Autoimmune Gastritis: Update and New Perspectives in Therapeutic Management

Abstract

Diagnosis of autoimmune gastritis (AIG) is often delayed because of the absence of typical symptoms. Clinical guidelines are lacking which results in inadequate treatment and poor cancer screening. This review presents an overview of current management options and aims at raising awareness for this often-neglected disease. Autoimmune gastritis is mostly thought of as a disease of the elderly with vitamin B12 deficiency and pernicious anemia. Today it is recognized that AIG is found with a similar prevalence among all age-groups, with iron deficiency being a frequent feature. Conventional therapy consists of adequate iron and vitamin B12 supplementation as well as symptomatic approaches. The associated risk for gastric adenocarcinoma and gastric neuroendocrine tumors requires regular endoscopic follow up. Novel therapies aiming to reduce gastric atrophy and cancer risk are currently under development. Treatment of autoimmune gastritis should focus on optimizing supplementation of deficiencies and include cancer prevention measures. Clinical research should address the possibility to arrest the inflammatory process and to prevent progression of AIG. International guidelines on management and endoscopic screening intervals should be set up.