What Is Atrophic Gastritis?
Atrophic gastritis (AG) develops when the lining of the stomach
has been inflamed for several years. The inflammation is most often the result
of a bacterial infection caused by the H. pylori bacterium. The bacteria
disrupt the barrier of mucus that protects your stomach lining from the acidic
juices that help with digestion. The infection will gradually destroy the cells
in your stomach lining if it’s not treated.
In some cases, AG occurs when the immune system mistakenly
attacks the healthy cells in your stomach lining. This is known as autoimmune atrophic gastritis.
What Causes Atrophic Gastritis?
AG is often caused by
the H. pylori bacterium.
The bacterial infection frequently occurs during childhood and
gets worse over time if it isn’t treated.
Direct contact with the feces, vomit, or saliva of an infected
person can spread AG from person to person. It may also occur after eating food
or drinking water that’s contaminated with the bacteria.
Autoimmune AG develops when your body produces antibodies that
attack healthy stomach cells by mistake. Antibodies are proteins that help your
body recognize and fight infections. They normally attack harmful substances such
as bacteria and viruses. However, antibodies in people with autoimmune AG
mistakenly target the stomach cells responsible for producing acidic juices
that help with digestion.
Antibodies may also attack a substance known as intrinsic factor.
Intrinsic factor is a protein stomach cells release that helps absorb vitamin
B-12. A lack of intrinsic factor can cause an illness called pernicious anemia.
In this disease, a B-12 deficiency makes it difficult or impossible for your
body to make enough healthy red blood cells.
What Are the Risk Factors for Atrophic
You’re more likely to develop AG if you have an H. pylori infection.
This type of infection is fairly common around the world. However, it’s more
prevalent in areas of poverty and overcrowding.
Autoimmune AG is quite rare, but people who have thyroid
disorders or diabetes are more likely to have this condition. You’re also more
at risk if you’re African-American or of Northern-European descent.
AG is more common in people who are of Hispanic or Asian descent.
Both AG and autoimmune AG can significantly increase your risk of
What Are the Symptoms of Atrophic Gastritis?
Many cases of AG go undiagnosed because there are usually no
symptoms. However, common signs of an H. pylori infection include:
- stomach pain
- 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 a B-12 deficiency, which can cause
symptoms of anemia,
- chest pain
- heart palpitations
- tinnitus (ringing in the ears)
A B-12 deficiency can also cause nerve damage, leading to:
- limb numbness and tingling
- unsteadiness when walking
- mental confusion
How Is Atrophic Gastritis Diagnosed?
An AG diagnosis usually involves a combination of clinical
observation and testing. During a physical exam, your doctor will check for
stomach tenderness by lightly pressing on certain areas of your stomach. They’ll
also look for signs of B-12 deficiency, such as paleness and a rapid pulse.
Your doctor might order blood tests to check for:
- low levels of pepsinogen, a protein produced by
the stomach cells
- high levels of gastrin, a hormone that
stimulates the production of stomach acid
- low levels of B-12 (for people who may have autoimmune
- antibodies that attack stomach cells and
intrinsic factor (for people who may have autoimmune AG)
In some cases, your doctor may need to perform a biopsy. Your
doctor will insert an endoscope, (a long, slender instrument with a light
attachment) down your throat and into your stomach. They’ll then take a sample
of tissue from your stomach to look for evidence of AG. The sample of stomach
tissue can also indicate signs of an H. pylori infection.
How Is Atrophic Gastritis Treated?
Most people with AG will see an improvement in symptoms once the
condition is treated.
Treatment usually focuses on eliminating the H. pylori infection
with the use of antibiotics. Your doctor may also prescribe medications that reduce
or neutralize stomach acid. A less acidic environment helps your stomach lining
People with autoimmune AG may also be treated with B-12
Preventing Atrophic Gastritis
AG is difficult to prevent, but you can lower your risk of
getting an H. pylori infection by practicing good hygiene. This
includes washing your hands after using the bathroom and before and after
handling food. Parents or caregivers of young children should make sure to wash
their hands after handling soiled diapers or linens. Teach your children good
hygiene practices to avoid the spread of bacteria.