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Atrophic Body Gastritis: Clinical Presentation, Diagnosis, and Outcome

These cases are often diagnosed as autoimmune gastritis. This association has been included as part of the autoimmune polyendocrine syndrome. A frequent clinical presentation of atrophic body gastritis is pernicious anaemia, considered an autoimmune condition, arising from vitamin B12 malabsorption as a consequence of intrinsic factor deficiency. Another presentation may be an otherwise unexplained iron deficiency anaemia, as a result of iron malabsorption and consequence of reduced gastric acid secretion. To date, no universally accepted criteria are available to define autoimmune gastritis and to distinguish this clinical entity from chronic, Helicobacter pylori-driven, multifocal atrophic…

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 A look into atrophic gastritis: A narrative review

The risk of gastric cancer is significantly elevated in individuals with atrophic gastritis. Chronic atrophic gastritis is a complex disease characterized by multifactorial origins, highly variable clinical symptoms, and a considerable lack of specificity, rendering early clinical identification challenging. Consequently, its accurate and timely recognition is paramount for prompt therapeutic intervention. The clinical manifestations of this disease are nonspecific, often involving a spectrum of systemic disorders. Thus, its etiology may extend beyond autoimmunity or H. pylori infection to encompass anemia induced by iron and vitamin B12 deficiency, other autoimmune disorders, or unexplained neurological abnormalities.

Articles of Interest

Autoimmune Atrophic Gastritis: A Clinical Review

Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa due to anti-parietal cell antibodies. This review provides a comprehensive and up-to-date overview of autoimmune atrophic gastritis, reporting recent evidence on epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management.

Chronic Atrophic Gastritis: Don’t Miss These Nutritional Deficiencies

Chronic atrophic gastritis (CAG) results in the destruction of gastric mucosa parietal cells leading to reduced gastric acid secretion and decreased intrinsic factor (IF) production. The consequence of which is achlorhydria, hypergastrinemia, and IF deficiency. As a result, CAG may lead to the malabsorption (albeit by different mechanisms) of vitamin B12 and iron, causing macrocytic anemia or iron deficiency anemia, respectively. Vitamin B12 deficiency, due to decreased IF production can result in megaloblastic anemia and varying neurologic dysfunction.

Clinical manifestations of chronic atrophic gastritis

Although the actual prevalence of chronic atrophic gastritis is unknown and it is probable that this entity goes largely underdiagnosed, patients in whom diagnosis is established usually present advanced stages of disease. Destruction of parietal cells, either autoimmune-driven or as a consequence of Helicobacter pylori infection, determines reduction or abolition of acid secretion.

Diagnosis and management of atrophic gastritis

Atrophic gastritis is defined as the loss of gastric glands, with or without metaplasia, in the setting of chronic inflammation mainly due to Helicobacter pylori infection or autoimmunity. Regardless of the etiology, the diagnosis of atrophic gastritis should be confirmed by histopathology.

Is Atrophic Gastritis Curable?

The treatment methods for atrophic gastritis can vary depending on the cause of the condition. For those with atrophic gastritis caused by H. Pylori bacteria, the primary goal is to eliminate and eradicate the bacteria using antibiotics. The doctor may also prescribe acid-reducing medications to help the stomach lining heal quickly. For those with autoimmune atrophic gastritis, where the immune system mistakenly attacks the stomach lining, the treatment often includes vitamin B12 injections and increasing the intake of foods such as shellfish, eggs, yogurt, beef, cereals, and fatty fish. Patients can also consume iron-rich foods to prevent iron deficiency anemia.

Stomach This: Autoimmune Atrophic Pangastritis, a Rare Type of Gastritis

Atrophic gastritis is categorized as autoimmune (formerly type A) or environmental (formerly type B, most frequently from Helicobacter pylori infection), with the latter being the most common.