Atrophic gastritis

Last revised by Daniel J Bell on 28 Oct 2023

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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