alcohol, bile reflux, and the immune system attacking the stomach lining.^[1]

So this guide runs in the order that works: find the cause, treat it, and eat for comfort while the lining recovers. Along the way, the usual foods-to-avoid list gets graded, including one item that almost every list gets backwards.

One disclosure before we start: Evexia’s owner also owns Greco Gum, a mastic gum brand, which comes up in one section near the end.

What is gastritis, and what causes it?

Gastritis is inflammation of the stomach lining. It’s confirmed from a biopsy taken during endoscopy and read under a microscope, rather than from symptoms.^[2] That distinction matters for everything below: gastritis is a finding, and the finding has a cause.

The main causes of gastritis, and what actually treats each

Cause	What happens	What treats it
H. pylori infection	A bacterium, usually picked up in childhood, inflames the lining for years or decades. Behind more than 90% of chronic gastritis	Testing, then eradication therapy
NSAID painkillers	Long-term use irritates the lining directly	Stopping or switching, with your doctor
Alcohol	One of the most common direct irritants of the lining	Cutting down or stopping
Bile reflux	Bile flows back into the stomach, most often after surgery that removes part of it, including some weight-loss operations	Medical assessment and management
Autoimmune gastritis	The immune system attacks healthy cells in the lining; over time this can impair vitamin B12 and iron absorption	Monitoring, with B12 and iron replacement where needed
Other causes	Coeliac disease, inflammatory bowel disease, chemotherapy, radiation, some infections and others	Treating the underlying condition

Damage from NSAIDs, alcohol and bile is often called reactive gastropathy.^[1] Long-running gastritis, whether autoimmune or from H. pylori, can progress to atrophic gastritis, where the stomach’s glands are gradually lost. That’s why vitamin B12 and iron deficiency sometimes turn up alongside it.^[2]

Gastritis symptoms, and why many people have none

The majority of people with gastritis or gastropathy don’t have any symptoms.^[1] H. pylori gastritis, usually acquired in early childhood, can run for decades as a symptom-free inflammation.^[2] When symptoms do appear, the usual ones are:^[1]

• pain or discomfort in the upper abdomen
• nausea or vomiting
• feeling full too soon during a meal, or too full after one
• loss of appetite
• weight loss

None of those is specific to gastritis. People with exactly these symptoms can have nothing abnormal at endoscopy, which is what defines functional dyspepsia.^[3] So a symptom list can tell you something is wrong in your upper gut, but not what.

How do you heal gastritis?

Start with the cause.

If it’s H. pylori, test and treat. For people under 60 with indigestion, the joint American and Canadian guideline recommends a non-invasive H. pylori test, and treatment if it’s positive.^[3] Clearing the infection can return the stomach lining to normal, provided the gastritis hasn’t already progressed to atrophy.^[2] Our H. pylori guide covers the treatment and what natural agents add to it.

If the test is negative, or treatment doesn’t settle things, the same guideline’s next step is a trial of acid-suppressing medication, usually a proton pump inhibitor.^[3] Worth knowing before concluding that medicine has nothing more to offer and diet is all that’s left: the standard pathway still has several steps to go.

If it’s NSAIDs, the fix is the drug, not your diet. Talk to your doctor before stopping anything prescribed, particularly low-dose aspirin taken for your heart.

If it’s alcohol, stop while the lining heals. It’s the single most useful dietary change on this page.

If it’s autoimmune, diet won’t change the process, but your doctor will want to keep an eye on B12 and iron.

Only then does the question of what to eat come in, and it’s mostly about comfort.

What foods should you avoid with gastritis?

Graded by how well the evidence supports avoiding each one.

Foods and habits to avoid with gastritis, graded by the evidence

Food or habit	Grade	What the evidence shows	What to do
Alcohol	Strong	One of the most common direct irritants of the stomach lining	Stop while healing; keep it light afterwards
NSAID painkillers	Strong	Long-term use is one of the most common causes of reactive gastropathy	Review with your doctor; don't stop prescribed aspirin yourself
Smoking	Moderate	Linked to both gastric and duodenal ulcers in a study of 8,013 adults	Stop
Coffee	Weak	No link to gastric or duodenal ulcers in the same study, or in a pooled analysis of earlier ones	Keep it if it sits well
Spicy food	No evidence of harm	No meaningful damage from spicy meals on endoscopy; chilli reduced aspirin injury	Eat it if it doesn't burn
Your personal triggers	Real, but individual	No study can tell you what your own stomach dislikes	A two-week food and symptom log

The alcohol and NSAID grades rest on their standing as the commonest irritants behind reactive gastropathy.^[1] Neither is controversial.

Is coffee bad for gastritis?

Probably not, for most people. The smoking and coffee rows come from the same study: 8,013 Japanese adults, all of whom had an endoscopy. After adjusting for age, weight, H. pylori, alcohol and other factors, current smoking was associated with both gastric and duodenal ulcers, and so was H. pylori infection. Coffee wasn’t associated with either, and the authors’ meta-analysis of earlier studies found no link either.^[6]

That’s a study of ulcers rather than gastritis, and it’s cross-sectional, so it can’t prove cause or its absence. But it’s a large sample, and it cuts against the idea that coffee is a hazard to the stomach lining. If coffee gives you discomfort, drop it. You don’t need to on the evidence alone.

Is spicy food bad for gastritis?

This is the one most lists get backwards. The belief that chilli damages the stomach is widespread. The evidence points the other way.

In a randomized crossover study, 12 healthy volunteers each ate four test meals, with endoscopy before and about 12 hours after: plain steak and chips, the same bland meal with a large dose of aspirin, a Mexican meal containing 30 g of jalapeños, and pepperoni pizza. Eleven of the 12 developed multiple stomach erosions after the aspirin meal. After the spicy meals, the median damage score was zero, with a single erosion in one person after each. The researchers also placed ground jalapeños directly into the stomach and found no visible damage 24 hours later.^[4]

A second study went further. Eighteen healthy volunteers took 600 mg of aspirin on two occasions four weeks apart, once half an hour after 20 g of chilli and once after water alone. With chilli beforehand, the median gastric injury score was 1.5; without it, 4.^[5] Capsaicin, the compound that makes chilli hot, had already shown this protective effect in animals. This was the first time it had been documented in people.

The caveats: small numbers, healthy volunteers, single exposures, and nobody with existing gastritis. And “doesn’t damage” isn’t the same as “won’t hurt”. If chilli burns on an already-inflamed stomach, that’s a perfectly good reason to skip it for now. It just isn’t a reason to believe it caused the problem or will stop it healing.

What foods help gastritis?

Two with real human data, both tied to H. pylori.

Broccoli sprouts. In a randomized trial, 48 people with H. pylori ate 70 g of broccoli sprouts a day for eight weeks, or the same weight of alfalfa sprouts as a placebo. The broccoli group saw falls in markers of H. pylori colonisation and of stomach inflammation; the alfalfa group didn’t. Two months after they stopped, the values were back where they started.^[7] That’s suppression rather than cure, which is still useful while you’re arranging treatment or eating through it.

Probiotics. A meta-analysis of 33 randomized trials with 4,459 patients found that adding probiotics to H. pylori eradication therapy raised eradication rates, by about 12% in relative terms. The benefit was confirmed only for four specific strains and mainly where the antibiotics were less effective, and the reduction in side effects held up only in unblinded trials.^[8] That evidence is for particular supplement strains taken during treatment. Yoghurt and kefir are reasonable foods to include, but the trial results don’t transfer to them automatically.

The rest of the list. Cranberry, garlic, green tea and honey appear on nearly every gastritis list. Our H. pylori guide grades them; none has the evidence to count as a treatment.

How to eat while it settles

The role of diet in the course of chronic gastritis is still largely unknown,^[2] so this part is led by comfort rather than trials.

• Smaller, more regular meals. If fullness is what hurts, less food at once is the obvious lever.
• No alcohol until you’re better, and ideally until the cause has been dealt with.
• A short food and symptom log for two weeks. Personal triggers are real even where population studies find nothing.
• Don’t shrink your diet out of fear. Coffee and chilli don’t need to go unless they bother you, and a varied diet with plenty of plants is easier to sustain than a list of bans.
• Broccoli sprouts and fermented foods, if you tolerate them.
• If you need pain relief, ask a pharmacist or doctor which option is easiest on your stomach.

In practice, a day might be porridge or eggs on toast for breakfast, a soup or grain bowl at lunch, and fish or chicken with rice and cooked vegetables for dinner, with yoghurt or fruit in between. Nothing on that list is medicinal. It’s simply ordinary food, in moderate portions, with the likeliest irritants left out while the actual treatment does its work.

If reflux is part of your picture too, our GERD diet guide covers that side. And the same irritants, alcohol and NSAIDs, come up again in the debate over leaky gut.

Mastic: the trials worth knowing

Mastic, the resin of the Chios mastic tree, has two placebo-controlled human trials worth knowing here. Both are positive. Neither measured gastritis itself.

Duodenal ulcer, 1984. Thirty-eight patients with symptomatic, endoscopically confirmed duodenal ulcers took either 1 g of mastic a day or a lactose placebo for two weeks. Symptoms eased in 80% of the mastic group against 50% on placebo, and endoscopy showed healing in 70% against 22%. The difference was highly significant, and no side effects were reported.^[9] It’s small, it’s old, and it’s about the duodenum rather than the stomach. It was also published just two years after H. pylori was identified,^[2] and the abstract says nothing about infection status. Treat it as an interesting early signal.

Functional dyspepsia, 2010. A larger, more modern trial randomized 148 people with functional dyspepsia to 350 mg of mastic three times a day or placebo for three weeks. Symptom scores were significantly lower on mastic, and 77% reported marked improvement against 40% on placebo. General stomach pain, stomach pain when anxious, a dull upper-abdominal ache and heartburn all improved significantly.^[10] Functional dyspepsia means endoscopy found no structural cause for the symptoms,^[3] so this was a trial in people whose stomachs looked normal. It tells you mastic eased upper-gut symptoms. It doesn’t tell you it heals an inflamed lining.

Mastic’s history with H. pylori, the main cause of gastritis, is a longer story with its own caveats, told in our H. pylori guide. The wider evidence is in mastic gum benefits.

If you want to try it, Greco is single-ingredient Chios mastic resin, with no mint, sweeteners or polyols, chewed as a gum. The trials gave measured oral doses, so chewing isn’t a like-for-like match for what they tested, and none of this replaces treating the cause. Greco Gum shares our owner (Hubert Ventures LLC).