Atrophic Gastritis

Atrophic gastritis (AG) is chronic inflammation and thinning of the stomach lining.  In addition, the cells in the stomach lining mimic cells of the small intestine.

Atrophic gastritis, known as environmental metaplastic atrophic gastritis (EMAG), occurs when environmental factors cause chronic inflammation. Often caused by a chronic infection of helicobacter bacteria.

These bacteria can disrupt the mucus that usually protects your stomach lining from acidic juices released during digestion. Over many years, this acid destroys the cells in your stomach lining, causing atrophic gastritis.

Autoimmune atrophic gastritis (AAG) is the second type of atrophic gastritis. It occurs when your immune system attacks your stomach lining cells.

Both EMAG and AAG can lead to an increased risk of developing small neuroendocrine tumours (NETs) in your stomach. NETs are usually non-cancerous (benign).

EMAG and AAG can also increase the risk of stomach cancer (gastric cancer).  Patients at a higher risk of gastric cancer will be offered surveillance endoscopies.

Causes of Environmental Atrophic Gastritis (EMAG):

Helicobacter infection causes EMAG.  Most people become infected with these bacteria during childhood.  Causes of infection include direct contact with contaminated.

• Water
• Vomit
• Saliva
• Food
• Faeces

Causes of Autoimmune Atrophic Gastritis (AGG):

Antibodies are proteins that are part of the immune system and help fight bacterial and viral infections. In AAG, antibodies attack the healthy stomach cells.  Antibodies may also attack a protein released by the stomach cells (intrinsic factor). Intrinsic factor usually helps to absorb vitamin B12. Without intrinsic factor, the body may not be able to make healthy red blood cells. This can lead to pernicious anaemia. A lack of vitamin B12 may also cause nerve damage neuropathy.

Symptoms of EMAG:

• Upper abdominal pain
• Iron deficiency anaemia
• Loss of appetite
• Nausea / vomiting
• Peptic ulcers
• Unexplained weight loss

Symptoms of AAG:

Autoimmune atrophic gastritis may not have any signs or symptoms. If AAG causes a vitamin-B12 deficiency, it can cause symptoms of anaemia and nerve damage.

• Chest pain
• Dizziness
• Palpitations
• Nausea / Vomiting
• Pale skin
• Tingling & numbness in limbs

EMAG Treatment:

• Antibiotics to treat helicobacter infection.
• Acid suppressant medication
• Lifestyle changes
• Surgery for severe symptoms, which are not helped with medication.

AAG Treatment:

• Vitamin B12 Injections
• Iron infusions

Follow-Up:

Sometimes surveillance endoscopies are required to monitor any changes to the stomach lining.

Further Information:

https://gutscharity.org.uk/