Silent Gastritis: How to Recognize It When Symptoms Are Almost Absent 0 14

"Silent" gastritis is not a separate diagnosis, but a clinical situation in which there are inflammatory changes, yet typical complaints are absent. A person continues to live in their usual rhythm, attributing mild heaviness, fatigue, or unstable appetite to stress and routine. We asked gastroenterologist Ekaterina Kanishcheva to explain how to detect it early to prevent inflammation.

What Forms of Gastritis Occur Asymptomatically and Why This Happens

There are three types of gastritis that are most commonly encountered: gastritis caused by the Helicobacter pylori bacteria, atrophic gastritis, and autoimmune gastritis. Any of these does not cause pain sensations, as there are few pain receptors in the gastric mucosa.

What people usually refer to as gastritis often turns out to be functional dyspepsia related to the Helicobacter pylori bacteria, cholelithiasis, gastric ulcer, or duodenal ulcer.

Our stomach is a "reservoir" for hydrochloric acid, with protective mucus constantly present on its walls, and glands produce bicarbonates that neutralize hydrochloric acid and protect cells from damage. There are few pain receptors, so pain as such is virtually absent.

Early Symptoms

Silent gastritis often develops without the usual signals – pain and heartburn. Inflammation of the mucosa may not interfere with daily life for a long time, and the first changes appear nonspecific and easily go unnoticed.

• A feeling of heaviness or fullness after eating, even with small portions.

• Unstable appetite.

• Periodic nausea without pronounced pain.

• Bloating, rumbling, feeling of "slow" digestion.

• Belching or unpleasant taste in the mouth.

• Why It Is Difficult to Identify Such Gastritis

Because there is no pronounced pain, and symptoms can easily be confused with fatigue and stress. In most cases, a person is troubled by functional dyspepsia, while gastritis is an "incidental" finding during examination.

Diagnostic Methods

In cases of gastritis, abdominal ultrasound is not informative. A clinical blood test may reveal signs of iron deficiency or vitamin B12 deficiency anemia if the disease has been developing for a long time.

The gastro panel can suggest atrophic or autoimmune gastritis and the presence of Helicobacter pylori infection. The C-13 urea breath test and stool antigen test for H. pylori using immunochromatographic methods (ICM) are also used for diagnosing Helicobacter pylori infection.

The "gold standard" is esophagogastroduodenoscopy with biopsy and subsequent morphological examination. Gastritis is always a morphological diagnosis, and it is incorrect to diagnose it without a biopsy taken during gastroscopy.

How Often Asymptomatic Gastritis Progresses to Atrophic Gastritis

There are no exact figures, but statistics show that atrophic gastritis is a common outcome of chronic inflammation, especially related to H. pylori and autoimmune gastritis. It is impossible to predict this process, but if there is an infection, the progression of the disease can be halted by eradicating the bacteria.

Dietary habits do not influence anything; this is a myth. Stress does not either, but it can cause pain and burning in the stomach area, a feeling of fullness, and early satiety. This is called functional dyspepsia and is not related to inflammation in the stomach wall.

When Urgent Diagnosis Is Needed, Even If the Stomach Does Not Hurt

• Significant or prolonged decrease in hemoglobin, iron, ferritin, and increased ESR.

• Elevated leukocytes.

• Presence of blood in stool.

• Difficulty swallowing.

• Sudden weight loss without changes in dietary habits.

• Drop in blood pressure and increased heart rate.

• Vomiting after eating.

In the case of gastritis caused by H. pylori bacteria, eradication therapy is recommended, which is prescribed by a gastroenterologist.

Preventive Measures

Even if there are no complaints, it is recommended to undergo esophagogastroduodenoscopy at age 45 to detect atrophic gastritis and stomach cancer at an early stage. If there are cases of stomach cancer in the family, it is advisable to undergo examination earlier.