Inflammatory names whose suffix is ‘itis’ are turning up way too often these days, even in casual conversation. What follows is the comparison to a disease. Gastritis is one of those words I’ve been hearing a lot lately, and it involves the loss of one of our most precious and protective barriers, the stomach lining.

Western Medicine would have you believe that this mucosal lining might be inflamed due to an infection, faulty diet, or digestive hormone imbalance, and these may very well be contributing. Gastritis results when the immune system detects a threat to the mucosal barrier. It is an autoimmune response that triggers inflammation. But there is an important underlying mechanism involving the vagus nerve and the enteric nervous system.

What Chinese Medicine has understood for thousands of years through a gestalt view, Western Medicine is just beginning to understand through a reductionist view. One example would be how the immune system (Water Element) relates to the nervous system (Fire Element). Each tempers and controls the other. When in excess, the yin of Water (immune system) extinguishes the yang of Fire (nervous system), and when in deficiency, Fire is allowed to burn out of control (inflammation), which further dries and depletes Water’s deep, feminine yin reserves, creating a vicious cycle of inflammation.

An introductory crash course in the Chinese Five Elements and their phases of transformation would not fit in a Substack post, so let’s suffice to say that the Chinese have been at this for a lot longer than we have in the West. Traditional Chinese Medicine is an elegant model for viewing and restoring whole bodily systems, including the gastrointestinal system. Gastritis gives us the opportunity to explore this relationship between Fire and Water, the nervous system, and the deep immune system.

The enteric nervous system (ENS) directly connects the brain to the gastrointestinal tract and is often called the “second brain.” It is an autonomous network of over 100 million neurons embedded in the gut wall, from the esophagus to the rectum, responsible for transforming psychological and emotional stress into physical inflammation and pain. I learned that lesson over 50 years ago as a sensitive and anxious teenager. One night while attending a rock concert with a bunch of friends, I became surrounded by older kids doing drugs. I felt unsafe and out of control, and became anxious and overwhelmed by the social pressure to be “cool.” To my utmost horror and embarrassment, that night after the concert, I became overtaken in the parking lot by unbearable cramping pain. I had to lie down. And so there I lay in a sea of people, clutching my side and writhing on the asphalt, waiting for the gas to pass. And so began my journey with irritable bowel syndrome triggered by emotional stress.

Today, kids are suffering from stress-induced gastritis in even greater numbers from the immense social pressures amplified by social media. Chronic stress causes the ENS to release hormones that trigger inflammation and impair nerve function in the gastrointestinal tract. Stress-induced neural dysfunction leads to deficiencies in acetylcholine and impaired gut motility, leading to worsening gastritis. Acetylcholine is a vital neurotransmitter in the central and peripheral nervous system and is essential for the parasympathetic nervous system (PNS), which is responsible for “rest and digest.”

When we live in the sympathetic nervous system’s “fight or flight” response, we exhaust our adrenals and diminish our digestive qi. Psychological and physiological stress cause the body to withdraw blood supply from the digestive system and redirect it toward more vital organs. This decreases the stomach lining’s defenses, making it more vulnerable to stomach acids and complications. The PNS also enhances immune function.

The vagus nerve is the main component of the PNS that activates digestion. It is the longest nerve in the autonomic nervous system, extending from the brain stem to the abdomen. The stimulation of receptors by acetylcholine drives PNS actions, such as increased gastrointestinal motility and glandular secretion. The source of acetylcholine ACH is from the vagus nerve. Additionally, the vagus nerve acts as a major anti-inflammatory pathway by releasing acetylcholine, which inhibits the production of pro-inflammatory cytokines, lowers systemic inflammation, and modulates intestinal permeability, which is essential for protecting the gut lining. The vagus nerve regulates inflammation throughout the body. It innervates the gut and spleen, relaying information from these areas and activating the hypothalamus-pituitary-adrenal (HPA) axis, contributing to reduced inflammatory responses. Poor vagal tone is associated with chronic inflammation and autoimmune conditions. Are we seeing a pattern here? By restoring the nervous system with Chinese herbs, vagal tone is improved.

The ENS and the vagus nerve form a crucial bidirectional communication link between the brain and the gut, known as the brain-gut axis. While the ENS, or second brain, is autonomous and controls digestion, the vagus nerve governs the primary highway upon which sensory data is sent to the brain, and motor instructions that regulate digestion and motility are sent to the gut. When information coming in through the senses is unreliable due to stress and trauma, we see a serious disruption of the Fire Element. The ENS relies on the governance of the vagus nerve. The nervous system in Chinese Medicine is under the governance of the Fire Element.

When the stomach lining is worn down to where it can’t protect itself from its own acids and enzymes, symptoms include severe indigestion, bloating, and upper abdominal pain that can lead to ulcers. Inflammation causes the symptoms of gastritis. Acute gastritis goes away when the acute cause resolves, but chronic gastritis takes longer to heal. Chronic gastritis affects about 2 out of every 10,000 people in the U.S., and over half of the world’s population has gastritis associated with the widespread, chronic bacterial Helicobacter pylori infection. Once H. pylori has been ruled out, identifying the sources of chronic stress and reducing or eliminating them will begin the healing process. Note: if you need to be tested or are positive for H. pylori, please read my post Think You Have an Ulcer? Think Again: H. pylori and Mastic Gum.

The good news is that Chinese Medicine offers very effective nervines and adaptogenic tonics to assist the body in healing from long-term stress. Chinese Medicine and Five Element Theory, which studies relationships and patterns, addresses the underlying causes of a chronic condition, while Western Medicine offers drugs that may relieve symptoms but allow imbalances to persist and may cause more harm than good in the long run.

One strategy employed by Chinese Medicine is the restoration of the Water Element’s deep feminine yin (kidneys/adrenals/deep immune system) that has been under assault by our masculine, over-driven, yang society. When the adrenals corresponding to the Water Element become depleted, we also see a depletion of endogenous glucocorticoids. These essential steroid hormones, secreted by the adrenal glands, regulate stress responses and immune function. We see extensive use of synthetic corticosteroids in Western Medicine for their anti-inflammatory and immunosuppressive properties in the treatment of asthma, allergies, autoimmune diseases, and other inflammatory conditions. Synthetic hormones are known to disrupt the HPA axis and create hormone imbalances.

Permanent lifestyle changes to reduce chronic stress and anxiety may be necessary. When I was 19 years old in 1974, I followed an East Indian guru and practiced meditation, which set me on a healing path. Today, there are many options for managing stress, including yoga and mindfulness practices. When stress and anxiety are high, the production of acidic digestive juices increases, and the mucus and prostaglandins that protect the stomach lining decrease. And with prolonged, chronic stress, changes can occur in the autonomic nervous system, including the parasympathetic and sympathetic systems. Chronic stress often leads to hypersensitivity of the sympathetic (fight or flight) nervous system, which can cause the onset of pathological symptoms at the gastric and intestinal levels. If left untreated, it can lead to gastroesophageal reflux disease (GERD), ulcers, and malabsorption of vitamins and minerals, specifically vitamin B12 and iron.

Herbal Strategies for Restoring Gut Health

• Mucilaginous herbs act as a demulcent to coat the stomach and intestinal lining and are used to soothe, protect, and hydrate irritated mucous membranes and inflamed tissues. These include: slippery elm bark (Ulmus rubra), marshmallow root (Althea officinalis), Aloe vera, oatstraw (Avena sativa), and plantain leaf (Plantago major).

• Oatstraw (Avena sativa), used in an infusion to moisten, hydrate, and as a nervine tonic. May be combined with Nettles, which helps to restore the deep feminine yin of the Water element.

• Oat gruel – Gently simmer a handful of old-fashioned oats and a handful of slippery elm bark (approx. ¼ cup each) in 1 quart of beef bone broth for 30 minutes, strain, and drink ½ cup as needed. The broth contains collagen and, combined with the herbs, coats, warms, and protects the stomach lining.

• Adaptogens & Nervine Tonics – Adaptogens provide significant benefits to help relieve the negative impact of constant worry, overwork, inadequate sleep, and unsustainable lifestyles. A nervine tonic is something you take consistently over a period of time. The longest-lasting results from herbal medicine is in its tonic ability to restore whole bodily systems. Nervines are complementary herbs for adaptogens. Adaptogens alone will not make up for a lack of sleep, a poor diet, or a lack of exercise. Most Americans are sleep-deprived, and adaptogens can help, but the most important thing in restoring the adrenals (Water element) is to sleep. Nervines enhance the effects of adaptogens. Nervine tonics are calming herbs that are mildly relaxing without being overtly sedative. This type of herb restores emotional balance and nourishes the nervous system, allowing it to do what it was designed to do. Nervines help calm anxiety and gastrointestinal tract symptoms caused by stress, lack of sleep, irritability, and hypertension. Some adaptogens are also used as nervines, including ashwaganda, eleuthero, reishi, rhodiola, and schisandra. Other nervine herbs include: chamomile, fresh milky oat, hawthorn, lemon balm, motherwort, and skullcap. A great way to begin is by having a cup of chamomile tea one hour before bed each night.

• Vital Adapt by Natura is an adaptogenic tonic that I regularly recommend. It nourishes adrenal and endocrine function and optimizes stress protection. Vital Adapt includes Eleuthro‚ Rhodiola‚ Schizandra, and Ashwagandha.

Lifestyle

• Ensure that you are getting between 7 and 9 hours of good sleep. Take naps and rest when tired. Sleep and rest are the most restorative things you can do for your nervous system. Without this, the body simply cannot restore itself. Additionally, be sure to retire around 10pm. Your liver does the bulk of its work between 11pm and 3am, and if you are active during this time, you are robbing the Liver of the energy it needs to do its work of filtering blood and hormone signaling. People who stay up to work past 11pm often experience a “second wind.” This is Liver energy that you are siphoning off, and it comes with a price.

• Regular, moderate exercise

• Manage your stress, favoring relaxing physical activities such as mindfulness yoga, Tai Chi, or Qigong.

• Mind-Body Techniques: gut-directed hypnotherapy, biofeedback, and cognitive behavioral therapy (CBT) can help manage digestive symptoms by addressing the stress response.

• Vegas nerve stimulation can be achieved by singing and humming!

Supplemental and Dietary

• Prebiotics and probiotics – gut flora influences the ENS and can contribute to or alleviate neuroimmune dysregulation and inflammation. It is well established that the gut is one of the most important components of the immune system and is influenced by microflora. Regular intake of probiotics can help maintain a healthy intestinal flora. Take an acidophilus supplement, eat fiber-rich and fermented foods, and drink organic, raw, unflavored kombucha, which is a potent source of probiotics and antioxidants that aid gut health by fostering a balanced, healthy gut microbiome, improving digestion, and reducing inflammation. It introduces beneficial bacteria that may help alleviate gut-related issues and improve nutrient absorption.

• Eat small and frequent meals and chew well to facilitate digestion and reduce the time food spends in the stomach.

• Bone broth is rich in collagen and an easily digestible form of protein that supports the gut lining by reducing inflammation, repairing the gut lining, reducing leaky gut by maintaining the integrity of the intestinal barrier, and fostering a healthy, diverse microbiome. You can find my bone broth recipe using Chinese herbs on my Wisdom of the Plant Devas blog: Chinese Herbal Chicken Soup for Optimal Health

• Multi-Stress B vitamin supplement, specifically B12, B1, & B6, which work together to support nerve cell survival, remyelination, and repair damage. Vitamin B12 is essential for nerve regeneration, maintaining the protective myelin sheath, and addressing peripheral neuropathy, while B1 and B6 support metabolism.

• Vitamin D: From fish oil, supports nerve health and myelin sheath maintenance.

• Vitamin E: Functions as an antioxidant that protects nerve cells from damage.

• Magnesium: Helps manage nerve pain and excitability

• Omega 3s: Found in fish oil, support nerve cell structure.

• Reduce irritants – Don’t feed the fire! Minimize intake of alcohol, sugar, and processed foods. Don’t use artificial sweeteners.

• Stay hydrated – drink sufficient water daily, approximately 2 quarts.

• Seek professional guidance: Consult with a knowledgeable herbalist, acupuncturist, or alternative practitioner for tailored advice.