What to know about atrophic gastritis

Atrophic gastritis occurs when a person's stomach lining is inflamed for an extended period, often for several years.

Over time, the inflammation associated with atrophic gastritis damages the stomach lining, causing digestive problems and nutrient deficiencies.

A bacterial infection usually causes atrophic gastritis, but it can also be an autoimmune condition. Treatments differ, depending on the cause, but diet and lifestyle can improve the outlook in both cases.

In this article, we look at the symptoms, causes, and treatments for atrophic gastritis.

What is atrophic gastritis?

Gastritis is the medical term for stomach inflammation. Atrophic gastritis is a chronic form of gastritis.

Doctors mostly find inflammation in the mucous membrane of a person's stomach lining. This leads to various digestive problems.

In the early stages, atrophic gastritis may not cause any symptoms, so the condition can persist for years without a person being aware that they have it.

When a person has autoimmune atrophic gastritis, their body mistakenly attacks healthy stomach cells, including a substance called intrinsic factor.

Intrinsic factor is responsible for helping the body absorb vitamin B-12. When a person cannot absorb enough B-12, they may develop pernicious anemia.

Pernicious anemia is a complication that makes it difficult for a person to create red blood cells.

Causes

A bacterial infection by Helicobacter pylori or H. pylori, usually causes atrophic gastritis. Around half of people with H. pylori-related gastritis will develop atrophic gastritis.

Otherwise, atrophic gastritis can be an inherited or genetic condition, which is called autoimmune atrophic gastritis. Here, the immune system attacks the healthy cells in the stomach lining.

A H. pylori infection causes the majority of atrophic gastritis cases. This infection is very common and often has no symptoms or is asymptomatic, especially at its onset.

Atrophic gastritis often starts when a person is a child. Left untreated, it will get worse over time and can lead to stomach ulcers.

There are many ways a person can come into contact with the H. pylori bacterium. These include:

drinking contaminated water

eating foods prepared or grown in contaminated water

having direct contact with saliva, vomit, or feces of a person who has H. pylori

Symptoms

Very often, a person may not know they have atrophic gastritis, as they may not have any noticeable symptoms. For this reason, a diagnosis of the condition may never happen in a person who has had it for years.

The symptoms differ, depending on whether a bacteria or autoimmune condition are causing atrophic gastritis.

When a bacterial infection is the cause of atrophic gastritis, a person may notice symptoms that include:

unusual or unintended weight loss

vomiting

lack of appetite

nausea

iron deficiency anemia

pain in the stomach

ulcers

When autoimmune atrophic gastritis is the cause, a person may notice symptoms of a vitamin B-12 deficiency and pernicious anemia. Symptoms include:

pain in the chest

general fatigue

tinnitus or ringing in the ears

dizziness

lightheadedness

heart palpitations

A vitamin B-12 deficiency can, in some cases, result in nerve damage. If this occurs, a person may notice:

confusion

unsteadiness when walking

tingling or numbness in the arms or legs

Diagnosis

Firstly, a doctor is likely to perform a physical examination and run tests to diagnose atrophic gastritis.

The physical exam usually involves the doctor feeling around the stomach region to check for tenderness.

Often, the doctor will also order blood tests to look for:

lowered levels of B-12

low levels of pepsinogen, a protein that stomach cells produce

antibodies that are attacking intrinsic factor or stomach cells

higher levels of the hormone that produces stomach acid called gastrin

If a doctor suspects that a person has H. pylori, they may order a breath test. This test involves swallowing a substance that contains particular carbon molecules and then breathing into a test tube.

If a person has H. pylori, the person's stomach releases carbon. The carbon will be present in the person's breath when they exhale.

A doctor may also take a biopsy of the stomach cells. To do a biopsy, a doctor will insert an endoscope, which is a long tube with a light on it, through the mouth and into the stomach. They then use a small tool inside the endoscope to take a sample of the stomach cells.

A biopsy will help the doctor to diagnose the cause of a person's symptoms and confirm whether or not they have atrophic gastritis.

Risk factors

A person is most at risk of atrophic gastritis if they come into contact with H. pylori. This global disease is most common in areas of the world that have extreme poverty or are over-crowded.

Autoimmune atrophic gastritis is much less common. It is more likely to occur in people of African-American, Asian, Hispanic, or northern European descent.

People with other medical conditions are more at risk of autoimmune atrophic gastritis. These conditions include:

thyroid disease

type I diabetes

vitiligo, a pigmentation disorder

Addison's disease

Also, people with atrophic gastritis are at a higher risk of developing stomach cancer.

Source: Medical News Today