Overview of atrophic gastritis
Atrophic gastritis (AG) develops when the lining of the stomach is inflamed for many years. The inflammation is more likely the result of a bacterial infection caused by the H. pylori bacteria. Bacteria break down the mucus barrier that protects the stomach lining from acidic juices that aid digestion. If left untreated, the infection will gradually destroy the cells in the stomach lining.
In some cases, AG occurs when the immune system accidentally attacks healthy cells in the lining of the stomach. This is called autoimmune atrophic gastritis.
What causes atrophic gastritis?
Direct contact with the faces, vomit, or saliva of an infected person is transmitted from the AG to the person. AG infection can also be caused by bacteria when eating food or drinking water.
Autoimmune AG develops when your body produces antibodies that accidentally attack healthy stomach cells. Antibodies are proteins that help your body detect and fight infections. These usually attack harmful substances such as bacteria and viruses. However, antibodies in people with autoimmune can mistakenly attack stomach cells causing them to produce acidic juices that aid digestion.
Antibodies can also attack a substance called an internal factor. The endogenous factor is the protein released by the cells of the stomach, which helps in the absorption of vitamin B-12. The lack of an internal factor can lead to a condition called malignant anaemia. In this disease, B-12 deficiency causes your body to make enough healthy red blood cells.
What are the risk factors for atrophic gastritis?
If you have a pylori infection, you are more likely to develop AG. This type of infection is very common throughout the world. It is more prevalent in areas where poverty and congestion are high.
Autoimmune AG is very rare, but people with thyroid disorders or diabetes are more likely to have this condition. If you are of African American or Northern European descent, you are also at higher risk.
What are the symptoms of atrophic gastritis?
Most cases of AG go undiagnosed because there are usually no symptoms. However, if there are an H. pylori infection, common symptoms:
- Abdominal pain
- Nausea and vomiting
- Lack of appetite
- Unexpected weight loss
- Stomach ulcers
- Iron deficiency anaemia (low level of healthy red blood cells).
Autoimmune AGs can lead to a B-12 deficiency, which causes symptoms of anaemia, including:
- Mild headache
- Chest pain
- Heart palpitations
- Tinnitus (ringing in the ears)
B-12 deficiency can also cause nerve damage, which can lead to:
- Numbness and tingling in the extremities.
- Instability when running
- Psychological confusion
How is atrophic gastritis diagnosed?
The diagnosis of AG generally involves a combination of clinical observation and testing. During the physical exam, your doctor will check the tenderness of your abdomen by pressing lightly on certain areas of your abdomen. They also see signs of B-12 deficiency, such as paleness, rapid pulse, and nerve defects.
- Low levels of pepsinogen, a protein produced by stomach cells.
- It is high in gastrin, a hormone that stimulates the production of stomach acid.
- Low B-12 (for those with autoimmune AG).
- Antibodies that attack stomach cells and endogenous factor.
In some cases, your doctor may need a biopsy. Your doctor will insert an endoscope (a long, thin instrument with a light attachment) down your throat and into your abdomen. They take a tissue sample from your stomach to look for evidence of AG. The pattern of the abdominal tissue also indicates signs of H. pylori infection.
How is atrophic gastritis treated?
Most AG symptoms improve after the condition is treated.
Treatment usually consists of the use of antibiotics. It focuses on eliminating the pylori infection. Your doctor may also prescribe medications that reduce or neutralize stomach acid. The low acid environment helps heal the stomach lining.
People with autoimmune AG can also be treated with B-12 injections.
Preventing atrophic gastritis
AG is difficult to prevent, but with good hygiene, you can reduce the risk of H. pylori infection. This includes washing your hands after using the bathroom and before and after handling food. Parents or caregivers of young children should be sure to wash their hands after handling dirty diapers or towels. Teach your children good hygiene practices to prevent the spread of bacteria.