ArticleEuropean journal of gastroenterology & hepatology2025
Autoimmune chronic atrophic gastritis: association between chronic proton pump inhibitors use and more severe atrophy and gastric intestinal metaplasia.
Article in European journal of gastroenterology & hepatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Clinical, Endoscopic and Histologic Differences in Gastric Mucosa Between Younger and Older Adults: An Observational Study on the Aging Stomach.Medical sciences (Basel, Switzerland) · 2025Observational
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11 authors.
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Abstract
INTRODUCTION AND
aimAutoimmune chronic atrophic gastritis (ACAG) is a chronic autoimmune disorder whose diagnostic complexity arises from diverse symptoms mimicking other gastrointestinal disorders, often leading to misdiagnosis. Despite diagnosis, patients are often treated with proton pump inhibitors (PPIs) before consulting a gastroenterologist, emphasizing the need for accurate identification and management of ACAG in primary care. This study aimed to explore factors influencing disease progression. MATERIALS AND
methodsWe retrospectively analyzed demographic data, medical history, use of PPI, and clinical, endoscopic, and histological data of consecutive adult patients with a histological diagnosis of ACAG referred to our outpatient clinic between January 2017 and December 2022. Operative link on gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) were recorded for each patient.
resultsSeventy patients with a diagnosis of ACAG (female 74.3%, median age 63.9 years) made up the study cohort. Eighteen patients were asymptomatic (25.7%), while 13 (18.6%), and 10 (14.3%) patients reported epigastric pain and asthenia, respectively. Median age at diagnosis of ACAG was 60.7 years [interquartile range (IQR): 46.4-68.2]. OLGA and OLGIM scores III and IV were associated with higher age at diagnosis (OLGA: 69.2 years, IQR: 65.2-75.1 vs. 57.1 years, IQR: 44.4-67.1, P = 0.005; OLGIM; 68.0 years, IQR: 56.1-73 vs. 58.5 years, IQR: 44.3-67.4, P = 0.031). The use of full-dose PPI was more frequent in patients with higher OLGA and OLGIM scores (OLGA I-II vs. III-IV: n = 11, 17.7% vs. n = 4, 50.0%, P = 0.036; OLGIM 0-II vs. III-IV: n = 10, 16.7% vs. n = 5, 50.0%, P = 0.017).
conclusionACAG patients with severe atrophy and those with severe gastric intestinal metaplasia were most likely PPI users. Timely diagnosis and heightened awareness among nongastroenterologists regarding the inappropriate use of PPI in this context are crucial.
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