Antral gastritis is inflammation of the antrum, the lower part of the stomach near the small intestine. This common condition often causes discomfort. While rarely life-threatening, antral gastritis requires attention due to its potential for progression and complications.
Understanding Antral Gastritis
Antral gastritis is inflammation of the stomach lining in the antrum, which grinds food and regulates its passage into the small intestine. This inflammation stems from various factors. A primary cause is Helicobacter pylori (H. pylori) bacteria, which colonize the stomach lining and trigger a chronic inflammatory response. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen also contributes by inhibiting protective prostaglandins.
Excessive alcohol consumption can irritate the stomach lining, leading to inflammation. Less frequent causes include bile reflux, where bile flows back into the stomach, and certain autoimmune conditions. Symptoms often include upper abdominal pain, a burning sensation, nausea, bloating, and a feeling of fullness after small meals. These symptoms vary in intensity and may appear intermittently.
When Antral Gastritis Poses Risks
While acute antral gastritis can resolve with treatment, persistent inflammation in the antrum carries several risks. Chronic inflammation can erode the stomach lining, leading to peptic ulcers. These open sores cause pain and may lead to complications like gastrointestinal bleeding from deep ulcers or severe inflammation.
Over time, chronic inflammation can thin the stomach lining, a condition called gastric atrophy, involving the loss of specialized glands. Gastric atrophy can progress to intestinal metaplasia, where stomach cells resemble intestinal cells. Metaplasia can further advance to dysplasia, an abnormal cell growth considered pre-cancerous.
Chronic antral gastritis, especially with H. pylori infection and progression through atrophy and metaplasia, increases the long-term risk of gastric cancer. This progression occurs over many years, emphasizing that antral gastritis requires attention to prevent long-term complications. Regular monitoring and management are important to interrupt this inflammatory cascade and reduce the risk of more serious outcomes.
Diagnosis and Management Approaches
Diagnosing antral gastritis involves medical history, symptom evaluation, and diagnostic tests. Upper endoscopy (EGD) is often the most definitive method. During this procedure, a thin, flexible tube with a camera visualizes the stomach lining, identifying inflammation, erosions, or ulcers.
Biopsy samples are frequently taken for microscopic examination to confirm inflammation, identify H. pylori, and detect cellular changes like atrophy, metaplasia, or dysplasia. H. pylori infection tests also include breath, stool antigen, and blood tests. Management depends on the underlying cause and severity.
If H. pylori is identified, antibiotics combined with proton pump inhibitors (PPIs) are prescribed to reduce stomach acid and eradicate the bacteria. For non-H. pylori gastritis, PPIs or H2 blockers decrease stomach acid, aiding healing. Lifestyle modifications support symptom management and recurrence prevention.
Avoiding NSAIDs, reducing alcohol, and eliminating specific food triggers can reduce stomach irritation. Adherence to treatment and regular follow-up with a healthcare provider are important for monitoring, assessing healing, and detecting early signs of progression. This helps manage symptoms and prevent long-term risks.