Autoimmune metaplastic gastritis: causes, symptoms, treatment

Autoimmune metaplastic gastritis Is a chronic inflammatory process of the gastric mucosa, leading to atrophy of the mucous membrane of the organ. As a rule, the term "autoimmune" means a violation of the immune system - antibodies circulate in the blood to the patient's own cells and tissues, respectively, attack them.

Autoimmune gastritis is associated with the presence of antibodies directed against the parietal cells of the stomach (these cells are responsible, among other things, for the production of hydrochloric acid and an intrinsic factor necessary for absorption vitamin B12 in the ileum) and against the intrinsic factor.

Due to damage to the lining cells, there is an increase in the acidity of gastric juice and a violation of the absorption of vitamin B12.

Causes of autoimmune metaplastic gastritis remains unclearbut there is some genetic predisposition. Also, people with autoimmune diseases

are more likely to coexist with other autoimmune pathologies, and, for example, autoimmune gastritis is more likely to be associated with type 1 diabetes, Hashimoto's thyroiditis, Sjogren's syndrome and other diseases.

During autoimmune gastritis, antibodies against the lining cells of the stomach bind to the mechanism responsible for the production of hydrochloric acid. Inflammatory infiltrations in the gastric mucosa are also observed.

Lesions typical of autoimmune gastritis, are located in the gastric trunk, to a small extent in the pyloric compartment (i.e., in the transition between the stomach and duodenum). It is estimated that autoimmune gastritis occurs in about 2-20% of people over the age of 50.

Signs and symptoms

Autoimmune metaplastic gastritis remains asymptomatic for a long time. Symptoms are associated with the development of macrocytic anemia(with the so-called large blood cells), which occurs due to a deficiency of vitamin B12.

Symptoms are initially nonspecific - they can occur in many different conditions. Symptoms associated with anemia include pallor (in vitamin B12 deficiency anemia, the skin is slightly yellowish and waxy). Patients complain of slight fatigue, weakness, sometimes drowsiness or poor concentration. Anemia (whatever the cause) can lead to a feeling of rapid heartbeat (tachycardia), and in more severe cases - to shortness of breath.

About half of people with vitamin B12 deficiency experience weight loss. Gastrointestinal symptoms that can occur with vitamin B12 deficiency and therefore autoimmune gastritis are taste disorders (dysgeusia), burning of the tongue, dyspeptic symptoms (nausea, satiety, abdominal discomfort).

Vitamin B12 is very important for the proper functioning of the nervous system, so a lack of it leads to the appearance of symptoms from this system. Deficiency of this vitamin causes, among other things, a feeling of numbness in the limbs, tingling in the fingers, weakening of muscle strength, in more severe cases, visual impairment is observed. On examination, the doctor may find that nerve reflexes have weakened.

- What to do if you experience autoimmune symptoms metaplastic gastritis?

Symptoms that occur during autoimmune gastritis and the development of secondary vitamin B12 deficiency are nonspecific. Symptoms suggestive of anemia require confirmation or exclusion. Rapid diagnosis is necessary in the case of rapidly worsening symptoms.

Anemia (regardless of its type) requires an explanation of its causes. Sudden onset of neurological symptoms (for example, lack of sensation in the limb, difficulty in movement, asymmetry of movement, paresis, loss of vision) requires an urgent appointment with a doctor, i.e. calling an ambulance or going to a hospital (emergency room help).

Persistent dyspeptic symptoms (nausea, vomiting, belching, feeling of heaviness, discomfort or abdominal pain) also require a visit to a general practitioner for further diagnosis.

Causes

The disease is caused by an attack by the cells of the immune system's own tissues in the stomach. However, the answer to the question of why this happens is unknown.

Scientists believe that the cause of the process may be a genetic predisposition to the so-called autoimmune reactions. This theory is supported by studies that show that other autoimmune diseases (thyroiditis, ulcerative colitis, rheumatoid arthritis, diabetes 1 type, celiac disease).

Diagnostics

Autoimmune metaplastic gastritis is diagnosed based on the presence of antibodies and typical microscopic changes in sections of the gastric mucosa. To collect stomach tissue sections, a gastroscopy (endoscopic examination) must be performed.

In the presence of neurological symptoms and macrocytic anemia, it is necessary to determine the concentration of vitamin B12 in the blood. Determination of macrocytic anemia requires determination of vitamin B12 and folate (the second cause of this type of anemia) in the blood. Patients with autoimmune metaplastic gastritis have antibodies against parietal cells, against intrinsic factor; antibodies to the intrinsic factor-vitamin B12 complex may also be present.

Because autoimmune gastritis is associated with a slightly higher risk of stomach cancers, if present persistent or persistent dyspeptic symptoms or weight loss despite treatment, please contact a doctor.

Treatment

Treatment for autoimmune gastritis includes lifelong parenteral (ie, oral) vitamin B 12 supplementation if anemia is diagnosed. Unfortunately, there is no possibility of causal treatment, because the use of immunosuppressive drugs, i.e. suppressing the formation of antibodies against their own tissues is ineffective.

Vitamin B12 is a symptomatic treatment and is included in the development of anemia. Helper methods are of very limited value. Due to a deficiency of an intrinsic factor necessary for the absorption of vitamin B12 in further parts of the gastrointestinal tract, dietary management is meaningless.

Can autoimmune metaplastic gastritis be completely cured?

Autoimmune gastritis cannot be completely cured. The diagnosis requires periodic blood morphology, sometimes the concentration of vitamin B12 in the blood and, in the case of anemia, parenteral replacement.

Autoimmune metaplastic gastritis is associated with an increased risk of developing adenocarcinoma by 3-5 times, so you need to visit your doctor regularly.