Are Probiotics Good for Gastritis?

People with gastritis experience abdominal pain and nausea when the lining of the stomach becomes inflamed. Taking probiotics for gastritis may help destroy the harmful bacteria that cause this condition while increasing the efficacy of antibiotics and other medications.

The stomach secretes acid and the enzyme pepsin to break down food during digestion. It is lined with a layer called the mucosa, which protects itself from damage caused by the acidity of gastric juice. The stomach lining can become irritated and inflamed, resulting in a decrease in the production of protective mucus, as the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK) notes.

Depending on the cause, gastritis can occur as a flare-up or it can be a long-standing, chronic condition that requires medication for treatment. In some cases, it may cause stomach ulcers when the mucosal lining erodes and exposes the tissue that lay beneath. Left untreated, severe gastritis and ulcers may lead to stomach cancer.

Gastritis can be detected by looking at an X-ray image of the stomach after the interior has been coated with a barium solution, according to the NIDDK. Another method uses an endoscope to capture images of the stomach lining when a camera is inserted into the patient's esophagus while sedated. Blood, stool and breath tests can indicate if gastritis-causing bacteria are present.

The NIDDK states that there are three main causes of gastritis. A bacterial infection caused by ​Helicobacter pylori​ is responsible for most cases. A review published in October 2018 in the journal ​Gastroenterology Research and Practice​ explains that harmful bacteria may colonize the stomach mucosa. These pathogens cause the tissues to become inflamed when they attach to the epithelial cells that line the stomach.

Gastritis may also occur when the mucosa is damaged by the overconsumption of anti-inflammatory drugs, such as ibuprofen and aspirin. Radiation treatment or exposure to radiation may damage the stomach lining too — and so does excessive alcohol use, according to the NIDDK.

Though less common than ​H. pylori​ or injury to the stomach lining, the body's immune system may contribute to this disorder when it targets the cells that make up the mucosal tissue. Several conditions can trigger this type of autoimmune response, including Crohn's disease, parasites, fungal and viral infections and food allergies.

​Read more:​ What Foods to Eat for an Inflamed Stomach Lining

Many types of bacteria in the gastrointestinal tract are pathogenic, but the human gut also houses certain bacteria that are beneficial to digestion because they help to break down complex carbs and synthesize vitamins, such as vitamin B12. "Good" bacteria aid the immune system by processing toxic contaminants in the GI tract, which helps prevent food- and waterborne illnesses.

When disease-causing bacteria take up residence in the mucosal layers of the stomach, small intestine and colon, a healthy community of beneficial microorganisms can keep the pathogen population in check. Maintaining a healthy microbiome encourages the "good" bacteria to compete for resources with pathogens, which prevents further colonization of the "bad" bacteria.

According to an analysis published in October 2017 in ​Applied Microbiology and Biotechnology​, approximately 50 percent of people are infected with ​H. pylori​, and the rate of infection is estimated to be much higher in developing countries. This bacterium spreads easily via saliva and contaminated water, but not everyone who is infected develops gastritis. Diet may be a key factor in promoting the colonization of "good bacteria" and hindering the spread of pathogenic bacteria.

People with gastritis typically experience pain in the upper abdominal area, nausea and vomiting, according to the NIDDK. Other symptoms include burning stomach pain, loss of appetite and burping. Erosion of the stomach lining due to gastritis can lead to bleeding and symptoms of blood loss, such as dizziness, shortness of breath, paleness, fainting and blood in vomit or stool.

Gastritis treatment typically involves managing acid production in the stomach with hydrogen (H2) blockers and proton-pump inhibitors to cut down on inflammation and eradicating the ​H. pylori​ population with antibiotics. Some patients also rely on antacid tablets to help neutralize stomach acid. The "triple therapy" combo of H2 blocker or PPI plus two antibiotics was the preferred course of treatment for the past 20-plus years, as noted in the Applied Microbiology and Biotechnology review.

The wide-spread use of antibiotics to fight ​H. pylori​ has resulted in an increase in antibiotic resistance for some of the drugs commonly prescribed. When bacteria become resistant to medication, the treatment is less effective. According to the journal Applied Microbiology and Biotechnology, the success rate for treatment with antibiotics may be as low as 70 percent.

The reduced efficacy of standard pharmaceutical therapies for treating ​H. pylori​ has prompted the exploration of other complementary treatments to eradicate this infection. One current method of treatment includes the use of probiotics for gastritis. The journal Applied Microbiology and Biotechnology notes that probiotics can help eradicate ​H. pylori​ infection, especially when used in conjunction with other medical therapies.

Probiotics are beneficial strains of live bacteria that aid in digestion and work with the immune system to combat pathogenic microorganisms in the gastrointestinal tract, improving overall gut health.

These beneficial bacteria may help with some of the side effects that can occur when taking antibiotics, such as abdominal upset or diarrhea, notes the National Center for Complementary and Integrative Health (NCCIH). They may also aid in recolonizing gut bacteria that have been destroyed by infection or antibiotics. Bacteria from the genus Lactobacillus and the genus Bifidobacterium are widely used probiotics for improving health.

When ​H. pylori​ colonize the mucosa, they excrete a substance that kills off much of the other bacteria already present in the stomach. Eliminating some of the other bacteria allows the ​H. pylori​ population to grow quickly. Increasing the number of probiotic bacteria in the stomach cuts down on the number of ​H. pylori.​ This is because probiotics secrete lactic acid and other substances that have a negative effect on ​H. pylori​ by killing it or stifling its ability to reproduce.

Probiotics have been shown to help with digestive discomfort, such as diarrhea and inflammation, according to the NCCIH. Individuals with gastritis often experience imbalance within the microbiome of organisms in the digestive tract due to the pathogenic effects of ​H. pylori​, such as a decrease in the population of Lactobacillus bacteria.

The ​Gastroenterology Research and Practice​ review, which assessed the use of probiotics to treat ​H. pylori​, states that probiotics alone don't eradicate the ​H. pylori​ but can reduce the colonization to a level that inflammation decreases. In general, the addition of probiotics to triple therapy or antibiotics may increase the rate of eradication of ​H. pylori​ compared with medication alone. Researchers also note that some specific strains of probiotics may be more effective for treating gastritis than others.

According to the NCCIH, probiotics have been shown to improve immune health by triggering an immune response to pathogens. A strong probiotic population in the GI tract can have an anti-inflammatory effect, which may improve the symptoms of gastritis. Probiotics also help boost the number of "good" bacteria that may be killed off by antibiotics used to treat ​H. pylori​.

​Read more:​ Probiotics vs. Acidophilus

Foods that contain probiotics have been fermented during preparation. Fermented foods that contain live, active bacteria include dairy products, such as yogurt, kefir and yakult. Kombucha tea is another fermented beverage that contains these beneficial microorganisms. Probiotics can also be taken in the form of dietary supplements.

Some pickled vegetables are good sources of probiotics, such as sauerkraut and kimchi. Consuming fermented soybean products like miso, natto and tempeh is another way to incorporate probiotic foods into your diet. Although they aren't fermented, green peas are a source of probiotic bacteria that are good for the mucosal lining of the stomach.

Yakult is a fermented milk beverage that contains a strain of Lactobacillus casei bacteria called Shirota. Drinking yakult for gastritis can be beneficial because it has been shown to reduce stress and anxiety, according to a study published in June 2016 in ​Applied and Environmental Microbiology​. The NIDDK states that stress can be a factor in gastritis, especially in cases where gastritis is acquired due to illness or injury.

Spicy, fatty, acidic and dairy foods do not cause gastritis, but they can increase inflammation and worsen your symptoms, according to the Wexner Medical Center at Ohio State University. Drinks containing caffeine, alcohol and even decaffeinated coffee and tea can also make things worse for some people with gastritis, so limit consumption. Foods and drinks that irritate the mucosa, increase acid production or remain in the stomach for a long time should be avoided.

While everyone should get plenty of fiber in their diet, it can be especially helpful for gastritis patients. Fiber provides food for the "good" bacteria in the digestive tract, including probiotics. Certain types of fiber found in fruits, vegetables, whole grains and beans are called ​"​prebiotics" due to the role they play in increasing the probiotic population.

​Read more:​ Foods to Avoid With Gastritis

People with gastritis can benefit from including lots of produce in their meal plans, protein from beans and lean meats and high-fiber grains, such as barley and whole wheat. Breakfast for gastritis patients should include prebiotics and probiotics, such as yogurt, fresh fruits, oats and egg white-veggie omelets while limiting fatty breakfast meats, cheese and low-fiber carbs.