atrophic gastritis

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

Pathology

Two types of atrophic gastritis have been described :

  • 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
Associations

Radiographic features

Fluoroscopy

Upper gastrointestinal fluoroscopic studies are non-specific but may demonstrate :

  • 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 .

Differential diagnosis