Gastritis and peptic ulcer disease are among the most common diagnoses in patients who come to Karlovy Vary for treatment. This is no coincidence: the resort has specialised in the gastrointestinal tract for several centuries, and Karlovy Vary drinking therapy appears in the official list of indications for treating gastritis and peptic ulcer disease under Czech spa medicine classification.
But there’s a lot of confusion around this subject. Some people arrive with acute gastritis and are surprised to be refused treatment. Others drink from the springs as tourists — at random — and say it “didn’t work.” Others don’t understand how a drinking cure differs from simply “drinking some mineral water.”
Here’s an honest breakdown: what actually happens in the stomach during a drinking cure, who it’s indicated for, who it’s contraindicated for, and what to know before you arrive.
An important note: this article is for informational purposes. A drinking cure for gastritis or peptic ulcer is only prescribed by a physician after reviewing your medical history. Self-treating these conditions with mineral water can cause harm.
The mechanism by which Karlovy Vary water acts on the digestive system is well understood — and specific, not vague.
Mechanical action. Warm water drunk on an empty stomach expands the stomach, mechanically flushes the mucosa, and washes away residual gastric juice from the previous meal. This is a baseline effect independent of mineral composition.
Bicarbonates neutralise acid. Sodium bicarbonate — the alkaline component of the water — reacts with gastric acid in a neutralisation reaction. This reduces the aggressiveness of gastric juice, which matters particularly in gastritis with high acidity and in peptic ulcer disease.
Mineral ions act on the mucosa. Ions of potassium, sodium, magnesium, calcium, and lithium act on the gastric mucosa according to their pharmacological properties — normalising gastric secretion and increasing mucosal resistance to chemical damage. Laboratory studies on animal models have shown that repeated intake of thermal water increases resistance to the processes that cause gastric ulcers.
The effect on Helicobacter pylori. This is an important nuance. Karlovy Vary water increases the resistance of the gastric mucosa to Helicobacter pylori — the bacterium responsible for most cases of gastritis and peptic ulcer. But it does not eliminate H. pylori — that is the job of antibiotics. This is why the drinking cure in H. pylori-associated gastritis supplements antibiotic eradication therapy rather than replacing it.
Temperature matters. Hot water (above 57°C) has a binding, calming effect on the mucosa. Warm water (41–50°C) — universal action. Cooler water (around 30°C) — stimulates motility and bile secretion. This is why the physician prescribes a specific Vřídlo bowl (A, B, or C) or a specific spring — depending on your diagnosis and acidity level. Detailed information on how individual springs differ in temperature and traditional therapeutic application is in our complete guide to the Karlovy Vary springs.
The stomach is ready to eat after 30 minutes. Following properly drunk Karlovy Vary water, the stomach empties completely in approximately 30 minutes — which is exactly why the drinking cure is taken 30–60 minutes before meals.
Not all forms of gastritis respond equally to drinking therapy. The official indications for the Karlovy Vary resort include:
Chronic gastritis — functional and organic stomach conditions. Gastritis with high acidity responds particularly well, because the bicarbonates in the water directly neutralise excess hydrochloric acid.
Peptic ulcer disease of the stomach and duodenum — in remission, outside acute phases.
Gastroesophageal reflux disease (GERD) — bicarbonates reduce acidity in reflux.
Post-surgical states — rehabilitation after gastric resection, vagotomy.
Irritable bowel syndrome, chronic constipation, duodenitis — also within the resort’s profile.
This is a critical section — and there are no compromises here.
Acute gastritis and exacerbation of chronic gastritis — an absolute contraindication. A drinking cure on an inflamed and damaged mucosa can worsen the condition. Medical treatment first, then the resort in remission.
Peptic ulcer in an acute phase — the same. An active ulcer requires medical treatment, not mineral water.
History of gastric bleeding (within the past 3 months) — contraindicated.
Malignant gastrointestinal conditions — drinking therapy is not applied.
Pyloric stenosis — impaired gastric emptying.
Concurrent severe heart or kidney failure — the high sodium content in the water places additional strain on these systems.
This is not a complete list. This is exactly why an initial consultation with a spa physician is not a formality — it’s a medical necessity.
Most tourists drink water at the springs — they try it, enjoy the atmosphere; it’s pleasant and interesting. But this is not treatment.
A therapeutic drinking cure for gastritis involves:
A specific spring. The physician prescribes not “Karlovy Vary water” in general, but a specific spring at a specific temperature. For high acidity — certain springs; for low acidity — others.
A specific volume. The standard is 200–300 ml per intake. Not an arbitrary glass — a precise dose.
Precise timing. 30–60 minutes before meals, three times a day. The timing affects how the water interacts with digestion.
A minimum duration. The standard is 21 days. Fewer than 10 days is medically meaningless: the body doesn’t have time to complete adaptation and produce a stable response.
Diet in parallel. A drinking cure for gastritis without diet is half the job. Sanatorium meals in Karlovy Vary are specifically adapted to the gastrointestinal profile: no spicy, fatty, or fried food, with appropriate cooking methods.
Walking. The stroll between springs is not a tourist ritual. Movement stimulates peristalsis and accelerates water absorption. This is why the colonnades are so long.
For gastritis and peptic ulcer disease, the spa physician needs to see a specific picture, not just symptoms. It’s worth bringing:
The more complete the documentation, the more precise the prescription.
A drinking cure is ideally repeated 1–2 times per year. Between visits, Karlovy Vary salt — the evaporated concentrate of the spring water — helps maintain the mineral ritual.
For patients with chronic gastritis in remission, some use Karlovy Vary salt as a supporting practice between resort courses — on their physician’s recommendation and at the right dosage. It doesn’t replace a full course at the springs, but maintains the connection to the therapeutic tradition.
Important: for any internal use of the salt with gastritis or peptic ulcer — consult a gastroenterologist first. Dosage, frequency, and contraindications are individual.
→ Karlovy Vary drinking salt: shop.feelkarlovyvary.cz
For chronic gastritis with high acidity, most patients notice a reduction in symptom intensity (heartburn, heaviness) by the end of the first week of the course. This is linked to the direct neutralising action of the bicarbonates.
However, the first 3–5 days sometimes bring a worsening of symptoms — a phenomenon known in balneology as the “balneological reaction” (balneologická reakce), a normal part of adaptation. If symptoms are severe or worsen after day 5 — see the physician immediately.
The long-term effect — mucosal recovery, reduced frequency of flare-ups, improved digestion — accumulates across 2–3 annual courses.
The documentary “Karlovy Vary: The Power of Water” screens daily at the City Hub “Feel Karlovy Vary” on Lázeňská 14 — 60 minutes on the geology of the springs, the history of balneology, and the real medicine behind the drinking cure. Featuring historians, physicians, and hydrogeologists. Screenings daily at 16:00 and 20:00 in four languages.
Can you come to Karlovy Vary with active gastritis? No. With an acute flare-up — medical treatment first, then the resort in remission. Drinking therapy during an acute phase is contraindicated.
Do you need to stop proton pump inhibitors (omeprazole) before the course? This decision belongs to your physician only. In some cases they continue in parallel; in others the schedule is adjusted. Do not discontinue medication independently.
Can you combine gastritis treatment with sightseeing? Yes, with caveats. The drinking cure takes 3–4 hours per day (morning spring visit, treatments, afternoon rest). The remaining time is free. But the diet is maintained throughout — street food and restaurant experiments are limited during the course.
How often should the course be repeated? For chronic gastritis, the standard recommendation is 1–2 times per year. Regular courses produce a cumulative effect and reduce the frequency of flare-ups.
Does Karlovy Vary treatment help for H. pylori gastritis? It helps as a supplement to antibiotic eradication therapy — it increases mucosal resistance and speeds recovery after antibiotic treatment. But it doesn’t replace antibiotics. The sequence: eradicate H. pylori first, then a resort course in remission.
→ How the drinking cure works: Drinking Cure in Karlovy Vary → All 13 springs guide: Complete Guide to the Springs → Where to stay: Area and Hotel Guide
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