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Pernicious Anaemia Society
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Atrophic Gastritis

Can you have Atrophic Gastritis without having Pernicious anemia?

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Yes.

Infection with Helicobacter pylori, overuse of NSAID painkillers, overindulgence in alcohol or cocaine, other diseases like Crohn's disease, allergies, and other infections can all cause gastric atrophy.

But those other causes will tend to affect the whole of the stomach. Autoimmune gastritis (the underlying cause of PA) tends to be restricted to the corpus and fundus, leaving the antrum unaffected.

Oh! I forgot. PA is caused by AMGA - Autoimmune Metaplastic Gastric Atrophy. The Metaplastic bit means that the types of cells found in the affected areas aren't the types you would expect to find there. This metaplasia should show up histologically (looking at biopsy samples under the microscope).

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Do you think they would show up if biopsies were only taken from oesophagus? I’m worried as I have burning during and after eating. Thank you for your reply.

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No, only biopsies from the corpus and fundus would show metaplasia. That's where the Parietal Cells, that are attacked by the immune system, are found.

AMGA is going to cause low acidity in the stomach. That can cause bloating, wind and diarrhoea. But I'm not sure if burning is a common symptom.

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Just to mention low acidity caused me bloating, wind and constipation rather than diarrhoea.

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How do you know if you have low acidity? That you for your reply

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Thank you for your reply. So everyone with PA has AMGA? Would everyone get stomach issues? Is AMGA more serious than other types of Atrophic gastrophy?Could I still be tested for PA if my b12 levels aren’t too low at the moment? I’ve been supplementing with a spray. I had Graves’ disease in the past and have read these 2 conditions can go together. I don’t really know where to start with all of this and am quite anxious. I hope I haven’t asked too many questions! Really appreciate your reply.

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I can get really bad burning pain - heartburn - due to low acidity - at times in the past (before I realised that it was related to low stomach acidity) it would get so bad that the only way of stopping it would be to throw up the contents of my stomach ... though nowadays I find that taking some lemon/lime juice in water will quieten it down quite quickly so my experience is that it is possible for low stomach acidity to cause heartburn.

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Thank you for your reply. Do you have PA? Should I keep supplementing or stop to see if my levels drop? I’m so worried about getting AMGA. I thought that an endoscopy that I had last year would have shown if I’d had it ( I had it because of burning and discomfort when swallowing )but another member says only if biopsies were taken from a certain place.

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don't have a formal diagnosis but pretty sure that I have PA and not another B12 absorption problem - I've also developed another auto-immune condition - hashis.

Not really sure what you are asking.

AMGA/PA is an autoimmune disorder that will result in B12 deficiency

There are lots of other conditions that can cause problems with B12 absorption.

The treatment for B12 absorption problems generally doesn't depend on the cause.

I would recommend that you DO NOT supplement unless you know you have an absorption problem - certainly not with mega doses of B12. The serum B12 test is difficult to interperet but falling levels over time - or a significant drop between two tests (>20%) would be evidence of a B12 absorption problem.

If you have hashimotos then the probability of developing PA is somewhere between 10% and 40% - that's the range that comes up in studies.

Being hypothyroid can affect absorption of various minerals and vitamins - generally iron is the first one to show problems.

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Thank you for your reply. I had Graves’ disease in the past which is another autoimmune thyroid disorder. I’m wondering whether it’s possible to get a conclusive blood test? Should I carry on supplementing do you think? My levels are normal at the moment. I don’t want to cause problems if my levels drop but I can’t see my gp doing a blood test if my current level is ok. Really appreciate your replies.

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suggest you read the pinned posts re testing.

healthunlocked.com/pasoc/po...

Taking supplements that contain B12 will affect any tests ordered by your doctor to assess your B12 status. You should not take any supplement with B12 before having your B12 assessed (including MMA/homocysteine/Active B12). For testing intrinsic factor antibodies: keep one week between an injection and the test.

If you have sympotms of B12 deficiency and you find that the supplementation is helping then I suggest you continue.

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Thank you for your reply. It’s the tummy problem I am most concerned about as I’ve read Atrophic gastritis can lead to more serious issues. I don’t know even if I have this condition but I’d like to know for sure so I could be monitored. Thank you again.

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AMAG/AMGA can lead to NETs - precancerous clusters of cells in the gut. Precancerous means they have the potential of becoming cancerous but this doesn't always happen and even if it does it can take years to develop. The increased risk of stomach cancer is quite marginal. You would need a referral to a gastro for regular monitoring - the causal link to PA appears to be high/astronomic levels of gastrin that result i patients with PA - so likely that checking gastrin levels could avoid unnecessary investigation.

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Have you ever had an endoscopy? Just wondering whether there would be signs of Atrophic gastritis? Kind regards

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No - I haven't had any gastric investigations.

Suggest that you start a new post and ask about others experiences

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Ok. Thank you.

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