Nutrition management in gastritis and reflux

Gastritis and gastro-oesophageal reflux disease (GERD or GORD) are two common digestive conditions that can cause significant discomfort and affect long-term health if not managed properly. Although gastritis and GERD often get confused, they’re not the same condition. People with chronic gastritis may also experience reflux symptoms because the inflamed stomach can delay emptying, which increases pressure and makes acid more likely to flow back into the oesophagus. Nutrition plays an essential role in managing symptoms and preventing complications.

What is gastritis?

Gastritis refers to inflammation of the stomach lining. 

When the stomach lining is inflamed, it becomes more vulnerable to damage from stomach acid, bacteria, and certain foods.

Over time, this can lead to complications such as:

• Osteoporosis – due to impaired absorption of calcium and zinc.

• Pernicious anaemia – due to reduced vitamin B12 absorption when stomach acid and intrinsic factor production are impaired.

• Digestive discomfort – indigestion, bowel irregularities, and pain.

Symptoms:

• Nausea & vomiting

• Abdominal pain

• Loss of appetite

• Bloating or indigestion

• Heartburn or a sour taste in the mouth

  
  

Causes of gastritis:

• Certain foods & drinks (spicy foods, alcohol, coffee, fizzy drinks)

• Smoking & excessive alcohol use

• Obesity or pregnancy (pressure on the stomach)

• Stress

• Certain medications (e.g. aspirin, NSAIDs, corticosteroids, antibiotics, oral contraceptives, SSRIs)

• Helicobacter pylori (H. pylori) infection

• Certain autoimmune conditions 

Treatment for gastritis depends on the underlying cause and may include lifestyle changes, medication (like antibiotics, PPI’s, antacids) and in rare cases surgery. 

What is acid reflux (GERD/GORD)?

Gastro-esophageal-reflux-disease (GERD) occurs when stomach acid flows back into the oesophagus, causing burning pain (heartburn), throat irritation, and sometimes erosion/harm of the oesophagus.

While cancer treatments vary, they often share some common side effects. Managing these side effects effectively is crucial to a patient’s ability to continue with treatment and to maintain optimal nutrition.

Symptoms:

• Sour/bitter fluid in the mouth

• Persistent heartburn

• Hoarseness or sore throat

• Chronic cough

• Difficulty swallowing or frequent throat clearing

  
  

Causes of GERD

• Obesity & pregnancy

• Smoking & alcohol

• Caffeine & highly acidic foods

• Stress

• Certain medications 

• Weak or relaxed lower oesophageal sphincter (LES) 

• Hiatal hernia 

• Gastroparesis (slow stomach emptying) 

Treatment for GERD includes lifestyle changes and may include medication and in some cases surgery. 

Nutrition and lifestyle tips for gastritis & reflux

The main goal is to reduce irritation of the stomach lining and limit acid reflux.

Eating tips:

• Eat small, frequent meals (5–6 per day).

• Eat slowly and chew food thoroughly.

• Avoid lying down or going to bed immediately after eating.

• Maintain a healthy weight.

• Quit smoking and avoid alcohol.

  
  

Foods to limit or avoid:

These foods are most linked to symptom flare-ups:

• Alcohol

• Caffeinated drinks (coffee, energy drinks)

• Fizzy or carbonated drinks

• Fatty, fried foods (fatty red meat, egg yolk in excess, bacon, boerewors, fries, takeout meals)

• Certain spices / spicy foods (curries, chillies, peppermint, ginger)

• Acidic foods (tomato, citrus fruit, pineapple, vinegar, lemon juice concentrated juices)

• Chocolate and peppermint

• Processed meats (sausages, ham, hot dogs, bacon)

• Full-cream dairy (milk, yoghurt & cheese) 

• Refined carbs and sugars like: White bread, baked goods, sweets & deserts. Following a lower carbohydrate diet may be beneficial. 

• Gas-forming foods if bloating is an issue (onions, garlic, cabbage, broccoli, beans…)

Include the following:

• Beverages: Water, rooibos tea, diluted 100% fruit juice (non-citrus). Regular green tea consumption was associated with a 40–50% lower incidence of gastritis in several studies.

• Cooking methods: Steaming, boiling, grilling, roasting, or using non-stick spray instead of added oils.

• Proteins: Lean meats (chicken without skin, fish, eggs in moderation), low-fat, unsweetened dairy (cottage cheese, milk & yoghurt).

• Carbohydrates: Whole grains / high fiber starches such as brown rice, oats, barley and bulgur wheat.

• Fruits and vegetables: Non-citrus, non-acidic varieties; peeling skins can help if fibre irritates the stomach. Examples: Mango, pawpaw, sweet potato without skin, butternut, gem squash, carrot… 

• Flavouring: Fresh herbs instead of dried spices or chilli.

Managing gastritis and reflux is not only about avoiding “trigger foods” but also about building sustainable eating habits that reduce irritation to the stomach and oesophagus. With the right dietary adjustments, you can ease discomfort, protect your digestive tract and improve long-term health.

If you experience persistent symptoms despite lifestyle changes, it is important to consult your doctor or a dietitian for tailored medical nutrition therapy.

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