Atrophic Gastritis: Symptoms, Management, and Treatment Options

Atrophic gastritis (AG) is a chronic condition characterized by the thinning of the stomach lining and a reduction in the number of gastric glands. Over time, this leads to impaired stomach function and can increase the risk of developing gastric cancer. Common symptoms include upper abdominal discomfort, bloating, dull or burning pain without a clear pattern, loss of appetite, belching, acid reflux, and nausea. These symptoms are often mistaken for general indigestion, making early diagnosis challenging.

Recognizing the Signs and Symptoms

In some cases, patients may also experience mild tenderness in the upper abdomen. When atrophic gastritis is accompanied by pernicious anemia, more severe symptoms such as fatigue, weakness, significant weight loss, and loss of appetite may occur, even if digestive symptoms are minimal. Because symptoms can vary widely, a proper diagnosis often requires endoscopic evaluation and lab testing.

Lifestyle and Dietary Modifications

Managing atrophic gastritis begins with lifestyle changes. A balanced and diverse diet is essential, focusing on fresh, nutrient-rich foods while avoiding moldy, smoked, or heavily processed items high in nitrates and nitrites. It's also important to avoid spicy, coarse, or overly strong foods, quit smoking, limit alcohol consumption, and ensure adequate rest and emotional well-being.

Pharmacological Treatments

For patients testing positive for Helicobacter pylori (H. pylori), eradication therapy is crucial. A standard regimen includes a bismuth-based quadruple therapy with a proton pump inhibitor (PPI) and two antibiotics. Supplementing with folic acid and vitamin C may help slow disease progression and support gastric health. Symptomatic relief can be achieved with prokinetic agents for bloating and nausea, digestive enzymes for meal-related discomfort, and acid-reducing medications like PPIs or H2 blockers for pain and reflux. Patients with psychological stress or sleep disturbances may benefit from mental health support to improve overall treatment outcomes.

Personalized Treatment Approaches

Integrating traditional Chinese medicine (TCM) with Western medicine can offer a more tailored treatment strategy. By analyzing symptoms, endoscopic findings, and laboratory results, doctors can develop individualized plans that address both the physiological and energetic imbalances associated with atrophic gastritis.

When Surgery Might Be Considered

Surgery is not typically required for atrophic gastritis alone. However, if precancerous changes such as severe dysplasia or intestinal metaplasia are detected—especially colonic-type metaplasia—endoscopic submucosal dissection (ESD) may be recommended. Regular monitoring is vital for patients with gastric polyps or abnormal tissue changes to detect any progression early.

In conclusion, early detection and proper management are key to preventing complications from atrophic gastritis. If you experience persistent digestive symptoms, consult a healthcare provider for a comprehensive evaluation and personalized treatment plan. Self-medication should be avoided to prevent worsening of the condition.