Autoimmune Gastritis: What Is It, Could You Have It and How Is It Treated?

Your Guide to the Causes, Symptoms, Diagnosis and Treatment of Autoimmune Gastritis

Subscribe for future episodes

  • Apple Podcast
  • Google Podcasts
  • Spotify

Download this Episode (right click link and ‘Save As’)

Nausea, a sore stomach, fatigue, and pins and needles. While these may seem like vague and varied symptoms, they can all be the result of a chronic inflammatory condition of the stomach known as autoimmune gastritis.

Figures suggest around 2% of the U.S. general population, or around one in 50 people, has autoimmune gastritis [1].

Having a pre-existing autoimmune disorder, such as a thyroiditis, vitiligo, Addison’s disease, or type-1 diabetes makes you much more prone to the condition.

In this article, I’ll walk you through some of the signs and symptoms of autoimmune gastritis as well as its diagnosis, risk factors and treatment options, including diet, probiotics, and vitamin B12. We’ll also touch on how autoimmune gastritis overlaps with several other autoimmune conditions.

autoimmune gastritis: Autoimmune disease written in a notebook surrounded by different things

What Is Autoimmune Gastritis?

“Gastritis” refers to inflammation in the gastric region (stomach), while “autoimmune” refers to the fact that this condition is caused by the body’s immune system attacking its own body cells.

Other terms for autoimmune gastritis include “autoimmune metaplastic atrophic gastritis,” “chronic autoimmune atrophic gastritis,” or combinations of these terms.

Autoimmune gastritis is a specific type of atrophic gastritis. Atrophic gastritis — or chronic stomach inflammation — is common: Estimates suggest that around a quarter of the population may have this chronic condition [2].

As the name suggests, atrophic gastritis or chronic atrophic gastritis involves atrophy (wasting away) of a part of the stomach lining known as the oxyntic mucosa. This includes a destruction of the parietal cells (oxyntic cells) that produce stomach acid as well as the substance known as intrinsic factor, which is essential for vitamin B12 absorption. It also includes destruction of cells that produce the main digestive enzyme pepsin in the stomach.

As the condition progresses, some of the normal stomach lining cells get replaced with abnormal intestinal-type cells (so called intestinal metaplasia). Intestinal metaplasia is recognized as a precancerous lesion, putting those affected at a six times increased risk of getting a common gastric cancer called gastric adenocarcinoma [3]. So getting diagnosed and treated for atrophic gastritis as soon as possible is key.

What Causes Autoimmune Gastritis?

Autoimmune gastritis is one of as many as 100 autoimmune conditions that are becoming more common. Rheumatoid arthritis, Hashimoto’s thyroiditis and inflammatory bowel disease are other examples [4]. 

Evidence suggests that increased permeability of the intestine or a “leaky gut”— driven by gut dysbiosis (disruptions to the healthy balance of bacteria in the gut) [5] — may behind many of these autoimmune conditions [6 Trusted SourcePubMedGo to source, 7, 8 Trusted SourcePubMedGo to source, 9, 10, 11 Trusted SourcePubMedGo to source, 12 Trusted SourcePubMedGo to source, 13 Trusted SourcePubMedGo to source].

Food intolerances that can occur as a result of gut imbalances [14 Trusted SourcePubMedGo to source, 15 Trusted SourcePubMedGo to source, 16 Trusted SourcePubMedGo to source, 17 Trusted SourcePubMedGo to source, 18, 19] can further drive autoimmune conditions, creating something of a vicious circle. With a leaky gut, food particles that aren’t fully digested leak into your bloodstream. So, the immune system may view them as potential threats and initiate an inflammatory response, further exacerbating your autoimmune condition.

Atrophic Gastritis vs. Autoimmune Gastritis

autoimmune gastritis: Illustration of a healthy gastric mucosa vs a gastric mucosa with atrophic gastritis

Though in both cases there is atrophy of the stomach’s mucosal lining, what distinguishes chronic autoimmune gastritis from more general atrophic gastritis is the underlying cause:

  • Atrophic Gastritis: Atrophic gastric is generally caused by a Helicobacter pylori infection [20 Trusted SourcePubMedGo to source] — this bacterium can survive in the high acidity of the gastric mucosa. Over time, this creates chronic inflammation.
  • Autoimmune Gastritis: In the case of autoimmune gastritis, the damage to the gastric mucosa is caused by a malfunctioning immune system, which may be caused by a combination of genetic factors and those relating to gut bacteria disruptions discussed above [1].

There may, however, be a link between H. pylori infection and autoimmunity — one theory is that the bacterium sets off the immunological processes that can lead to autoimmune gastritis [21]. Other research indicates up to 30% of people with H. pylori infection also have autoantibodies to parietal cells, and these disappear when the infection is eradicated [22].

Can Reflux Medications Cause Atrophic Gastritis?

autoimmune gastritis: Omeprazole capsules with a plastic medicine bottle

Proton pump inhibitors (PPI) — drugs such as omeprazole that are given to help with GERD and acid reflux — have been touted as a potential increased risk for atrophic gastritis (though not autoimmune gastritis specifically).

For example, a 2017 systematic review and meta analysis found moderate evidence that incidence of gastric atrophy was statistically higher in those taking PPIs [23 Trusted SourcePubMedGo to source]. But it’s certainly not clear-cut — another systematic review and meta analysis in 2014 found no compelling evidence that long-term PPI use caused or accelerated gastric atrophy or intestinal metaplasia [24].

Whatever the main underlying cause of your stomach inflammation, many of the health issues you can experience are a result of reduced stomach acid secretion. 

Signs and Symptoms of Autoimmune Gastritis

Autoimmune Gastritis: What Is It, Could You Have It and How Is It Treated? - Symptoms of Atrophic Gastritis Square L

It’s possible to have chronic atrophic gastritis or autoimmune gastritis and not realize it. In fact, it’s really common for the condition to be quite advanced before it is recognized. But non-specific symptoms like fatigue, bloating, and abdominal pain may be signs of gastritis. Identifying the cause as early as possible can help you to feel better and avoid more serious complications. Autoimmune gastritis usually moves from mild to severe within three years [22].

When you do experience symptoms, these may include [25]:

  • Nausea and vomiting
  • Feeling full in the upper abdomen after eating
  • Abdominal pain
  • Fatigue

You might feel pain and discomfort specifically in the upper (fundus) part of the stomach because it’s where the acid-secreting parietal or oxyntic cells are concentrated. 

In autoimmune gastritis, the immune system attacks the acid-producing machinery known as the H+/K+ ATPase proton pump inside the parietal cell.

Low Stomach Acid

autoimmune gastritis: Risk factors for low stomach acid chart by Dr. Ruscio

Many of the signs and symptoms of atrophic gastritis — whether autoimmune in nature or not — actually occur because of a lack of stomach acid secretion (also known as achlorhydria).

What happens when your stomach acid production is low? For a start, you will be less able to fight off gastrointestinal infections, and you may also experience digestive problems and much poorer absorption of some nutrients.

Malabsorption of nutrients, particularly vitamin B12, is one reason why many people with achlorhydria and advanced autoimmune gastritis may experience [26]: 

  • Extreme fatigue
  • Nervous symptoms like numbness and tingling
  • Increased risk of heart disease

Chronic achlorhydria can also lead to increased risk of stomach cancer — in this case, a slower growing carcinoid tumour [27].

The sequence of events goes like this:

Low stomach acid —> excess gastrin hormone produced by the lower antrum region of the stomach in an attempt to restore acid levels —> overgrowth (hyperplasia) of “enterochromaffin-like” cells in the stomach lining —> development of gastric carcinoids

Pernicious Anaemia

Stressed woman with her hand on her forehead and her eyes closed while working

Pernicious anaemia related to a lack of stomach acid and intrinsic factor is one of the main longer term conditions that can result from autoimmune gastritis [28 Trusted SourcePubMedGo to source].

In pernicious anaemia (also known as megaloblastic anemia), red blood cells don’t divide properly and are too large and too few in number. The symptoms can be serious [29] – including not just debilitating fatigue and an inability to concentrate, but also nervous system damage that can start as pins, needles and numbness, and can progress to irreversible neurological damage. 

Supplementing to overcome a vitamin B12 deficiency is therefore key to treating autoimmune gastritis, which we’ll talk about more in the treatment section below.

How Is Autoimmune Gastritis Diagnosed?

Often, autoimmune gastritis is not diagnosed until after antibiotic treatment for eradication of a suspected Helicobacter pylori infection has been ineffective or only partially effective.

A definitive diagnosis of autoimmune gastritis can usually be made by a specialist in gastroenterology after an endoscopic biopsy. In this procedure, a doctor inserts a flexible thin tube (an endoscope) with a tiny camera and light down into your stomach and collects a small sample of tissue.

Is Antibody Testing Helpful?

The anti-parietal cell antibody test (also known as the parietal cell antibody test) is another potentially useful test that is less invasive than endoscopy. 

This blood test checks for the presence of autoantibodies that are suggestive of autoimmune gastritis. 

However, I would always use this test on a case-by-case basis because it isn’t specific — parietal cell antibodies can also be found in atrophic gastritis and can be a hallmark of autoimmune thyroid disease and type-1 diabetes. 

Parietal cell antibodies may also only be elevated earlier in the disease and can sometimes fall again as the disease progresses and the oxyntic mucosa continues to deteriorate, so the results may be confusing or misleading [1, 22].

Other tests that may or may not be relevant depending on your own condition include:

  1. Anti-intrinsic factor antibody test — more specific than the antiparietal cell antibody test for detecting pernicious anemia
  2. Anti-H. pylori antibody test — for when H. pylori infection is also suspected
  3. Gastrin-17 test — helps identify deterioration of the oxyntic mucosa (gastrin is the hormone that stimulates stomach acid secretion)
  4. Pepsinogen I and pepsinogen I / Pepsinogen II serological tests — effective screens for advanced atrophic gastritis (pepsinogen is the precursor to the digestive enzyme pepsin)

Related Diagnoses (and the Gut-Bacteria Connection)

autoimmune gastritis: Gut-bacteria connection chart

Autoimmune conditions often come in clusters. If I see someone with a diagnosis of autoimmune gastritis, I would almost certainly expect them to have related autoimmune disease.

In fact, a 2012 observational study found more than half of a group of 99 patients with autoimmune gastritis had other autoimmune conditions, including Hashimoto’s thyroiditis, type-1 diabetes, vitiligo, celiac disease, rheumatoid arthritis, Grave’s disease, connective tissue disease, and psoriasis [30].

A common thread that ties all these autoimmune conditions together is your gut microbiome. Across many autoimmune diseases, there is often shared disruption to the healthy balance of bacteria in the gut [31 Trusted SourcePubMedGo to source].

That’s why it’s vitally important to look at your symptoms as a whole. We’ll run through a series of recommended treatment steps in the next section that will help with autoimmune diseases in general as well as autoimmune gastritis more specifically. While these generalized treatments might help, an expert in functional medicine is uniquely qualified to help look at all your symptoms and the underlying causes holistically, should you need extra help.

Treating Autoimmune Gastritis

Many of the treatments that may help with autoimmune gastritis also help autoimmune disease generally.

Dietary Measures

I really can’t overstress how helpful dietary changes can be in tackling autoimmune conditions and improving your gut health, which underlies so many aspects of our health.

To restore your gut to health, start by identifying and eliminating the foods that you may be sensitive to. These could be driving autoimmunity, dysbiosis, and inflammatory processes. Gluten is a very common food sensitivity that can lead to immune system dysregulation in the intestines [14 Trusted SourcePubMedGo to source, 15 Trusted SourcePubMedGo to source, 16 Trusted SourcePubMedGo to source, 17 Trusted SourcePubMedGo to source].

I suggest that you start with the least level of restrictions and only cut out more potentially troublesome foods if you don’t get good results:

As a first step, remove all highly processed foods that may increase inflammatory processes in the gut and body. 

  • A diet based on simple whole foods and that isn’t heavily grain or dairy based, such as one based on Paleo principles is an excellent way to do this.

If you don’t get symptom improvement after a couple of weeks on Paleo, you may find a plan that eliminates more potentially troublesome foods (e.g. the Autoimmune protocol (AIP) diet to be a better fit for you.

  • AIP hasn’t been tested in gastritis but has shown promise in other autoimmune conditions, including inflammatory bowel disease and Hashimoto’s thyroiditis [32, 33]

Eating slowly and mindfully can also be a great help: In one observational study of people with chronic gastritis, 58% noted that their symptoms of stomach ache and bloating were related to habits such as eating too many sweets and leftovers but also through eating too fast and having irregular meal times [34].

Supplements

Supporting your diet with the right supplements is very important for helping to improve your autoimmune and digestive conditions.

Probiotics

Woman wearing a probiotics white shirt while pointing to the intestines illustration printed on it

I would strongly recommend that people with autoimmune gastritis start a regimen of reputable probiotics

There’s not much research looking directly at the benefits of probiotics on autoimmune gastritis specifically. But there are plenty of studies that show probiotics help with autoimmune disease more generally by improving gut health and helping to reduce the gut permeability (leaky gut) that allows allergenic materials to pass into the bloodstream [35, 36].

Probiotics will also help if you have a coexisting H. pylori infection. A 2018 systematic review of 11 studies, including seven randomized controlled studies, found that even alone, multi-strain probiotics eradicated H. pylori in 14% of cases [37].

However, they work best with antibiotics to eradicate the infection. A 2019 systematic review and meta analysis involving nearly 9,000 patients found that, compared with controls, those given probiotics as part of their H. pylori eradication treatment had higher rates of eradication and lower incidences of total side effects [38].

Gut Rebuilding Nutrients (Glutamine and N-Acetyl-Cysteine)

Some amino acid supplements can also help with atrophic and autoimmune gastritis as they help to repair tissues, including the gut lining.

These gut rebuild supplements include glutamine, which in several studies has been shown to help improve the integrity of the gut lining, not specifically for people with autoimmune gastritis, but in those with leaky gut and diarrhea-predominant IBS for example [39 Trusted SourcePubMedGo to source].

Also useful is NAC (n-acetylcysteine), which is a very safe and natural amino acid  compound that is also a powerful antioxidant. In one study, NAC helped prevent H. pylori induced gastritis [40 Trusted SourcePubMedGo to source] and the supplement has also been shown to enhance gut healing in people with atrophic gastritis [41]. 

Vitamin B12

Because autoimmune gastritis destroys cells that make intrinsic factor, patients with this condition will generally need to take large doses of vitamin B12. 

Research studies on the effect of vitamin B12 in autoimmune gastritis have shown that:

  • Early supplementation with B12 and iron (see below) may prevent anemia and neurological problems [22].
  • Patients testing positive for anti-parietal cell antibodies can see a reduction in positivity following regular intramuscular B12 injections (in this study from100% to 42.9%) [42]. 
  • Two studies have shown that vitamin B12 injections can also help to reduce stomach autoimmunity [43].

Traditionally, vitamin B12 was injected directly into the muscle to get around absorption problems, but this might not always be necessary according to more recent research. Again, it is something I would discuss with patients on a case-by-case basis, but a respected review suggests that high oral doses of vitamin B12 can in some cases be as effective as injections in treating B12 deficiency [44].

Other Supplements

Iron supplements may also be required if you have autoimmune gastritis. Reduced stomach acid makes this mineral hard to absorb, increasing the risk of iron deficiency anemia. 

People with autoimmune gastritis can also be deficient in folic acid, another B vitamin. In this case, it can be worth supplementing this vitamin [25].

To help with poor digestion and low stomach acid symptoms caused by autoimmune gastritis, you may also consider taking a supplement of hydrochloric acid (HCl) and pepsin. It’s always best to monitor your symptoms closely when trialing HCl. If symptoms do not improve within a couple of weeks, it should not be continued (unless otherwise advised by your doctor).

The Bottom Line

Autoimmune gastritis can be tricky to diagnose and can occur alongside a suite of other autoimmune issues, which may complicate diagnosis. 

However tackling the underlying gut health issues and inflammation can be a great help, as can correcting specific deficiencies of Vitamin B12 and stomach acid.

For more guidance, consider scheduling a virtual or in-person consultation at our functional medicine center.

➕ References
  1. Sara Massironi, Alessandra Zilli, Alessandra Elvevi, Pietro Invernizzi. The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective. Autoimmunity Reviews. 2019. Volume 18, Issue 3, Pages 215-222, ISSN 1568-9972. https://doi.org/10.1016/j.autrev.2018.08.011
  2. Bruno Annibale, Gianluca Esposito & Edith Lahner (2020) A current clinical overview of atrophic gastritis, Expert Review of Gastroenterology & Hepatology, 14:2, 93-102, DOI: 10.1080/17474124.2020.1718491
  3. Zullo A, Hassan C, Romiti A, Giusto M, Guerriero C, Lorenzetti R, Campo SM, Tomao S. Follow-up of intestinal metaplasia in the stomach: When, how and why. World J Gastrointest Oncol. 2012 Mar 15;4(3):30-6. doi: 10.4251/wjgo.v4.i3.30. PMID: 22468181; PMCID: PMC3312926.
  4. https://www.aarda.org/diseaselist/
  5. Saffouri, G.B., Shields-Cutler, R.R., Chen, J. et al. Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders. Nat Commun 10, 2012 (2019). https://doi.org/10.1038/s41467-019-09964-7
  6. Fasano A. Leaky gut and autoimmune diseases. Clin Rev Allergy Immunol. 2012 Feb;42(1):71-8. doi: 10.1007/s12016-011-8291-x. PMID: 22109896. Trusted SourcePubMedGo to source
  7. Mu Q, Kirby J, Reilly CM, Luo XM. Leaky Gut As a Danger Signal for Autoimmune Diseases. Front Immunol. 2017 May 23;8:598. doi: 10.3389/fimmu.2017.00598. PMID: 28588585; PMCID: PMC5440529.
  8. de Oliveira GLV, Leite AZ, Higuchi BS, Gonzaga MI, Mariano VS. Intestinal dysbiosis and probiotic applications in autoimmune diseases. Immunology. 2017 Sep;152(1):1-12. doi: 10.1111/imm.12765. Epub 2017 Jun 29. PMID: 28556916; PMCID: PMC5543467. Trusted SourcePubMedGo to source
  9. Yap YA, Mariño E. An Insight Into the Intestinal Web of Mucosal Immunity, Microbiota, and Diet in Inflammation. Front Immunol. 2018 Nov 20;9:2617. doi: 10.3389/fimmu.2018.02617. PMID: 30532751; PMCID: PMC6266996.
  10. Xu H, Liu M, Cao J, Li X, Fan D, Xia Y, Lu X, Li J, Ju D, Zhao H. The Dynamic Interplay between the Gut Microbiota and Autoimmune Diseases. J Immunol Res. 2019 Oct 27;2019:7546047. doi: 10.1155/2019/7546047. PMID: 31772949; PMCID: PMC6854958.
  11. Dong L, Xie J, Wang Y, Zuo D. Gut Microbiota and Immune Responses. Adv Exp Med Biol. 2020;1238:165-193. doi: 10.1007/978-981-15-2385-4_10. PMID: 32323185. Trusted SourcePubMedGo to source
  12. Fitzgibbon G, Mills KHG. The microbiota and immune-mediated diseases: Opportunities for therapeutic intervention. Eur J Immunol. 2020 Mar;50(3):326-337. doi: 10.1002/eji.201948322. Epub 2020 Feb 6. PMID: 31991477. Trusted SourcePubMedGo to source
  13. Honda K, Littman DR. The microbiota in adaptive immune homeostasis and disease. Nature. 2016 Jul 7;535(7610):75-84. doi: 10.1038/nature18848. PMID: 27383982. Trusted SourcePubMedGo to source
  14. Coucke F. Food intolerance in patients with manifest autoimmunity. Observational study. Autoimmun Rev. 2018 Nov;17(11):1078-1080. doi: 10.1016/j.autrev.2018.05.011. Epub 2018 Sep 11. PMID: 30213697. Trusted SourcePubMedGo to source
  15. Pietschmann N. Food Intolerance: Immune Activation Through Diet-associated Stimuli in Chronic Disease. Altern Ther Health Med. 2015 Jul-Aug;21(4):42-52. PMID: 26030116. Trusted SourcePubMedGo to source
  16. Levy J, Bernstein L, Silber N. Celiac disease: an immune dysregulation syndrome. Curr Probl Pediatr Adolesc Health Care. 2014 Dec;44(11):324-7. doi: 10.1016/j.cppeds.2014.10.002. PMID: 25499458. Trusted SourcePubMedGo to source
  17. Briani C, Samaroo D, Alaedini A. Celiac disease: from gluten to autoimmunity. Autoimmun Rev. 2008 Sep;7(8):644-50. doi: 10.1016/j.autrev.2008.05.006. Epub 2008 Jun 25. PMID: 18589004. Trusted SourcePubMedGo to source
  18. Ghoshal UC, Shukla R, Ghoshal U. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut Liver. 2017 Mar 15;11(2):196-208. doi: 10.5009/gnl16126. PMID: 28274108; PMCID: PMC5347643.
  19. Caminero, A., Meisel, M., Jabri, B. et al. Mechanisms by which gut microorganisms influence food sensitivities. Nat Rev Gastroenterol Hepatol 16, 7–18 (2019). https://doi.org/10.1038/s41575-018-0064-z
  20. Annibale B, Esposito G, Lahner E. A current clinical overview of atrophic gastritis. Expert Rev Gastroenterol Hepatol. 2020 Feb;14(2):93-102. doi: 10.1080/17474124.2020.1718491. Epub 2020 Jan 24. PMID: 31951768. Trusted SourcePubMedGo to source
  21. Masoud Youssefi, Mohsen Tafaghodi, Hadi Farsiani, Kiarash Ghazvini, Masoud Keikha. Helicobacter pylori infection and autoimmune diseases; Is there an association with systemic lupus erythematosus, rheumatoid arthritis, autoimmune atrophy gastritis and autoimmune pancreatitis? A systematic review and meta-analysis study. Journal of Microbiology, Immunology and Infection. 2020. ISSN 1684-1182. https://doi.org/10.1016/j.jmii.2020.08.011
  22. Lenti, M.V., Rugge, M., Lahner, E. et al. Autoimmune gastritis. Nat Rev Dis Primers 6, 56 (2020). https://doi.org/10.1038/s41572-020-0187-8
  23. Li Z, Wu C, Li L, Wang Z, Xie H, He X, Feng J. Effect of long-term proton pump inhibitor administration on gastric mucosal atrophy: A meta-analysis. Saudi J Gastroenterol. 2017 Jul-Aug;23(4):222-228. doi: 10.4103/sjg.SJG_573_16. PMID: 28721975; PMCID: PMC5539675. Trusted SourcePubMedGo to source
  24. Song  H, Zhu  J, Lu  D. Long‐term proton pump inhibitor (PPI) use and the development of gastric pre‐malignant lesions. Cochrane Database of Systematic Reviews 2014, Issue 12. Art. No.: CD010623. DOI: 10.1002/14651858.CD010623.pub2.
  25. Rodriguez-Castro KI, Franceschi M, Miraglia C, Russo M, Nouvenne A, Leandro G, Meschi T, de’ Angelis GL, Di Mario F. Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed [Internet]. 2018 Dec. 17 [cited 2021 Jun. 16];89(8-S):100-3. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/7919
  26. Rodriguez-Castro KI, Franceschi M, Noto A, Miraglia C, Nouvenne A, Leandro G, Meschi T, de’ Angelis GL, Di Mario F. Clinical manifestations of chronic atrophic gastritis. Acta Biomed [Internet]. 2018 Dec. 17 [cited 2021 Jun. 16];89(8-S):88-92. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/7921
  27. https://www.merckmanuals.com/professional/gastrointestinal-disorders/gastritis-and-peptic-ulcer-disease/autoimmune-metaplastic-atrophic-gastritis
  28. Lenti MV, Rugge M, Lahner E, Miceli E, Toh BH, Genta RM, De Block C, Hershko C, Di Sabatino A. Autoimmune gastritis. Nat Rev Dis Primers. 2020 Jul 9;6(1):56. doi: 10.1038/s41572-020-0187-8. PMID: 32647173. Trusted SourcePubMedGo to source
  29. https://www.nhlbi.nih.gov/health-topics/pernicious-anemia
  30. Emanuela Miceli, Marco Vincenzo Lenti, Donatella Padula, Ombretta Luinetti, Claudia Vattiato, Claudio Maria Monti, Michele Di Stefano, Gino Roberto Corazza. Common Features of Patients With Autoimmune Atrophic Gastritis. Clinical Gastroenterology and Hepatology. 2012. VOLUME 10, ISSUE 7, P812-814. DOI: https://doi.org/10.1016/j.cgh.2012.02.018
  31. De Luca F, Shoenfeld Y. The microbiome in autoimmune diseases. Clin Exp Immunol. 2019 Jan;195(1):74-85. doi: 10.1111/cei.13158. PMID: 29920643; PMCID: PMC6300652. Trusted SourcePubMedGo to source
  32. Chandrasekaran A, Groven S, Lewis JD, Levy SS, Diamant C, Singh E, Konijeti GG. An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease. Crohns Colitis 360. 2019 Oct;1(3):otz019. doi: 10.1093/crocol/otz019. Epub 2019 Aug 7. PMID: 31832627; PMCID: PMC6892563.
  33. Abbott RD, Sadowski A, Alt AG. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus. 2019 Apr 27;11(4):e4556. doi: 10.7759/cureus.4556. PMID: 31275780; PMCID: PMC6592837.
  34. Yuan Li, Zeqi Su, Ping Li, Yicong Li, Nadia Johnson, Qi Zhang, Shihao Du, Huali Zhao, Kexin Li, Chi Zhang, Xia Ding, “Association of Symptoms with Eating Habits and Food Preferences in Chronic Gastritis Patients: A Cross-Sectional Study“, Evidence-Based Complementary and Alternative Medicine, vol. 2020, Article ID 5197201, 11 pages, 2020. https://doi.org/10.1155/2020/5197201
  35. Liu Y, Alookaran JJ, Rhoads JM. Probiotics in Autoimmune and Inflammatory Disorders. Nutrients. 2018 Oct 18;10(10):1537. doi: 10.3390/nu10101537. PMID: 30340338; PMCID: PMC6213508.
  36. Rao RK, Samak G. Protection and Restitution of Gut Barrier by Probiotics: Nutritional and Clinical Implications. Curr Nutr Food Sci. 2013 May 1;9(2):99-107. doi: 10.2174/1573401311309020004. PMID: 24353483; PMCID: PMC3864899.
  37. Losurdo G, Cubisino R, Barone M, Principi M, Leandro G, Ierardi E, Di Leo A. Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis. World J Gastroenterol 2018; 24(1): 139-149 [PMID: 29358890 DOI: 10.3748/wjg.v24.i1.139]
  38. Shi, Xiaoguang MMa; Zhang, Junhong MDa; Mo, Lingshan MMb; Shi, Jialing MBa; Qin, Mengbin MDc; Huang, Xue PhDd,∗ Efficacy and safety of probiotics in eradicating Helicobacter pylori, Medicine: April 2019 – Volume 98 – Issue 15 – p e15180 doi: 10.1097/MD.0000000000015180
  39. Zhou Q, Verne ML, Fields JZ, Lefante JJ, Basra S, Salameh H, Verne GN. Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome. Gut. 2019 Jun;68(6):996-1002. doi: 10.1136/gutjnl-2017-315136. Epub 2018 Aug 14. PMID: 30108163. Trusted SourcePubMedGo to source
  40. Jang S, Bak EJ, Cha JH. N-acetylcysteine prevents the development of gastritis induced by Helicobacter pylori infection. J Microbiol. 2017 May;55(5):396-402. doi: 10.1007/s12275-017-7089-9. Epub 2017 Apr 29. PMID: 28455589. Trusted SourcePubMedGo to source
  41. Fabio Farinati, Romilda Cardin, Gianni della Libera, Teresa Pallotta, Massimo Rugge, Antonio Colantoni, Giovanni Gurrieri. Effects of N-acetyl-l-cysteine in patients with chronic atrophic gastritis and nonulcer dyspepsia: a phase III pilot study. Current Therapeutic Research. 1997. Volume 58, Issue 10, Pages 724-733. ISSN 0011-393X. https://doi.org/10.1016/S0011-393X(97)80106-3
  42. Andy Sun, Julia Yu-Fong Chang, Yi-Ping Wang, Shih-Jung Cheng, Hsin-Ming Chen, Chun-Pin Chiang. Effective vitamin B12 treatment can reduce serum antigastric parietal cell antibody titer in patients with oral mucosal disease. Journal of the Formosan Medical Association. 2016. Volume 115, Issue 10, Pages 837-844. ISSN 0929-6646. https://doi.org/10.1016/j.jfma.2016.05.003.
  43. Lin, H.-P., Wang, Y.-P., Chia, J.-S., Chiang, C.-P. and Sun, A. (2011), Modulation of serum gastric parietal cell antibody level by levamisole and vitamin B12 in oral lichen planus. Oral Diseases, 17: 95-101. https://doi.org/10.1111/j.1601-0825.2010.01711.x
  44. Wang  H, Li  L, Qin  LL, Song  Y, Vidal‐Alaball  J, Liu  TH. Oral vitamin B12 versus intramuscular vitamin B12 for vitamin B12 deficiency. Cochrane Database of Systematic Reviews 2018, Issue 3. Art. No.: CD004655. DOI: 10.1002/14651858.CD004655.pub3.
  45. Rodriguez-Castro KI, Franceschi M, Miraglia C, Russo M, Nouvenne A, Leandro G, Meschi T, de’ Angelis GL, Di Mario F. Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed [Internet]. 2018 Dec. 17 [cited 2021 Jun. 16];89(8-S):100-3. Available from: https://www.mattioli1885journals.com/index.php/actabiomedica/article/view/7919

Need help or would like to learn more?
View Dr. Ruscio’s additional resources

Get Help

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!