What to know about atrophic gastritis
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?
Atrophic gastritis affects the stomach lining.
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.
Pernicious anemia is a complication that makes it difficult for a person to create red blood cells.
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
Stomach pain and nausea can characterize atrophic gastritis.
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
- lack of appetite
- iron deficiency anemia
- pain in the stomach
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
- heart palpitations
A vitamin B-12 deficiency can, in some cases, result in nerve damage. If this occurs, a person may notice:
- unsteadiness when walking
- tingling or numbness in the arms or legs
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.
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:
Also, people with atrophic gastritis are at a higher risk of developing stomach cancer.
Vitamin B-12 shots may help to prevent complications from atrophic gastritis.
A doctor will treat atrophic gastritis by focusing on the underlying cause. Once they have treated the cause, a person's symptoms will clear up.
A doctor will typically prescribe antibiotics to treat cases where bacteria is causing atrophic gastritis. In some cases, they may also prescribe medication to reduce the production of stomach acids while the stomach heals.
In cases of autoimmune atrophic gastritis, a doctor may prescribe B-12 injections. These injections will prevent or eliminate complications of a B-12 deficiency.
Also, treatment for autoimmune atrophic gastritis will likely focus on ensuring a person is not iron deficient.
Diet and lifestyle
In addition to medical treatment, people can take steps at home to manage symptoms of atrophic gastritis.
For those with autoimmune atrophic gastritis, a diet rich in vitamin B-12 could help prevent further complications due to the deficiency. Good sources of B-12 include:
- fortified cereal
- fatty fish
To prevent contact with H. pylori, a person should take special care with regards to hygiene when traveling to countries where contaminated water is a concern.
Some steps people can take to prevent contact with these bacteria include:
- practicing safe food handling by washing all fruits and vegetables thoroughly
- avoiding food grown using contaminated water
- drinking bottled water when other water may be contaminated
Treating atrophic gastritis that is caused by bacteria is relatively easy with medication. People can usually expect a full recovery once a doctor determines and treats the underlying cause.
Both types of atrophic gastritis can raise a person's risk of certain cancers. However, early detection and treatment can improve the overall outlook and reduce the risk of complications.
People with autoimmune atrophic gastritis have a good prognosis with early detection and treatment. They may require B-12 injections to help prevent complications.