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Antrum Gastritis: Causes, Symptoms and Treatment
Antrum gastritis is an inflammation of the lower part of the stomach lining (antrum). It is most commonly caused by Helicobacter pylori and leads to stomach pain and digestive discomfort.
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Antrum gastritis is an inflammation of the lower part of the stomach lining (antrum). It is most commonly caused by Helicobacter pylori and leads to stomach pain and digestive discomfort.
What is Antrum Gastritis?
Antrum gastritis is an inflammation of the gastric mucosa (stomach lining) that is limited to the lower portion of the stomach, known as the gastric antrum (antrum pyloricum). This region is located just before the junction with the duodenum (small intestine) and plays a key role in gastric emptying and the regulation of acid production. Unlike diffuse gastritis, which affects the entire stomach, antrum gastritis is localised to this specific area.
Causes
The most common cause of antrum gastritis is infection with the bacterium Helicobacter pylori (H. pylori). This bacterium preferentially colonises the antrum, triggering a chronic inflammatory response. Other causes include:
- Regular use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin, which damage the protective lining of the stomach
- Bile reflux into the stomach
- Autoimmune reactions in which the immune system attacks the stomach lining
- Excessive alcohol or caffeine consumption
- Chemical irritants such as corrosive substances
- Chronic stress as a contributing factor
Symptoms
Antrum gastritis can present with a variety of symptoms that differ in severity. Common symptoms include:
- Pressure or pain in the upper abdomen
- Nausea and occasional vomiting
- Heartburn and acid regurgitation
- Bloating and a feeling of fullness after eating
- Loss of appetite
- In severe cases: blood in the stool or vomiting blood (if mucosal lesions are present)
Some individuals experience no or only mild symptoms, even when the inflammation is already advanced.
Diagnosis
Antrum gastritis is typically diagnosed through an upper endoscopy (gastroscopy), which allows the physician to directly visualise the stomach lining and take tissue samples (biopsies). These are then examined in the laboratory for H. pylori and signs of inflammation. Additional diagnostic methods include:
- Urea breath test: a non-invasive test to detect H. pylori infection
- Blood test: detection of antibodies against H. pylori
- Stool antigen test: direct detection of H. pylori antigens in stool samples
- pH-metry: measurement of stomach acid levels when excessive acid production is suspected
Treatment
Treatment of antrum gastritis depends on the underlying cause:
H. pylori Infection
The standard therapy is known as eradication therapy, which involves a combination of two antibiotics (e.g., clarithromycin and amoxicillin) together with a proton pump inhibitor (PPI) such as omeprazole, taken for 7 to 14 days. This triple therapy is effective in most cases and leads to complete resolution of the infection and inflammation.
NSAID-Induced Gastritis
The triggering medication should be discontinued or replaced with a stomach-friendly alternative in consultation with a physician. Acid suppressants (PPIs or H2 blockers) and antacids can help relieve symptoms.
General Measures
- Avoiding alcohol and nicotine
- Dietary adjustments: light, easily digestible meals, low in fat and acid
- Stress reduction and regular meal times
- Avoiding NSAID pain relievers where possible
Prognosis
With consistent treatment of the underlying cause -- particularly after successful H. pylori eradication -- antrum gastritis heals completely in most cases. If left untreated, it can progress to chronic gastritis and increase the long-term risk of gastric ulcers (ulcus ventriculi) or, in rare cases, stomach cancer. Regular follow-up examinations are therefore recommended.
References
- Malfertheiner P. et al. - Management of Helicobacter pylori infection: the Maastricht V/Florence Consensus Report. Gut, 2017. DOI: 10.1136/gutjnl-2016-312288
- Herold G. et al. - Internal Medicine (Innere Medizin). Self-published, Cologne, 2023.
- World Gastroenterology Organisation (WGO) - Helicobacter pylori and peptic ulcer disease: WGO Global Guideline. 2021. Available at: www.worldgastroenterology.org
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