Ask a doctor on the topic of Oncology

Gastritis Type A

May 18, 2017 | 20,00 EUR | answered by Nadja Struß

Dear Sir or Madam,

During a routine gastroscopy due to an upcoming gallbladder surgery, I received the following diagnosis: In the corpus, there is an image of a chronically atrophying type A gastritis with a significant reduction in parietal cells and hyperplasia of neuroendocrine cells. Otherwise, endoscopically and biopsically inconspicuous, H. pylori: negative.

Since receiving this diagnosis, I have been completely unsettled and suffer from fears regarding stomach cancer. Can you tell me what my risk of developing stomach cancer is compared to individuals without gastritis? If there is indeed an increased risk, do you think that getting a gastroscopy every year is sufficient, or can stomach cancer develop more quickly? I have read that stomach cancer develops in stages. Can you make a statement about the condition of my gastric mucosa based on my findings, or is this not possible through remote diagnosis? If the gastric mucosa is already damaged, how quickly can this lead to stomach carcinoma? My vitamin B12 levels are already low and I will need to start injections. I can no longer sleep properly due to fear, especially since my mother has been diagnosed with colon and uterine cancer. Fortunately, this was detected early. Thank you for your efforts and your response.

Best regards

Nadja Struß

Dear inquirer,

In type A gastritis, the body produces antibodies against the parietal cells in the stomach lining, leading to a vitamin B12 deficiency. Approximately 10% of patients with hyperplasia of enterochromaffin-like cells (ECL cells, neuroendocrine cells) develop malignant neoplasms.

There are no fixed intervals for gastric endoscopy, but with annual check-ups and in case of relevant gastrointestinal symptoms, you are on the safe side (weight loss, fullness, stomach pain on an empty stomach).

It is also important to keep in mind that about half of patients with autoimmune gastritis also develop antibodies against thyroid antigens (as in Hashimoto's or Graves' disease), leading to hypothyroidism.

Unfortunately, there is no causal therapy for autoimmune gastritis. The focus is on preventing complications such as vitamin B12 deficiency and stomach cancer.

All the best,

Nadja Struß