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Chronic Atrophic Gastritis

Chronic Atrophic Gastritis
The term chronic atrophic gastritis is commonly used to denote inflammation associated with the mucous membrane located in the stomach.
Nicks J
Last Updated: May 31, 2018
In this condition the mucosa lining of the stomach is swollen, causing severe pain. The inflammation doesn't occur suddenly but is gradual and so, it may take months or even years for chronic atrophic gastritis to develop. Hence, it is often diagnosed in adults and rarely in the elderly. As we all know, the lining the stomach wall has innumerable gastric glands and their main job is to release gastric juice and other digestive enzymes to promote digestion.
This coating of gastric glands over the stomach wall is made up of different layers, one of which is the mucosa (mucus secreting membrane). The gastric glands also contain different cells such as parietal cells and the chief cells and together they are referred as gastric glandular cells. These cells are the ones that actually secrete gastric acid to aid digestion.
The mucosa lining (as mentioned above) is a thick layer of mucus that lies over the walls of the stomach. This protective layer of mucous membrane ensures that the stomach wall does not get damaged from gastric juice that is produced by the gastric glands. The gastric juice, also referred as stomach acid play a critical in the digestion of ingested food. However, if the stomach wall is directly exposed to this acid, it can be problematic as it can lead to formation of ulcers. However, this does not happen due to the mucous membrane that lines the stomach wall.
The chronic inflammation of the mucosa in atrophic gastritis is typically accompanied by destruction of gastric glandular cells and their place is subsequently taken by fibrous and intestinal tissues. In the absence of gastric glandular cells, the production of gastric acid that aids in digestion takes a backseat. No wonder, people suffering from chronic inflammation of the stomach lining are often heard complaining about digestive problems. Due to this stomach problem, the body is unable to absorb essential nutrients, especially vitamin B12 from food.
Causes
The mucous membrane (stomach lining) acts like a barrier that protects the underlying tissues from getting damaged by the alkaline and acidic substances, such as digestive enzymes and gastric acids, involved in digestion. When this protective shield gets damaged or is weakened, chronic atrophic gastritis develops, disrupting the digestion process. There are a number of factors that can weaken the mucous membrane. They are as follows:
Pain Relievers: Using painkillers regularly can lead to this stomach ailment. Pain relievers such as ibuprofen and aspirin, when used often can indeed have a negative impact on the mucosa lining. The mucosa lining is likely to get damaged and inflamed with too much use of painkillers.
Alcohol Abuse: Gradual onset of gastritis has also been attributed to alcohol abuse. Too much intake of alcohol on a daily basis may not go too well with the mucosa lining. Initially, it may respond with chronic inflammation and with no check on alcohol consumption, the mucosa lining may soon get eroded.
Bacterial infections: Helicobacter pylori is a bacterium that commonly infects the stomach and is considered to be the main cause of this indigestion problem. H. pylori can damage the mucosa lining by penetrating through the stomach's inner protective coating. A point to note that suffering from this infection just once, might not lead to this stomach problem. Recurring or persistent infections of H.pylori bacteria is the primary contributor in the development of chronic atrophic gastritis.
Attack of Antibodies (An Autoimmune Disorder): Antibodies present in our body are necessary to fight against fungal and bacterial infections. However, when these antibodies attack the stomach lining, the stomach's protective shield can be damaged. Recent research indicates that this abnormal behavior of the immune system may also be due to the presence of H.pylori bacteria in the stomach. The antibodies in autoimmune atrophic gastritis typically target the parietal cells (gastric acid producing cells). As a consequence of this unexpected attack there is a sharp drop in the production of gastric acid, which eventually triggers indigestion.
Surgery: Removal of a part of the stomach during a surgical procedure can also cause inflammation of the mucosa lining.
Symptoms
Stomach pain and discomfort are the most common symptoms of this type of gastritis. In addition to the pain, patients also suffer from stomach upsets and indigestion problems. Patients with this condition often experience recurrent pain in their upper abdomen. Other symptoms of this disease are as follows:
  • Occasional vomiting
  • Unexplained nausea
  • Meal related bloating
  • Abdominal pain due to indigestion
  • Weak appetite (desire for food decreases considerably)
  • Weight loss
  • Sore tongue
  • Restlessness
  • A feeling of stomach becoming full after consuming only a small amount of food
  • Formation of stomach ulcers (an open painful wound); if the ulcers bleed, the person may vomit blood. Persistent bleeding can make the person weak and tired.
  • Black, tarry stools
Treatment
If left untreated, the condition of the patient worsens and becomes serious. Over a period of time the stomach may lose its ability to produce digestive juices. The patient is also at a greater risk of having stomach cancer in case of extensive thinning of the stomach lining. The production of stomach acid causes irritation to the inflamed tissue of the stomach.
Treatment is aimed at reducing the inflammation of the stomach lining. Medicines are prescribed to neutralize the effect of acids. Antacids such as Mylanta and Maalox can reduce the pain considerably. If antacids don't work, acid blockers such as Ranitidine (Zantac) and Cimetidine (Tagamet) are used to minimize the production of acid in the stomach.
In order to treat the H. pylori infection, a combination of anti-secretory agents (proton pump inhibitors) and anti-microbial agents (antibiotics), such as bismuth subsalicylate or ranitidine bismuth citrate are used. These help in eliminating the bacteria and relieving the pain. Patients diagnosed with this disease are known to have deficiencies of vitamin C and vitamin B12. Hence, treatment also involves increasing the intake of these nutrients with the help of a healthy diet. Certain herbs can also help to combat this illness.
People suffering from this stomach problem should follow a healthy diet in order to reduce the severity of symptoms. Spicy foods, as well as fatty or fried foods do not have any place in chronic gastritis diet. Eating frequent meals in small amounts is recommended. Smoking and alcohol can cause considerable damage to the protective mucous membrane of the stomach, thereby causing irritation to the stomach.
Hence, alcoholic drinks and smoking must be strictly avoided. There are also some dietary supplements available in the market that promote the well-being of the mucous membranes. Eating healthy, nutritious food, and following an exercise routine regularly, not only accelerates the healing process, but also decreases the risk of chronic atrophic gastritis.
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