Gastritis flare up. How to judge cause?

September 18, 2021 4:48 AM

I have gastritis, probably caused by anxiety. I suspect some foods might be exacerbating it. I've gone on a bland diet. How can I judge whether a certain food might be irritating my stomach? Pain minutes after eating? Pain only starting the next day? Please don't suggest alternative diagnosis to gastritis for my problem, if you don't mind.

At the moment my only symptom is burning pain just above belly button. No heartburn, no acid reflux. I won't list all the tests I've had, but I have had all of them and the GI specialist says I have a damaged stomach lining. My doctor says it's because of anxiety and that seems to fit. I am seeing a therapist and doing everything I can to alleviate the anxiety. I have been tracking my symptoms and everything I eat.

I started taking a PPI which seemed to help but then things got worse again, probably because my husband got Covid and I was quite anxious about that. We're both fully vaccinated and I haven't had any Covid symptoms.

I already avoid all the obvious gastritis causing things (coffee, alcohol, etc). I would like to restrict my diet even more for a while to reduce the likelihood of things that might be irritating my gut. So I'm on a bland diet for the moment, being careful to get enough fibre.

My question is, what is a typical time window after eating something, to judge whether it affected me? So I can reduce the number of factors I'm tracking. For example, I had my usual breakfast. Felt fine for several hours afterwards. Pain starts about 6 hours later. Seems unlikely to be what I had for breakfast , right?

posted by Zumbador to Health & Fitness (7 answers total)

I wasn't ever diagnosed with gastritis (I avoid tests as much as possible), but I had a lot of digestive issues that went away when I went vegan and I've known a few people who had the same experience. That's a lot, I know, but maybe try giving up dairy for a few weeks? That seems to be the common food that gives people the most trouble. Maybe you've tried this - I don't know if it's considered an obvious gastritis-causing food. I hope you figure something out!
posted by FencingGal at 5:51 AM on September 18, 2021 [3 favorites]

There’s no guarantees about fixed time windows; it could be something like “food X sets up your gut to be irritable, and then food Y triggers stomach pain, but only when it’s consumed after food X.” Or “slow stomach emptying causes food Z to have a delayed reaction.” Or lots of other possible mechanisms resulting in lots of possible time windows.

I would keep a diary of what you eat/drink and when, along with when your symptoms start, how long they last, and what they are. That could help you narrow down the variables.

For example, someone might find that they get stomach pain after lunch on days where they had a mid-morning coffee, no matter what they then ate for lunch. In that case, it would seem likely that the coffee was the culprit. Then they could try not having the coffee for a couple of weeks, still keeping a diary, and see whether they still get stomach pain.

You might also want to record other possible variables. If you think stress could be a possible contributor, you could note things like your stress level on a scale of 1-5; how much sleep you got the night before; etc.
posted by snowmentality at 8:02 AM on September 18, 2021 [2 favorites]

I have chronic gastritis, also theorized to stem from stress. I've found there's no real time period I can count on to judge which food is causing me problems. Often I have a really bad flare up because I've eaten five mildly bothersome things over the course of a few days rather than one very bothersome food on one day. And often I will have pain because I haven't eaten in awhile, especially if my stomach is already irritated. Even water can cause me pain on some days. Food tracking and food elimination trials have helped me kind of figure out what I should avoid, but it's not a perfect approach. My must avoids are: NSAIDs, mint, and coffee. I can tolerate small amounts of acidic foods and caffeine, but if I overdo it* I'll pay for it with days to weeks of pain and sometimes ulcers.

*I often don't realize I'm overdoing it until it's too late.
posted by Stoof at 8:58 AM on September 18, 2021 [3 favorites]

Have you been tested for H. pylori?
posted by the Real Dan at 12:30 PM on September 18, 2021 [2 favorites]

Response by poster: Yes I have been tested for H Pylori. I do not have that infection.
posted by Zumbador at 8:58 PM on September 18, 2021

If your doctor says the gastritis is because of anxiety, are you on medication for that in addition to therapy? If not, that could be a really helpful avenue to explore with your doctor. I have found in my own experience that the Buspirone I take for anxiety has also significantly improved the acid reflux I had been experiencing for several years; I understand studies also have shown improvement in dyspepsia. Serotonin and other neurotransmitters are very involved in gut things like digestion as well, and so some of those medications can help even beyond their anxiolytic (or anti-depressant) effects.
posted by lysimache at 5:42 AM on September 19, 2021 [1 favorite]

Response by poster: Lysimache thanks for that suggestion. I'm currently not on any medication for anxiety but my doctor is very keen that I should be. She's suggested an SSRI but I don't remember which one. Taking anti anxiety medication is a big step for me but I think I might be ready to take that step.
posted by Zumbador at 8:04 AM on September 19, 2021