Atrophic gastritis

Atrophic gastritis is a chronic inflammatory process of the mucous membrane of the stomach.

Symptoms and Complications

Chronic inflammation of the stomach walls causes the loss of the glandular component, subverting normal gastric function; thus, in the presence of atrophic gastritis, there is a gradual onset of hypochlorhydria and achlorhydria, with dyspepsia and gastrointestinal disorders associated with hypergastrinaemia, deficit or lack of secretion of pepsinogen and intrinsic factor.

Furthermore, in the absence of adequate treatment, pernicious anemia and hyperhomocysteinemia due to vitamin B12 deficiency may occur, especially in the elderly.

In the presence of atrophic gastritis, the risk of gastric cancer is also increased, especially when the disease has autoimmune origins.

Causes

Atrophic gastritis can be caused by chronic gastric inflammation - like that Helicobacter pylori dependent - or have an "autoimmune origin."

In the first case, atrophic gastritis focuses on the antrum and then extends to the entire mucosa (multifocal atrophic gastritis); instead, when it is due to abnormal antibodies that attack the parietal cells of the stomach and the intrinsic factor (autoimmune atrophic gastritis), electively involves the fundus and the body.

Complications

Both forms are statistically related to a higher incidence of stomach cancer; in autoimmune disease, the association with Hashimoto's thyroiditis, thyrotoxicosis, myxedema, Addison's disease and type I diabetes is also more frequent.

The damage to the gastric mucosa is due to the action of bacterial "toxins" or to the action of the aforementioned antibodies; between the two forms, it is more pronounced in autoimmune atrophic gastritis.