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H Pylori & Atrophic Gastritis

Gastritis is inflammation of the stomach (caused by H pylori infection, alcohol, NSAIDs, aspirin, irritating foods, dehydration, smoking, etc.)

Atrophy means “shrinking” or “wasting away”.

Atrophic gastritis, therefore, is the result of chronic, or long-term inflammation of the stomach, where the mucosa and stomach lining are damaged and replaced by intestinal and fibrous tissues.

When the stomach mucosa is damaged by chronic inflammation, the glandular cells become dysfunctional and may be destroyed.

These glandular cells are responsible for the production of many factors within gastric juice, including:

  • Hydrochloric acid
  • Pepsin (digestive enzymes)
  • Intrinsic factor (needed for vitamin B12 absorption)

When the glandular cells are damaged by chronic inflammation, production of these important substances can be affected, leading to many digestive problems.

For example, if hydrochloric acid and enzyme levels are low, food cannot be digested properly, leading to bloating, constipation or diarrhea and malnutrition.

Low acid levels can also lead to yeast and fungal overgrowth in the stomach, parasitic infection and the overgrowth of very nasty bacteria such as Campylobacter and Clostridium difficile. C difficile itself can cause life-threatening colitis.

Intrinsic factor is required for the proper absorption of vitamin B12. If intrinsic factor is not produced properly, B12 cannot be taken into the body, leading to deficiency. B12 deficiency itself can cause fatigue, malaise and neurological conditions, including depression.

Helicobacter Pylori Gastritis

The 2 main causes of atrophic gastritis are the result if 1) H pylori infection and 2) autoimmune reactions against the parietal cells and intrinsic factor.

H pylori-induced gastritis usually occurs in the antrum of the stomach. H pylori associated atrophic gastritis is often asymptomatic, but individuals with this disease are at increased risk of developing gastric carcinoma and the risk may decrease following H pylori eradication.


Autoimmune Gastritis

Autoimmune gastritis is usually restricted to the stomach corpus & fundus. Individuals with autoimmune gastritis may develop pernicious anemia because of extensive loss of parietal cell mass and anti-intrinsic factor antibodies.

An autoimmune reaction is where the immune system forms antibodies against its own tissues. So just as it attacks germs and other pathogens, the immune system can attack our own cells.

Hashimoto’s thyroiditis, rheumatoid arthritis, lupus and coeliac disease are other examples of autoimmune diseases.

Signs & Symptoms of Atrophic Gastritis

Acute H Pylori infection causes the following symptoms:

  • Stomach pain
  • Fullness
  • Nausea
  • Vomiting
  • Flatulence
  • Fever.


Chronic H pylori infection can cause any of the symptoms discussed on this website. According to the “EMedicine” website, the journey towards atrophic gastritis may involve experience of the following symptoms:

Persistence of the organism causes H pylori chronic gastritis, which usually is asymptomatic or may manifest as gastric pain and, rarely, nausea, vomiting, anorexia, or significant weight loss. Symptoms associated with complications of chronic H pylori– associated atrophic gastritis may develop, including gastric ulcers and gastric adenocarcinoma.

Autoimmune atrophic gastritis can lead to the following symptoms:

  • Iron-deficiency anaemia:
    • Weakness
    • Light-headedness
    • Vertigo
    • Tinnitus
    • Palpitations
    • Angina
    • Symptoms of congestive failure.
  • Chronic Idiopathic Thrombocytopenic Purpura (ITP)
  • Sore tongue
  • Anorexia
  • Moderate weight loss
  • Diarrhoea
  • Neurological symptoms
    • Numbness and paresthesias in the extremities
    • Weakness
    • Ataxia
    • Sphincter disturbances may be present
    • Mild irritability or depression to severe dementia or psychosis

As you can see, the complications of chronic gastritis, whether from H pylori infection or autoimmune causes are highly varied and may seriously affect ones quality of life.

We cannot underestimate the power of H pylori to cause enormous problems in patients far and beyond the common, classic symptoms that doctors are aware of.

H pylori bacteria are not just a cause of heartburn and acid reflux. They have the potential to devastate the stomach and intestines to the point where the rest of the body cannot function correctly.

It is therefore imperative to seek treatment for H pylori if you have been diagnosed. If, despite successful H pylori eradication, symptoms do not improve, you may need to seek advice from a doctor or gastroenterologist to determine the extent of H pylori- or autoimmune-related damage to your stomach.

References For H Pylori & Atrophic Gastritis

Fleming, SL. PhD. Helicobacter pylori. 2007. Chelsea House Publications.

Galland, L. MD. The Indigestion &Heartburn Cure. 2009.

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