Antral Gastritis Explained
Antral gastritis is the inflammation of the inner mucosal lining in the antral part of the stomach.
Antrum means the lower portion of the stomach. This mucus-secreting protective layer on the inner side of the stomach wall prevents the stomach wall from corrosive acid, helping in the digestive process. When this protective layer is weakened or damaged due to inflammation of the gastric mucosa, it is gastritis.
What are the different types and causes of Antral Gastritis?
Acute gastritis (often Erosive or Haemorrhagic gastritis)
Here, due to inflammation, gastric mucosal erosion happens and is also accompanied by bleeding.
The different causes include,
- Chemical/drug-induced – mainly pain killer or Non-steroidal anti-inflammatory drugs (NSAIDS) or steroid-induced (seen in about 50% of cases)
- Corrosives – acid, alkali
- Alcohol-induced (seen in 20% of GI bleeding)
- Severe stress secondary to past surgery, trauma, CVA, or long bedridden conditions
- Portal hypertension with gastropathy, bile reflux
- Viral infections like Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) are associated with AIDS.
Chronic non-erosive gastritis
Here, inflammation of the gastric mucosal layer happens without erosion. This may present with chronic gastritis, too.
- Type A gastritis – This is an autoimmune gastritis involving fundic glands, leading to Achlorhydria and vitamin B12 non absorption.
- Type B gastritis or Chronic Helicobacter Pylori gastritis – The causative agent is Helicobacter pylori, a gram-negative bacterium found in the gastric submucosal layer. The mechanism of injury is not clear, but frequent infection may cause chronic inflammatory changes and may culminate in complete atrophic gastritis. Sometimes, there may be metaplasia of gastric epithelium with a 4–6 fold rise in the incidence of Adenocarcinoma.
This H pylori infection may give rise to peptic ulcers.
- Specific gastritis – This is caused by the result of any other specific disease, like viral infection, granulomatous inflammation like Tuberculosis (TB), Crohn’s, etc.
Antral Gastritis Symptoms
The symptoms of gastritis are listed below:
The symptoms of antral gastritis are a burning sensation in the epigastric area (upper mid-abdomen area).
- Upper abdominal pain, mainly in the epigastrium
- Bloated distended abdomen
- Anorexia
- Maybe a stomach ulcer
- Nausea and vomiting, etc.
- In severe cases, there may be bleeding, that is, hematemesis and melena, in a GI ulcer.
Antral Gastritis Diagnosis
The following tests are performed for diagnosing Antral Gastritis,
- Blood examination may show Anaemia in chronic bleeding ulcer cases.
- Key investigation is Upper GI endoscopy plus/minus biopsy for H Pylori.
- Urea breath test
- USG abdomen, if associated with biliary pathology
What are the possible complications of Antral Gastritis?
The possible complications of Antral Gastritis, if not treated properly, include,
- H Pylori can cause stomach ulcers that can bleed, leading to Anaemia.
- Autoimmune gastritis-induced vitamin B12 malabsorption can lead to Pernicious anaemia.
- Chances of occurrence of Gastric cancer.
Antral Gastritis Treatments
The treatment is based on two aspects,
- Diet and lifestyle changes and
- Specific medications
The treatment is based on two aspects,
What is the diet/lifestyle advice for antral gastritis?
The diet/lifestyle advice for Antral Gastritis includes:
- Avoid spicy and hot foods and long-term fasting.
- Eat small, frequent meals. In the diet, lactose or gluten is to be avoided.
- Also, avoid fried and acidic foods,
- Relaxation exercises to de-stress are very important.
- Avoid excess tea/coffee.
What are the different types of medicines used?
Different medications for Antral Gastritis include:
- Antacids may be taken to neutralise the formed acid.
- H2 blockers (Ranitidine, Cimetidine) and PPI (Omeprazole, Pantoprazole, Esomeprazole, etc.) to stop further acid production.
- NSAID-induced gastritis may be treated with Sucralfate.
- Anti-H. Pylori kit with triple drugs like PPI/Metronidazole/Clarithromycin for amoxicillin to be used as per the doctor’s advice.
- Vitamin B12 is to be taken in cases of malabsorption in gastritis.
Conclusion
Thus, the symptoms of Antral Gastritis may be mild and may also be severe if untreated. It is really important to consult a doctor, even in case of mild symptoms, for proper dietary and medicinal advice. If any other background disease is present, it needs to be examined and treated accordingly.
