A look into atrophic gastritis: A narrative review

Atrophic gastritis represents a prevalent chronic condition affecting the digestive system. It is characterized by the progressive atrophy of the stomach’s glandular and parietal cells, which are subsequently replaced by connective tissue, distinguishing it from acute gastritis. Nonspecific digestive symptoms include post-meal abdominal distension and early satiety. Abdominal pain, reminiscent of peptic ulcers, is a common finding, often leading to anemia-related symptoms. The incidence of atrophic gastritis shows regional variability, and many individuals remain undiagnosed; clinical recognition typically occurs in the advanced stages of the disease. The primary etiological factor is the degeneration of gastric parietal cells, with Helicobacter pylori infection or autoimmunity as potential mechanisms. The ensuing loss of gastric parietal cells results in decreased gastric acid secretion, elevating serum gastrin concentration, and consequently increasing the risk of neuroendocrine tumors. Anemia commonly progresses from microcytic to macrocytic or is associated with vitamin B12 deficiency. Furthermore, vitamin B12 insufficiency is strongly associated with degenerative neurological illnesses, marked by central neural demyelination, atrophy, sensory nerve abnormalities, hyperhomocysteinemia, and an elevated risk of cardiovascular disease.