What is chronic gastritis, and what are its forms?
Chronic gastritis is a persistent inflammation of the stomach lining that lasts for months or years—as opposed to acute gastritis (which resolves quickly). It can lead to progressive mucosal atrophy, intestinal metaplasia, and, if left untreated, gastric cancer. Arnaud, Ph.D. in Pharmacy, emphasizes the importance of regular endoscopic monitoring. Our line of digestive medications and supplements naturally supports the protection of the stomach lining.
- Type B chronic gastritis (antral, H. pylori): the most common type (80% of chronic gastritis cases) — begins in the antrum → may spread to the gastric body — riskof ulcers and gastric cancer (intestinal-type adenocarcinoma) — eradication of H. pylori = curative treatment
- Chronic Type A gastritis (fundic, autoimmune): antibodies against parietal cells and intrinsic factor—progressive destruction of HCl-producing and intrinsic factor-producing cells → hypochlorhydria → vitamin B12 malabsorption → Biermer’s anemia —annual monitoring of complete blood count (CBC) and vitamin B12 levels
- Atrophic gastritis: advanced stage of chronic gastritis — loss of gastric glands → severe hypochlorhydria — OLGA/OLGIM classification (stages I–IV) — systematic biopsies to assess cancer risk
- Intestinal metaplasia: replacement of the gastric mucosa by intestinal-type epithelium — precancerous — OLGA/OLGIM staging — surveillance colonoscopy and endoscopy every 1–3 years depending on the stage
- Chemical gastritis (reactive, type C): post-gastrectomy biliary reflux or chronic NSAID use — erythematous antral-pyloric lesions — causal treatment (sucralfate, reduction of NSAIDs)
Deficiencies and complications of chronic gastritis
- Vitamin B12 deficiency: atrophic gastritis + type A → insufficient intrinsic factor → B12 not absorbed in the ileum — symptoms: macrocytic anemia + sensory neuropathy (tingling, cognitive impairment) — high-dose intramuscular or sublingual vitamin B supplementation
- Iron deficiency: hypochlorhydria → insufficient acidity to reduce Fe³⁺ to absorbable Fe²⁺ → iron-deficiency anemia — iron supplementation + intake with vitamin C (improves absorption) — comprehensive evaluation (complete blood count + ferritin + transferrin)
- Gastric cancer (adenocarcinoma): Correa’s cascade—chronic gastritis → atrophy → intestinal metaplasia → dysplasia → cancer—risk increased 3–6-fold if extensive atrophic gastritis—endoscopy with systematic biopsies (Sydney Protocol) every 1–3 years
- Gastric MALT lymphoma: associated with H. pylori — regresses in 70–80% of cases after H. pylori eradication — refractory cases: radiation therapy or chemotherapy
- Zollinger-Ellison syndrome (excessive gastrin): rare hypertrophic gastritis — elevated serum gastrin — very low gastric pH — secretory pancreatic or duodenal tumor
Natural support and healing agents for chronic mucosal inflammation
- Chios mastic (Pistacia lentiscus): documented antibacterial properties against H. pylori — promotes healing and reduces inflammation of the gastric mucosa — 1–2 g/day before meals — the gold standard natural active ingredient for managing chronic gastritis
- Deglycyrrhizinated licorice (DGL): stimulates production of gastric mucus and protective prostaglandin E2 — promotes cell regeneration — chewable tablets 20 minutes before meals — excellent complement to PPIs in cases of atrophic gastritis
- Zinc carnosine (PepZinGI): synergistic combination of zinc and carnosine — clinical data on the healing of erosive gastric mucosa — 75 mg × 2/day — available in our digestive supplements
- Probiotics (Lactobacillus reuteri, Lactobacillus acidophilus): inhibit H. pylori colonization — reduce side effects of triple therapy by 40% — maintain the gastric microbiota
- Aloe vera gel (for internal use) + chamomile tea: anti-inflammatory agents for the gastric mucosa — natural daily routine (aloe vera juice on an empty stomach + chamomile after meals) — supports mucosal regeneration
Long-term monitoring, treatment, and diet
- Systematic H. pylori eradication if chronic gastritis is confirmed: triple therapy for 7–14 days + follow-up after 4 weeks — halves the risk of gastric cancer — indicated even in the absence of symptoms if atrophic gastritis or metaplasia is present
- PPIs as a course of treatment, not continuously: prolonged use → iatrogenic hypochlorhydria → B12, Mg, and Fe deficiencies (reduced acidity → reduced absorption) — gradual tapering + natural remedies as a follow-up
- Endoscopic monitoring according to OLGA/OLGIM staging: stage 0–I → endoscopy every 5 years — stage II → every 3 years — stage III–IV → every 1–2 years with multisite biopsies (Sydney protocol)
- Anti-inflammatory gastric diet: 5–6 small meals per day — cooked vegetables, white rice, lean white meats, fruit compote — reduce alcohol, NSAIDs, coffee, spices, and tobacco — see our comprehensive gastric dietary guidelines
- Warning signs (urgent endoscopy): unexplained macrocytic anemia, severely low B12 levels, nighttime pain, weight loss, dysphagia, repeated vomiting, gastrointestinal bleeding
