Atrophic Gastritis – Causes, Symptoms and Risk factors

What is atrophic gastritis?

Atrophic gastritis (AG) occurs when the mucosal lining of the stomach has been inflamed for several years. The inflammation is usually caused by the bacterium  Helicobacter pylori . The bacteria damage mucosal barrier that protects your stomach lining from the acidic environment that is necessary for digestion. The infection will slowly destroy the cells in your stomach lining if it’s left untreated.(1)

In some cases, AG happens when the immune system mistakenly attacks the healthy and normal cells in your stomach lining. This is called as autoimmune atrophic gastritis.

What causes atrophic gastritis?

AG is often caused by theH. pylori bacterium. The bacterial infection usually occurs during childhood and it worsen over time if it left untreated.

Direct contact with the feces, vomit, or saliva of an infected person can transmit AG from person to person. An AG infection can also occurs because of taking food or drinking water that is contaminated with the bacteria.(2)

Autoimmune AG develops when your body produces antibodies that attack normal and healthy stomach cells by mistake. Antibodies are proteins present in our blood that help your body to identify and fight infections. They normally attack harmful microbes or foreign substances such as bacteria and viruses, parasites etc. However, in people with autoimmune AG, antibodies mistakenly attack and destroy the stomach cells which are responsible for producing acidic juices that supports digestion.

Antibodies may also attack a substance called as intrinsic factor. Intrinsic factor is a protein released by parietal cells of stomach that helps in absorption of vitamin B-12. A deficiency of intrinsic factor can result in an illness called pernicious anemia. In this disease, it is difficult for the body to make sufficient healthy red blood cells because of the deficiency of a vitamin B-12.

What are the risk factors for atrophic gastritis?

You have more chance to develop AG if you have an H. pylori infection. This type of infection is very common around the world. It is more frequent in areas of poverty and over populated areas.

Autoimmune AG is very rare, but people who have thyroid disorders or diabetes are at more risk to develop this condition. You also have more chances to have it, if you’re African-American or of northern European descent.

AG is also more common in people who are of Hispanic or Asian descent.

Both AG and autoimmune AG can remarkably increase the risk of stomach cancer.

What are the symptoms of atrophic gastritis?

Many cases of AG are difficult to diagnose because there are usually no symptoms present. However, if an H. pylori infection is present, common symptoms are:

  • stomach ache
  • nausea and vomiting
  • loss of appetite
  • unexpected weight loss
  • stomach ulcers
  • iron deficiency anemia (a low level of healthy red blood cells)

Autoimmune AG may lead to vitamin B-12 deficiency, which can lead to symptoms of anemia, which are:

  • weakness and fatigue
  • lightheadedness
  • dizziness
  • shortness of breath
  • chest pain
  • heart palpitations
  • tinnitus (ringing in the ears)
  • Skin pallor

A B-12 deficiency can also lead to nerve damage, which can results in:

  • numbness and tingling in limbs
  • unsteady walk
  • mental confusion

How is atrophic gastritis diagnosed?

An AG diagnosis usually have a combination of clinical observation and testing. During a physical exam, your doctor will check for stomach tenderness by slightly pressing on certain areas of your stomach. They’ll also check for signs of B-12 deficiency, such as paleness, rapid pulse, breathlessness and neurological deficits.

Your doctor might perform blood tests to check for:

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

In some cases, your doctor may require to perform a biopsy. Your doctor will insert an endoscope, (a long, slender tubular instrument with attached light) via your throat and into your stomach. They’ll then take a sample of tissue from your stomach to look for any indicatio of AG. The sample of stomach tissue can also specify signs of an Helicobacter pylori infection.

How is atrophic gastritis treated?

Most people with Atrophic Gastritis will notice an improvement in symptom after the treatment of the condition.

Treatment usually aim to removing the H. pylori infection with the use of proper antibiotics. Your doctor may also recommend medications that lower or neutralize stomach acid. A less acidic environment helps your stomach lining to cure.

People having autoimmune AG may also be treated with B-12 injections.

Preventing atrophic gastritis

Atrophic Gastritis is not easy to prevent, but you can decrease your risk of getting an H. pylori infection by maintaining good hygiene. This includes washing your hands after using the bathroom and before and after having food. Parents or caregivers of young children should make sure to wash their hands after handling soiled diapers or linens. Help your children to learn good hygiene practices to avoid the transmission of bacteria.

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