Is gastric mucosal atrophy dangerous?

This is an automatically translated article.

The article was professionally consulted by a doctor from the Department of Medical Examination & Internal Medicine - Vinmec Danang International General Hospital.
Chronic gastritis in the final stage begins to appear atrophic gastritis of the gastric mucosa. Gastric mucosal cells are lost or replaced by intestinal mucosal epithelial cells, pyloric glands, and fibrous tissue. Atrophic gastritis caused by Helicobacter pylori usually has no symptoms but the risk of stomach cancer is very high..

1. What is atrophic gastritis?

Atrophic gastritis is a phenomenon caused by H. pylori bacteria that cause stomach ulcers, which destroy the mucosa after a long time. Gastric mucosal atrophy is a condition characterized by chronic inflammation in which gastric glandular cells are lost and replaced by intestinal mucosal epithelium, pyloric and fibrous stroma.
Chronic gastritis in the final stage will cause atrophic gastritis of the gastric mucosa. But there are also some cases of autoimmune atrophic gastritis, when the immune system attacks healthy mucosal cells due to an error in the body. It's called autoimmune atrophic gastritis.

2. Silent developments

The disease is usually caused by infection with H. pylori bacteria that reside and infect the stomach. Bacterial foci are located within the gastric mucosa and the gastric surface epithelium and are rarely present in the deeper glands.
This infection is usually acquired during childhood and develops throughout the patient's life if left untreated. Significant damage associated with the release of bacteria and inflammatory toxins results in damage to gastric epithelial cells leading to progressive cell loss or gastric atrophy over time.
The process of chronic gastritis caused by H.Pylori progresses with 2 clinical forms, mainly antral gastritis and multifocal atrophic gastritis. It should be noted that patients with gastric carcinoma and peptic ulcer are more likely to have a multifocal form of atrophic gastritis, which is common in developing countries in Asia.
For autoimmune atrophic gastritis - cobalamin (vitamin B12) deficiency. The disease has an insidious onset and slow progression. This is because the body produces antibodies against the healthy cells in the stomach lining due to a mistake. Antibodies are proteins that help the body detect and fight infection. They usually fight harmful agents such as bacteria or viruses.
However, the antibodies in autoimmune atrophic gastritis mistakenly attack the stomach cells that secrete acid to help digest food. Antibodies can also attack stomach intrinsic factor, which is a protein secreted by stomach cells that helps absorb vitamin B12. When intrinsic factor deficiency can cause pernicious anemia, a lack of vitamin B12 prevents the body from producing enough red blood cells. Vitamin B12 deficiency affects mainly the hematological, digestive and nervous systems. Causes megaloblastic anemia, thrombocytopenic purpura...
When the gastric mucosa is atrophied, the acid secretion function of the patient is most affected, so the symptoms related to this problem are common. more: dyspepsia, fullness, quick satiety, loss of appetite, belching, feeling of tightness in the chest after eating, abdominal bloating, loose stools. However, in some cases, the protective function is affected first, so the patient has a lot of abdominal pain above the navel and a lot of pain when eating spicy food. Despite having a lot of pain, the patient always complains of indigestion, fullness, bloating, and loss of appetite. Patients are often misdiagnosed as peptic ulcers for two reasons:
Peptic ulcer disease also has symptoms of abdominal pain and bloating. But it should be noted that peptic ulcer will cause abdominal pain, heartburn, sour mouth more than gastric mucosal atrophy. Gastritis is associated with gastric mucosal atrophy in up to half of cases, and endoscopic evaluation of the stomach with the old method will be difficult to detect mild and moderate gastric mucosal atrophy.

3. Risk factors

People infected with H.pylori bacteria. It is the most common condition in the world, and is common in densely populated and poor countries.
Autoimmune atrophic gastritis is quite rare, and is common in people with thyroid dysfunction or diabetes. The disease is also common in people of Nordic or African American descent.
Both forms of atrophic gastritis increase the risk of stomach cancer.

4. Symptoms

Many cases of gastric mucosal atrophy go undiagnosed because the disease is silent and does not show any typical symptoms. However, you need to be alert when you see the following signs:
Abdominal pain, nausea and vomiting Anorexia, weight loss Anemia, iron deficiency Fatigue, dizziness, dizziness Chest pain, heart palpitations Ù Ears numb hands legs Mental disorders (occurs when autoimmune gastritis due to vitamin B12 deficiency) When you see the above symptoms, you should immediately go to a medical facility for examination, diagnosis and timely treatment.

5. Treatment of atrophic gastritis of the stomach lining

According to gastroenterologists, atrophic gastritis can be improved after drug treatment. Your doctor will prescribe antibiotics to kill H. In addition, patients can use some drugs to reduce gastric acid secretion and neutralize acid. For cases of autoimmune gastritis, the patient may be prescribed vitamin B12 injections.
In addition, patients should pay attention to nutrition and scientific activities to support effective treatment of atrophic gastritis. Specifically: limit spicy and hot foods, fried foods, fast food, alcohol, carbonated water... At the same time, eat a lot of green vegetables and fruits to supplement fiber and minerals for the body. . Daily exercise, walking, cycling help strengthen resistance, increase immunity. Always keep your mind relaxed, get enough sleep, limit overwork... These will help you prevent and treat atrophic gastritis effectively.
Things to note when treating
Diet:
Eat and drink in moderation, on time. Eat small meals (4-5 times/day). Eat soft, easy-to-digest foods and limit fatty foods. Avoid stimulants: strong tea, alcohol, spices. Unlike peptic ulcer, there is an excess of acid, so you must abstain from eating acidic foods. On the contrary, for gastric mucosal atrophy, it is not advisable to abstain from acid, but also to pay attention to adding vitamin C to the diet. According to studies, vitamin C helps cells regenerate, partially recovering the atrophy of the stomach lining. However, giving acidic substances and vitamin C supplements by mouth to patients with gastric mucosal atrophy must be gradual and little by little because people with gastric mucosal atrophy are very sensitive to acidic foods, can abdominal pain when eating a lot of sour or when taking too much vitamin C orally.
Patients should not arbitrarily use anti-acid drugs too much or arbitrarily increase the dose not according to the doctor's instructions because it can make gastric mucosal atrophy worse and difficult to recover.
The treatment of gastric mucosal atrophy needs to be persistent with a combination of drugs to strengthen the protection of the stomach and the way of eating, living as well as abstaining. If properly diagnosed and treated, symptoms will improve within 1-3 months, but for gastric mucosal atrophy to recover, it takes at least a year and recovery of gastric mucosal atrophy is only partial. not 100%. Therefore, after completing the treatment, patients need to pay attention to their diet and activities to avoid recurrence of the disease.

6. Prevention

Atrophic gastritis is difficult to prevent, but the risk of H. pylori infection can be reduced by maintaining good hygiene, such as washing hands before eating or preparing food, and after going out. toilet. Maintain good hygiene habits to avoid the spread of bacteria.
For Vietnamese people who have eating habits such as sharing a bowl of dipping sauce, or taking food with chopsticks they are eating. It is a factor that increases the likelihood of H.pylori infection in the family. Therefore, give up this bad habit to reduce the risk of infection.
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