Atrophic gastritis is a chronic, long-term inflammation of the gastric mucosa. Over time, this condition leads to a disruption in the renewal of cells in the mucous membrane, causing structural changes. As the disease progresses, the gastric glands lose their ability to function properly, affecting secretion production (such as pepsin and acid), gastric motility, and the digestive process in the intestine. Intestinal metaplasia, where gastric glands are replaced by intestinal epithelial tissue, can also occur.
This condition is a significant precursor to stomach cancer, with the risk increasing for those who suffer from it over many years.
Causes of Atrophic Gastritis
The causes of atrophic gastritis are both internal and external. The most common factors include:
- Helicobacter pylori infection (85% of cases) – This bacterium thrives in the stomach’s acidic environment, reducing acid aggressiveness and promoting colonization of the mucous membrane, leading to chronic inflammation.
- Autoimmune disorders (10% of cases) – The immune system mistakenly attacks the stomach’s parietal cells, leading to the destruction of the mucous membrane.
- Duodenal reflux (5% of cases) – This occurs when contents from the duodenum damage the stomach lining, often caused by an incomplete pyloric sphincter.
Additional factors that can contribute include stress, poor diet (such as excessive spicy foods, coffee, and alcohol), smoking, long-term use of certain medications (e.g., NSAIDs), and chronic diseases (e.g., tuberculosis, diabetes, liver cirrhosis).
Symptoms and Diagnosis
Atrophic gastritis presents a range of symptoms, including:
- Local symptoms: Feeling of heaviness or pressure in the stomach, nausea, belching, and burning sensations.
- Systemic symptoms: Fatigue, weakness, and digestive issues like bloating, diarrhea, or constipation.
For diagnosis, EGD (esophagogastroduodenoscopy) is the primary method. This involves using a probe to examine the stomach’s mucous surface and take tissue samples to test for Helicobacter pylori. A thinning of the mucosa, pale color, and decreased folds are common signs of atrophic gastritis.
Treatment and Management
The treatment of atrophic gastritis focuses on alleviating symptoms, managing underlying causes, and preventing further damage. The treatment varies depending on the type of gastritis:
- Type A (autoimmune): Often treated with corticosteroid medications to manage immune dysfunction. A special diet (Pevsner Diet No. 2) is recommended, emphasizing protein-rich foods to stimulate gastric secretion and prevent further damage.
- Type B (Helicobacter pylori): Treatment involves antibiotics to eradicate the infection, along with medications to reduce acidity.
In both cases, patients are advised to avoid irritants such as alcohol, caffeine, and spicy foods. Smaller, more frequent meals are recommended, and a balanced diet rich in vitamins and minerals is essential for healing and managing symptoms.
The Risk of Stomach Cancer
Chronic atrophic gastritis is a precursor to stomach cancer. Helicobacter pylori, in particular, has been linked to the development of cancer due to its ability to damage the gastric lining over time. In fact, atrophic gastritis can lead to gastric cancer in 13% of cases, which is significantly higher than in other types of gastritis. Early diagnosis and effective treatment can help mitigate the risk of cancer by reducing inflammation and promoting the healing of the stomach lining.
For more information, read about Symptoms of Atrophic Gastritis and Diagnosis and Treatment on gastritinfo.com.