# Gastritis - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ACG Clinical Guideline: Management of Dyspepsia 2017 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lansoprazole monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (rabeprazole monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph) - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lansoprazole monograph) - Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (rabeprazole monograph) - Gastritis - disease-level clinical article (gastritis-clinical.txt) ## Treatment metadata - Omeprazole — 20 mg — oral.solid - Lansoprazole — 30 mg — oral.solid - Referral & safety-netting (no drug therapy) - Rabeprazole — 20 mg — oral.solid ## Complete treatment card ```text GASTRITIS Sources: ACG Clinical Guideline: Management of Dyspepsia 2017 · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lansoprazole monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (rabeprazole monograph) · Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph) Review status: REVIEWED against Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph), Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lansoprazole monograph), Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (rabeprazole monograph), Gastritis - disease-level clinical article (gastritis- clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Acute gastritis tends to start suddenly with epigastric pain, bloating, nausea, and vomiting that settles on its own [abdominal distension · abdominal pain · epigastric pain · nausea · vomiting] - Symptom severity does not track with biopsy findings, and H pylori gastritis can stay silent while it progresses - H pylori dyspepsia is confirmed retrospectively by symptom improvement after eradication, which can take up to 6 months [indigestion] - Autoimmune gastritis is usually silent and turns up incidentally through pernicious, megaloblastic, or iron-deficiency anemia [anaemia] - When autoimmune gastritis does cause symptoms, most patients report fullness or discomfort after meals - It frequently clusters with other autoimmune conditions, especially thyroid disease, plus Addison disease, myasthenia gravis, and vitiligo TESTS (9) - Endoscopy with biopsy for histopathology is the gold-standard test for confirming gastritis - Endoscopy is not required to diagnose functional dyspepsia, but testing for H pylori should still be done - New symptoms at an older age, weight loss, bleeding, dysphagia, an abdominal mass, fever, or family history of GI cancer are alarm signs - Under age 60 with dyspepsia and no family history of gastric cancer, endoscopy to exclude malignancy is not advised - Urea breath testing or stool antigen testing detects H pylori, and retesting after treatment should wait 4 to 6 weeks post-therapy - Patients 60 or older with dyspepsia should get endoscopy with histology to assess for gastritis - Autoimmune gastritis diagnosis rests partly on finding atrophic changes affecting the stomach body and fundus - Anti-parietal cell antibodies are sensitive but not specific, since H pylori infection also raises them, while anti-intrinsic-factor antibodies are highly specific - Atrophic gastritis looks pale with visible vessels and flattened folds on endoscopy, detected with high sensitivity by narrow-band imaging IF NOT THIS - what else fits (8) - Functional dyspepsia - Peptic ulcer disease - Gastric cancer - Cholecystitis - Zollinger-Ellison syndrome - Pancreatitis - Myocardial ischemia mimicking gastritis pain - Celiac disease Source StatPearls "Gastritis" - disease-level clinical article Status traced to the source above 1. OMEPRAZOLE [1st line] Adult 20 mg once daily before a meal x 4-8 weeks Peds Specialist pediatric gastroenterology use only Choice Alternatives. Both are proton pump inhibitors of equivalent effect; omeprazole is the cheaper and most widely stocked. Source Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph) Why PPI therapy is first-line for NSAID-induced and reactive gastritis; if H. pylori positive, eradicate it. Caution For NSAID-induced gastritis, stop the offending NSAID. For H. pylori-associated gastritis, cross-refer to the H. pylori eradication regimen. Distinguish from functional dyspepsia (gastritis implies mucosal inflammation visible on endoscopy). Egypt OMEGASTAZOLE 20MG 14 CAPS. RIVA PHARMA S... 18.00 EGP (1.29/unit) OMEPRAL 20MG 14 CAPS. MEMPHIS 32.00 EGP (2.29/unit) RISEK 20 MG 28 CAPS. JULPHAR 75.00 EGP (2.68/unit) OMISEC 20MG 14CAPS. THE UNITED PH... 42.00 EGP (3.00/unit) EPIRAZOLE 20MG 14CAPS. EIPICO 44.00 EGP (3.14/unit) OMEPAK 20 MG 14 CAPS. SEDICO 50.00 EGP (3.57/unit) RISEK 20 MG 14 CAPS. JULPHAR 57.00 EGP (4.07/unit) NAPIZOLE 20MG 14 CAPS. GLOBAL NAPI P... 62.00 EGP (4.43/unit) 2. LANSOPRAZOLE [1st line] Adult 30 mg once daily in the morning at least 30 minutes before food; 15 mg once daily where the purpose is prophylaxis of NSAID-associated gastroduodenal injury in a patient over 65 or with a previous ulcer x 4 weeks for symptom control, up to 8 weeks if gastric ulceration is present; up to 12 weeks for NSAID prophylaxis Peds 1 to 11 years: 15 mg once daily at 30 kg or less; 30 mg once daily over 30 kg. Avoid under 1 year. 12 years and over: 15 mg once daily (Avoid under 1 year. Children 11 years and under: 15 mg once daily if 30 kg or less, 30 mg once daily if over 30 kg. Children 12 years and over: 15 mg once daily.) Source Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (lansoprazole monograph) Why 17 live products and the cheapest widely stocked alternative to omeprazole. The 15 mg NSAID-prophylaxis dose is the one most gastritis presentations in Egyptian primary care actually need, because NSAID use is the commonest identifiable cause. Caution Do not exceed 30 mg daily in the elderly unless there is a clear clinical reason - clearance is reduced. 15 mg daily in severe hepatic impairment (Child-Pugh C) Stop and reconsider if severe or persistent diarrhoea develops - colitis and Clostridioides difficile are reported. Long-term use is associated with hypomagnesaemia, vitamin B12 deficiency, fundic gland polyps and fracture risk. Stop for any rash on sun-exposed skin with joint pain - subacute cutaneous lupus erythematosus is a recognised PPI reaction. Orodispersible tablets must not be crushed or chewed. Egypt LORAL 30MG 10 CAPS. PHARCO 30.00 EGP (3.00/unit) GASTROCURE 30MG 10 CAPS. ALFACURE PHAR... 33.60 EGP (3.36/unit) ZOLLIPAK 30MG 10 CAPS SEDICO 33.60 EGP (3.36/unit) LOPRAL 30MG 5 CAPS. UP PHARMA 27.50 EGP (5.50/unit) LANTANON 30MG 10 CAPS. UNIPHARMA CO.... 57.00 EGP (5.70/unit) ZALLANZ 30 MG 20 DELAYED REL. CAPS. EL-OBOUR 60.00 EGP ZALLANZ 30 MG 30 DELAYED REL. CAPS. EL-OBOUR 90.00 EGP LANSOFAST 30 MG 30 ORO-DISPERSIBLE TABS NAPCO > DELPHI PHARMA 174.00 EGP 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Gastritis - disease-level clinical article (gastritis-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Alarm signs (weight loss, bleeding, dysphagia, abdominal mass, persistent vomiting, family history of UGI cancer) require urgent investigation or endoscopy. 4. RABEPRAZOLE [2nd line] Adult 20 mg once daily in the morning; 10 mg once daily is adequate for maintenance in many patients x 4-8 weeks, then step down to 10 mg daily or stop Peds Not recommended in children - the formulary states there are insufficient safety and efficacy data at any paediatric age. Source Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (rabeprazole monograph) Why 18 live products. Needs no dose reduction in renal impairment and only a modest one in severe liver disease, which makes it a practical PPI in a comorbid patient. Caution The formulary states rabeprazole is contraindicated in pregnancy and not recommended in breastfeeding - use omeprazole instead in a pregnant patient. Severe hepatic impairment (Child-Pugh C): use 10 mg with caution. Monitor magnesium at baseline and periodically if the patient is also on digoxin or a diuretic. No dose change is needed in renal impairment. Long-term PPI cautions apply: Clostridioides difficile, B12 deficiency, fracture risk. Egypt RABEGERDAZOLE 20 MG 21 TABS. AL ROWAD PHAR... 40.50 EGP (1.93/unit) RABEPRAZOLE 20 MG 14 TABS. GLOBAL NAPI P... 31.20 EGP (2.23/unit) PACREDO 20 MG 30 F.C. TABS. MARCYRL PHARM... 121.50 EGP (4.05/unit) BEPRA 20MG 21 F.C. TAB. GLOBAL NAPI P... 154.50 EGP (7.36/unit) IDIZOLE 20MG 7 ENTERIC COATED TAB. GLAXO SMITHKLINE 19.20 EGP HYGIGASTIN 20 MG 14 ENTERIC COATED TABS. MEDIZEN PHARMACEUTICAL INDUSTRI... 22.00 EGP RABGERD 20 MG 14 E.C. TABS. EGPI > TRUE I... 70.00 EGP PATRIMAC 20 MG 28 E.C.TABS. ALROWAD FOR P... 166.00 EGP Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)