Stomach pain, burning sensation, heartburn, bloating sensation and nausea are very common symptoms in everyday life. Many people call all of this "gastritis", but today we know that there are different causes behind these symptoms and one of the main ones is the bacterium Helicobacter pylori.

The new updates and medical consensus published in 2026 brought important changes in both the diagnosis and treatment of gastritis and ulcers.

The main reason for these changes is that some antibiotics used in the past began to lose effectiveness, because many bacteria became resistant to traditional treatments.

What is gastritis and what is an ulcer?

Gastritis is an inflammation in the stomach wall.

An ulcer occurs when this inflammation progresses and forms a wound in the stomach or intestine.

The most common causes include:

  • infection by the bacterium Helicobacter pylori,

  • frequent use of anti-inflammatory medications,

  • smoking,

  • excessive alcohol,

  • stress,

  • self-medication,

  • inadequate diet.

How does a person usually feel?

The most common symptoms are:

  • burning sensation in the stomach,

  • pain in the "pit of the stomach",

  • heartburn,

  • feeling full quickly,

  • nausea,

  • bloating,

  • discomfort after eating,

  • sensation of poor digestion.

A very common example is a person who starts feeling only mild burning after meals, begins using antacids on their own, and notices that the problem always returns.

Not everyone needs to have an endoscopy

This was one of the guidelines reinforced in recent updates.

Many people believe that any suspicion of gastritis necessarily requires an upper digestive endoscopy, but this is not always true.

In younger patients without signs of severity, it is often possible to begin investigation with less invasive tests.

The respiratory test gained prominence

One of the most important tests currently is the urea breath test.

It is simple, quick and non-invasive.

The patient ingests a specific substance and, through breathing, the test can identify whether the bacterium Helicobacter pylori is present in the body.

In addition to this, the following can also be performed:

  • stool test to detect the bacterium,

  • specific laboratory tests,

  • clinical evaluation of symptoms.

This helps to avoid unnecessary invasive tests in many patients.

When is endoscopy necessary?

Endoscopy remains very important in some situations.

Mainly when the patient presents with warning signs, such as:

  • unexplained weight loss,

  • anaemia,

  • persistent vomiting,

  • difficulty swallowing,

  • bleeding,

  • dark stools,

  • family history of gastric cancer,

  • advanced age.

In these cases, investigation needs to be more detailed.

What changed in treatment in 2026?

For many years, the most commonly used treatment was a combination of a medication to reduce stomach acidity, such as omeprazole, together with antibiotics such as amoxicillin and clarithromycin.

The problem is that this treatment began to fail in many people because of bacterial resistance, particularly to clarithromycin.

Therefore, the new 2026 consensus began to recommend more modern and more effective treatments in some cases.

What were the main updates?

The new guidelines began to prioritise:

  • longer duration treatments,

  • different combinations of antibiotics,

  • more frequent use of bismuth in some regimens,

  • and more modern medications to control stomach acidity.

Bismuth gained prominence because it helps protect the stomach and increases treatment efficacy against the bacterium Helicobacter pylori.

Another important change was the increased use of more modern medications to reduce stomach acid production, such as vonoprazan, which can act more quickly and intensely compared with older medications in some patients.

Furthermore, treatment became more individualised. Today, the doctor considers factors such as:

  • previous treatments,

  • bacterial resistance,

  • allergies,

  • symptoms,

  • and the patient's clinical history.

In other words: treatment is no longer "the same for everyone" and has become more personalised to increase the chances of success.

Another important change: confirming that the bacterium has disappeared

In the past, many people completed treatment and simply observed whether symptoms improved.

Today, consensus recommends confirming whether the bacterium has actually been eliminated.

This is because, in some cases, symptoms may even improve temporarily, but the bacterium remains present.

Confirmation can be done with:

  • breath test,

  • stool test,

  • or specific medical evaluation.

What else has been reinforced in the new guidelines?

The most recent updates also drew attention to some important points:

Avoid self-medication

Many people use antacids continuously without investigating the real cause of the problem.

This can mask important symptoms.

Reduce excessive use of anti-inflammatory medications

Frequent use of these medications can cause gastritis, bleeding and ulcers.

Attention to gastric cancer

Prolonged infection by Helicobacter pylori can increase the risk of cancer in the stomach over the years.

Therefore, correctly diagnosing and treating the bacterium has become even more important.

The most important thing you need to understand

Not all stomach pain is just "poor diet" or "stress".

Today, the treatment of gastritis and ulcers is more modern, more strategic and more individualised.

The new 2026 consensus emphasises that the focus is not just to relieve symptoms temporarily, but to identify the correct cause, treat the bacterium when necessary and prevent future complications.

Important

This content is exclusively informative and educational in purpose. It does not replace medical evaluation, individualised diagnosis or treatment directed by a healthcare professional.

If you experience symptoms such as stomach pain, burning sensation, frequent heartburn, vomiting, weight loss or any persistent discomfort, seek medical care for proper evaluation.