Atrophic Gastritis – Causes, Symptoms and Risk factors

What is atrophic gastritis?

Atrophic gastritis (AG) happens when the lining of the stomach has been inflamed for many years. Inflammation is usually associated with the bacterium Helicobacter pylori. Bacteria damage the mucous barrier which protects your mucous membrane from the acid environment necessary for digestion. This infection will slowly destroy your abdominal wall cells if left untreated.(1)

In some cases, AG occurs when the immune system accidentally attacks healthy and normal cells in the mucous membrane of your stomach. This is called as autoimmune atrophic gastritis.

What causes atrophic gastritis?

AG is a common cause of H. pylori bacterium. Bacterial infection usually occurs in children and gets worse over time if not treated.

Direct contact with a person’s feces, vomiting or saliva can transmit AG from one person to another. An AG infection may also occur due to the consumption of food or drinking water that is contaminated with the bacteria.(2)

Autoimmune AG develops when your body generates antibodies which attack the normal, healthy cells in the stomach by mistake. Antibodies are proteins found in your blood that help your body identify and control infections. They usually attack harmful germs or extraneous substances such as bacteria and viruses, parasites, etc. But for people with autoimmune AG, antibodies by mistake attack and destroy the stomach cells responsible for the production of acid juices that promote digestion.

Antibodies can also attack something known as intrinsic factor. The intrinsic factor is a protein released by the parietal cells of the stomach that facilitates the uptake of vitamin B-12. An intrinsic factor deficiency can lead to a condition called pernicious anemia. This condition makes it difficult for the body to produce enough healthy red blood cells due to vitamin B-12 deficiency.

What are the risk factors for atrophic gastritis?

You have a better chance of developing AG if you are infected with H. pylori. Such an infection is very common worldwide. It is more common in areas of poverty and in areas with larger populations.

Auto-immune AG is very rare, but people with thyroid problems or diabetes are at greater risk of developing this condition. You’re more likely to have it as well, whether you’re African-American or North European.

AG is also more common among people who are from Hispanic or Asian backgrounds.

Autoimmune AG and AG may significantly increase the risk for stomach cancer.

What are the symptoms of atrophic gastritis?

Many AG cases are hard to diagnose as there are generally no symptoms present. However, in the presence of H. pylori, the following are common symptoms:

  • stomach ache
  • nausea and vomiting
  • loss of appetite
  • sudden weight loss.
  • stomach ulcers
  • iron deficiency anemia (low levels of healthy RBC.)

Auto-immune AG may result in vitamin B-12 deficiency, which may lead to symptoms of anemia, which are:

B-12 deficiency may also cause nerve damage, which may include:

  • numbness and tingling within the limbs.
  • unsteady walk
  • mental confusion

How is atrophic gastritis diagnosed?

A AG diagnosis usually includes a combination of clinical observation and testing. During a physical examination, your doctor will check the sensitivity of the stomach by pressing lightly on some parts of your stomach. They will also look for signs of B-12 deficiency, such as paleness, rapid heartbeat, shortness of breath, and neurological deficits.

Your physician may conduct blood tests to verify:

  • reduced levels of pepsinogen, a proenzyme produced by major chief cells of the stomach.
  • high concentrations of gastrin produced by G-cells, a hormone which stimulates the production of gastric acid.
  • reduction in B-12 levels (in people who may have auto-immune AG)
  • antibodies which attack stomach cells and intrinsic factor (for people who may have auto-immune AG)

In some cases, your physician may ask you for a biopsy. Your doctor will insert an endoscope (a long, slender tube device with light attached) through your throat and stomach. They will then remove a tissue sample from your stomach for any indication of AG. The abdominal tissue sample may also indicate evidence of Helicobacter pylori infection.

How is atrophic gastritis treated?

Most people suffering from atrophic gastritis will notice improved symptoms following treatment of the condition.

The treatment is usually aimed at eliminating H pylori infection by using suitable antibiotics. Your doctor may also recommend medicines to decrease or neutralise gastric acid. A lower acid environment helps your abdominal wall heal.

People with autoimmune AG can be treated with B-12 injections as well.

Preventing atrophic gastritis

Atrophic gastritis is not easily prevented, but you may decrease your risk of H pylori infection by maintaining good hygiene. It includes handwashing after using the bathroom and before and after eating. Parents or guardians of young children should ensure to wash their hands after handling dirty diapers or laundry. Help your children learn good hygienic practices to prevent the spread of bacteria.

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