Inflammation of the stomach lining — and the condition most often treated with a long-term PPI when it should have been tested for H. pylori.
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Gastritis is inflammation of the stomach lining. It can be sudden and short-lived, or low-grade and present for years without ever announcing itself clearly.
The word gets used loosely. People are told they have gastritis when what they have is indigestion, and people with genuine gastritis are told they have a sensitive stomach. The distinction matters because gastritis has causes — and two of them, Helicobacter pylori and anti-inflammatory drugs, are treatable or removable.
The single most common failure in managing this is a proton pump inhibitor prescribed indefinitely without anyone ever testing for H. pylori. That converts a curable infection into a decade of daily tablets.
A great deal of gastritis causes no symptoms at all and is found incidentally at endoscopy done for another reason.
The symptoms that change the picture entirely: vomiting blood or material like coffee grounds, black tarry stools, difficulty swallowing, unintended weight loss, or persistent vomiting. Those are not gastritis symptoms to manage — they are reasons to be investigated urgently.
Spicy food and psychological stress do not cause gastritis, though both can aggravate existing symptoms. This is one of the most persistent misconceptions about the condition.
The two questions that matter are whether H. pylori is present, and whether anything warrants endoscopy.
Anyone over 55 with new, persistent, unexplained upper abdominal symptoms, and anyone of any age with the red flags listed above, warrants urgent endoscopy under NICE guidance rather than a trial of treatment.
Full blood count for anaemia from slow blood loss, ferritin, and B12 where autoimmune gastritis is a possibility. Coeliac serology is worth including, since it produces overlapping symptoms.
This assesses well by video, and the most valuable part of the consultation is usually deciding what to test rather than what to prescribe.
What we will not do is issue an indefinite PPI repeat to someone who has never been tested for H. pylori, or prescribe acid suppression to someone with red flag symptoms instead of arranging investigation.
What needs seeing in person: anything requiring endoscopy, and any suspicion of bleeding.
Call 999 or go to A&E immediately for vomiting blood, or vomit that looks like coffee grounds; black, tarry, foul-smelling stools; severe sudden abdominal pain; or feeling faint alongside abdominal pain. These indicate bleeding or perforation.
Seek same-day advice for persistent vomiting preventing you keeping fluids down, or severe pain that is not settling.
Arrange a prompt appointment — not urgent, but not to be delayed — for difficulty swallowing, unintended weight loss, a persistent feeling of food sticking, new upper abdominal symptoms if you are over 55, or symptoms that have not responded to four weeks of treatment. Under NICE NG12 these warrant consideration of urgent endoscopy.
Elaborate elimination diets. Spicy food, coffee and citrus aggravate symptoms in some people and are irrelevant in others — there is no universal gastritis diet, and cutting out foods that were never the problem is a common waste of effort. Track what genuinely troubles you rather than following a list.
Ask whether you still need it, and whether you were ever tested for H. pylori. If the answer to the second is no, that is the conversation to have. Do not stop a long-term PPI abruptly — rebound acid feels worse than the original problem and convinces people they cannot manage without it.
Your NHS GP will assess, test and treat gastritis free of charge, including H. pylori testing and eradication, and NHS endoscopy is free. For anyone with red flag symptoms, the NHS urgent cancer pathway is fast and is the right route — we would refer you into it rather than compete with it.
What paying gets you is time and speed. Twenty minutes is enough to take a proper medication history and work out that the ibuprofen for a bad back is the cause. H. pylori testing can be arranged the same week rather than after a wait.
Where it is genuinely valuable is the long-term PPI review. Someone who has taken omeprazole daily for eight years, never been tested for H. pylori, and never had a structured attempt at stopping is extremely common — and unpicking that properly takes longer than a ten-minute appointment allows.
Private endoscopy shortens the wait for non-urgent investigation. It does not jump the urgent NHS queue, which is already fast.
NICE CG184, Gastro-oesophageal reflux disease and dyspepsia in adults, is the principal guideline. It sets out the test-and-treat approach for H. pylori, the recommended PPI courses, and the requirement to review long-term acid suppression annually.
NICE NG12, Suspected cancer: recognition and referral, defines the criteria for urgent direct-access endoscopy — including dysphagia at any age, and upper abdominal symptoms with weight loss or in those aged 55 and over.
NICE Clinical Knowledge Summary, Dyspepsia — proven peptic ulcer and Helicobacter pylori infection, cover eradication regimens, the two-week PPI washout before testing, and the importance of retesting after treatment.
NICE NG141 and antimicrobial stewardship guidance inform the position that eradication therapy is used on confirmed infection rather than empirically.
No. Gastritis is inflammation of the stomach lining; reflux is acid moving up into the oesophagus. They feel different — gastritis is upper abdominal, reflux is behind the breastbone — though many people have both and the treatments overlap.
If you have persistent upper abdominal symptoms and have never been tested, yes. It is the commonest treatable cause, the test is non-invasive, and eradicating it can end the problem permanently rather than managing it indefinitely.
This is the single most useful thing on this page.
Not in the way people mean. Everyday psychological stress does not inflame the stomach lining. Severe physical stress — major surgery, burns, critical illness — genuinely can.
Stress does worsen how symptoms feel, and it changes eating, drinking and smoking, which are real contributors.
In moderation once it has settled, but not during a flare. Alcohol directly irritates the inflamed lining, and the effect is dose-related rather than all-or-nothing.
Acute gastritis often settles within days to a couple of weeks once the cause is removed. Chronic gastritis from H. pylori improves over weeks to months after successful eradication.
If four weeks of proper treatment has changed nothing, the diagnosis needs revisiting rather than the prescription repeating.
For the overwhelming majority of people, no. Long-standing H. pylori gastritis carries a small increased risk of stomach cancer over decades, which is a further argument for eradicating it rather than a reason for alarm.
The features that need investigating — weight loss, swallowing difficulty, bleeding, being over 55 with new symptoms — are listed above, and they exist precisely so the small number of serious cases are found.
Usually not, and long-term use without review is the commonest problem we see with this condition. Where the cause is treated — H. pylori eradicated, NSAID stopped — many people can come off. Taper rather than stopping abruptly.
September 5, 2026
Ongoing
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Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
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Usually
Free
Same day
Often 10 to 15 minutes
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Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
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