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The Low FODMAP Diet and Gastritis

A low-FODMAP diet has been touted as a cure for a wide range of digestive problems. Gastritis refers to inflammation of the stomach lining, and if you’re wondering whether you should try a low-FODMAP diet for your gastritis, this article will help you make your decision based on science.

What is gastritis?

Gastritis refers to inflammation of the stomach lining. There are many causes of gastritis, but the most common is infection with bacteria called H.pylori. H.pylori spreads via a fecal-oral route, which means you can get infected if your food is prepared without good hygiene practices.

H.pylori lives in your stomach lining and causes inflammation, leading to symptoms like:

  • Dyspepsia — this is long-term belly pain coupled with discomfort after eating and fullness after eating just a little
  • Bloating
  • Abdominal pain
  • Alarm symptoms like unintentional weight loss — these usually show up if there is underlying cancer, which is one cause of gastritis (it’s not normally seen with H.pylori gastritis)

There are many other causes of gastritis including:

  • Infections — these can be bacterial, viral, fungal, or parasitic
  • Heavy alcohol intake
  • NSAIDs — these are a class of pain-relieving drugs. Advil is one example.
  • Chemotherapy
  • Radiation
  • Autoimmune — this is when the body attacks itself
  • Allergic

Doctors usually divide gastritis into acute and chronic.

Acute gastritis sets in abruptly and normally resolves quickly after treatment for most people. Chronic gastritis (such as that from H.pylori) continues for longer periods, and is a significant risk factor for ulcer development and stomach cancer.

This is why you shouldn’t attempt to treat your gastritis symptoms yourself and should consult a doctor. Interventions like a low-FODMAP diet can augment medical treatment but never replace them until strong scientific evidence exists. So let’s look at what science says about treating gastritis with a low-FODMAP diet.

Does a low-FODMAP diet help with gastritis?

A low-FODMAP diet may help with gastritis symptoms but we’re not sure.

Currently, there are no studies available that look at the effectiveness of a low-FODMAP diet in treating gastritis. However, a low-FODMAP diet has been shown to be very effective in treating irritable bowel syndrome (IBS), so if you have IBS and gastritis, the diet can be useful.

Despite the lack of scientific evidence, many people report a significant improvement in their gastritis symptoms on a low-FODMAP diet. But before you make changes to your diet, you should consult a doctor. 

Implementing a low-FODMAP without expert supervision is never a good idea. You can develop nutritional deficiencies if you do it improperly.  

Plus, if you have already developed an ulcer due to long-lasting gastritis, you’ll need a high-calorie diet to help your body heal the ulcer. In this case, making the wrong changes to your diet can be harmful.

What is a low-FODMAP diet?

A low-FODMAP diet involves eliminating carbohydrates called Fermentable Oligo-Di-Monosaccharides and Polyols from your diet.

These carbohydrates include lactose (found in most dairy products), fructose (found in most fruits), fructans (found in wheat), and galactans (found in foods like lentils, legumes, and beans). Polyols are found in sweetners and fruits like peaches, cherries, and apricots.

FODMAP carbohydrates are osmotic, which means they draw in water in your gut. Plus, bacteria feed on these sugars and release gas, which can lead to symptoms like bloating and abdominal pain. This is why a diet low in FODMAPs may help gastritis patients, especially if they also have food allergies or IBS.

While no foods have been directly shown to cause gastritis, some patients report a worsening of their symptoms after eating certain foods. If your gastritis symptoms worsen after eating high-FODMAP foods, a low-FODMAP diet will help.        

To implement a low-FODMAP diet, you begin by eliminating all FODMAP foods for a period of 2-6 weeks. This is called the elimination phase. Once your symptoms completely resolve, you start adding foods back to your diet, one at a time. This helps you identify the culprit that has been triggering your symptoms.

Remember, you need to consult your doctor before taking up a low-FODMAP diet.

Although the evidence for a low-FODMAP diet’s use in gastritis is not strong enough, here are some dietary recommendations that doctors often make for gastritis patients.

What kind of food is good for gastritis?

High-fiber, low-fat foods are generally good for gastritis. You may want to increase the following in your diet:

  • Whole grains
  • Vegetables
  • Fruits
  • Lean meat
  • Fish
  • Caffeine-free, non-carbonated drinks

 Additionally, probiotic foods (or supplements) promote the growth of healthy bacteria in your gut. This prevents H.pylori growth, which is the most common cause of gastritis. So you may also want to increase the following probiotic foods in your diet:

  • Kimchi
  • Yogurt
  • Kombucha
  • Sauerkraut
  • Kefir

What kind of food is bad for gastritis?

Spicy, fatty foods can contribute to inflammation and are bad for gastritis. While no food has been shown to cause gastritis, avoiding the following can ease your symptoms by limiting inflammation:

  • Alcohol
  • Fast food (or other greasy items)
  • Acidic foods like citrus fruits and tomatoes
  • Fruit juices
  • Dairy products
  • Anything that comes in a can

What else can help with gastritis?

Apart from dietary modifications, you can try reducing your meal size and increasing the period between them. Weight-loss exercise can also help.

It’s also a good idea to replace NSAIDs with acetaminophen as your painkiller. Acetaminophen is effective for headaches but doesn’t cause adverse stomach effects like an NSAID.

Finally, you should note that the most common cause of gastritis — H.pylori — requires medical therapy for treatment. Doctors usually administer what’s called triple therapy for H.pylori, which requires you to take two antibiotics and an acid-suppressing proton-pump inhibitor. You should not attempt to treat an H.pylori infection solely with dietary modifications (like the low-FODMAP diet).

Takeaway

Gastritis is when the lining of your stomach becomes inflamed. The most common cause of gastritis is H.pylori, which is treated with triple therapy. There is no scientific evidence to suggest a low-FODMAP diet can treat gastritis, but many patients report an improvement in their symptoms while on the diet. Before you make any changes to your diet, talk to your doctor!

Medically Reviewed by Onikepe Adegbola, MD PhD


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