What complications can atrophic gastritis cause?
Feb 17, 2025
Source: Cainiu Health
Dr. Shen Yonghua
Introduction
Atrophic gastritis can lead to complications such as gastric ulcers, gastrointestinal bleeding, anemia, gastric cancer, and gastric polyps. To reduce the occurrence of these complications, patients with atrophic gastritis should actively seek treatment, improve their lifestyle habits, pay attention to dietary adjustments, avoid consuming spicy, greasy, and irritating foods, quit smoking and alcohol consumption, maintain a positive mindset, and undergo regular follow-up gastroscopies to monitor disease progression.
In general, atrophic gastritis can lead to complications such as gastric ulcers, gastrointestinal bleeding, anemia, gastric cancer, and gastric polyps. Detailed explanations are as follows:
1. Gastric Ulcer: Atrophic gastritis causes thinning of the gastric mucosa and glandular atrophy, weakening the protective function of the gastric mucosa. Gastric acid and pepsin are more likely to damage the gastric mucosa, leading to gastric ulcers. Patients typically experience periodic and rhythmic upper abdominal pain, often described as dull, distending, burning, or severe pain. Symptoms such as acid regurgitation, belching, nausea, and vomiting may also occur.
2. Gastrointestinal Bleeding: In atrophic gastritis, the blood vessels in the gastric mucosa are more easily exposed. When stimulated by gastric acid, these vessels may rupture and bleed. Mild cases may only show positive occult blood in stool, while severe cases may present with hematemesis (vomiting blood) and melena (black tarry stools). Massive bleeding can lead to symptoms of shock such as dizziness, palpitations, fatigue, pallor, hypotension, and even be life-threatening.
3. Anemia: Atrophic gastritis may impair the absorption of nutrients such as vitamin B₁₂ because the atrophied gastric mucosa produces less intrinsic factor, which is essential for vitamin B₁₂ absorption. Deficiency of vitamin B₁₂ can cause megaloblastic anemia, with symptoms including pallor, dizziness, fatigue, tinnitus, and loss of appetite. Additionally, long-term chronic blood loss may lead to iron-deficiency anemia.
4. Gastric Cancer: Atrophic gastritis is considered a precancerous lesion for gastric cancer. Under long-term inflammatory stimulation, gastric epithelial cells may undergo dysplastic hyperplasia, progressing from mild to severe dysplasia, and ultimately developing into gastric cancer. Patients may experience weight loss, loss of appetite, upper abdominal mass, hematemesis, melena, and in advanced stages, metastatic symptoms such as hepatic pain and jaundice if liver metastasis occurs.
5. Gastric Polyps: Long-term inflammation caused by atrophic gastritis may stimulate excessive proliferation of gastric epithelial cells, forming gastric polyps. Most gastric polyps are asymptomatic, but some patients may experience mild upper abdominal pain, bloating, nausea, or vomiting. If the surface of a polyp becomes eroded or ulcerated, upper gastrointestinal bleeding may occur, manifesting as melena.
To reduce the risk of these complications, patients with atrophic gastritis should actively seek treatment, improve lifestyle habits, adjust their diet, avoid spicy, greasy, and irritating foods, quit smoking and alcohol consumption, maintain a positive mindset, and undergo regular gastroscopic follow-ups to monitor disease progression.
