Atrophic Gastritis is a condition which is characterized by partial loss of gastric mucosa due to chronic inflammation. Chronic inflammation results in loss of glandular gastric cells, which are replaced by intestinal epithelial cells. Atrophic gastritis is a chronic process and is often associated with Helicobacter Pylori infection. However there are several other factors like autoimmune disorders or environmental factors which may result in the destruction of the gastric cells.
The prevalence of atrophic gastritis in general population is not known, since the condition is often asymptomatic. Estimates however suggest that about 50% of the world population is infected by H.
pylori which make chronic gastritis a common condition. The prevalence is higher in Asia and other developing countries. In United States, it is estimated that about 20% of individuals below the age of 40 years are affected by the condition, while the prevalence increases to 50% among older population.
Various epidemiological studies have shown that atrophic gastritis can affect both males and females; however its prevalence in females is higher, with a female to male ratio of 3:1.
Atrophic gastritis is caused primarily due to H. Pylori infection or is associated with autoimmune gastritis.
There are several sub classifications of atrophic gastritis; however, this doesn’t impact the presentation and the treatment of the condition.
Symptoms Of Atrophic Gastritis
Atrophic gastritis is the end stage of chronic gastritis and hence the symptoms associated with the condition are very similar to chronic gastritis. In most cases, chronic gastritis is asymptomatic, however the most common symptoms associated with the condition include,
- Epigastric pain with sensation of fullness in the abdomen.
- Nausea and vomiting along with flatulence may be experienced in cases of acute H. pylori infection.
- Fever and malaise are observed in cases of acute infection by H. pylori.
- Anorexia or loss of appetite with weight loss is also observed.
- Autoimmune gastritis is associated with cobalamin deficiency which is manifested in the form of megaloblastic or pernicious anemia. Anemia itself may be associated with symptoms like tinnitus, palpitation, weakness and light headedness.
- In severe cases neurological manifestations are also observed, due to deficiency of cobalamin. These include numbness in the extremities with generalized weakness. Mental function disturbances in the form of irritability or dementia may also be observed.
Complications of atropic gastritis include gastric ulcers or adenocarcinoma.
Treatment For Atrophic Gastritis
Conventional treatment regimen comprises of use of a combination of three or four antibiotics to help destroy the H. pylori infection. Though studies have shown that the effectiveness of these antibiotic therapies is as high as 90%, they don’t help in improvement of the atrophy and the disease continues to progress.
Diet plays a crucial role in recovery. Food sources of vitamin B12 can help alleviate the symptoms associated with pernicious anemia and autoimmune gastritis. Increase the intake of low fat milk and dairy products, lean meat, fish, sea food, etc.
Homeopathic drugs like Arsenic Alb and Phosphoricum have been beneficial in management of symptoms like retrosternal burning, flatulence, nausea and vomiting.