Atrophic gastritis

Last revised by Andrew Murphy on 15 Jul 2020

Atrophic gastritis is a chronic condition of autoimmune and non-autoimmune etiology. 

Two types of atrophic gastritis have been described 1-3:

  • type A: autoimmune
    • gastric body and fundus atrophy secondary to antiparietal cell antibodies
    • decreased secretion of acid and intrinsic factor, with the latter leading to vitamin B12 deficiency
  • type B: non-autoimmune (more common)
    • gastric antrum atrophy secondary to Helicobacter pylori infection (most common), alcohol, NSAIDs, or bile salt reflux

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

Patients with atrophic gastritis are three times more likely to develop gastric cancer 2

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