What lifestyle modifications should I advise to a patient diagnosed with gastritis?

While specific trial evidence for lifestyle modifications in gastritis is limited, expert opinion from guidelines on related conditions like dyspepsia and gastro-oesophageal reflux disease (GORD) recommends these measures to encourage self-management and for general health benefits [1, 3, 4, NICE, 2019].

• Dietary and Eating Habits
  • Advise the patient to eat smaller meals more frequently, approximately every 3 hours ².
  • They should avoid eating late at night or less than 3 hours before bedtime ²,⁶.
  • Encourage healthy eating habits ²,⁶.
  • Suggest identifying and avoiding known irritants such as alcohol, caffeine, fruit juices, carbonated drinks, chocolate, and fatty and spicy foods ²,⁶.
  • Keeping a food diary can help identify specific triggers ².
• Smoking and Alcohol
  • Strongly advise stopping smoking, as it increases gastric acid output and delays gastric emptying [1, 2, 3, 4, NICE, 2019].
  • Recommend reducing alcohol consumption, as it can cause direct injury to the gastric mucosa ¹,²,³,⁴.
• Weight Management and Physical Activity
  • Advise maintaining a healthy weight and avoiding excessive weight gain ²,⁶.
  • Encourage regular physical activity ²,⁶.
• Sleep Position
  • Suggest raising the head of their bed by 10–15 cm, which may be particularly helpful for nocturnal symptoms ²,³,⁶.
  • They could also try to sleep on their left side rather than on the right side or supine ².
• Stress and Anxiety
  • Address any associated stress and anxiety, as psychological therapies may reduce dyspeptic symptoms in the short term [1, 3, 4, 6, NICE, 2019].
• Medication Review
  • Review current medications and consider reducing or stopping those that may cause or worsen symptoms, such as nonsteroidal anti-inflammatory drugs (NSAIDs), calcium-channel antagonists, anticholinergics, antidepressants, nitrates, theophyllines, bisphosphonates, and corticosteroids ¹,²,⁶.