Atrophic gastritis is a chronic condition of autoimmune and non-autoimmune aetiology.
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Pathology
Two types of atrophic gastritis have been described 1-3:
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type A: autoimmune
gastric body and fundus atrophy secondary to anti-parietal cell antibodies
decreased secretion of acid and intrinsic factor, with the latter leading to vitamin B12 deficiency
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type B: non-autoimmune (more common)
gastric antrum atrophy secondary to Helicobacter pylori infection (most common), alcohol, NSAIDs, or bile salt reflux
Associations
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pernicious anaemia (megaloblastic)
Radiographic features
Fluoroscopy
Upper gastrointestinal fluoroscopic studies are non-specific but may demonstrate 1,2:
decreased/absent fundal folds ('bald fundus')
narrow tubular stomach (fundal diameter <8 cm)
small/absent areae gastricae
Treatment and prognosis
Patients with atrophic gastritis are three times more likely to develop gastric cancer 2.
Differential diagnosis
linitis plastica: this is usually nodular 2
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