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Postgastrectomy gastritis
Last reviewed: 23.04.2024
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Postgastrectomy gastritis is a gastric atrophy that develops after a partial or subtotal gastrectomy (except for cases of gastrinoma).
The metaplasia of the remaining mucous membrane of the body of the stomach is characteristic. The degree of gastritis is usually the largest in the zone of anastomosis.
[What causes postgastrectomy gastritis?
Several mechanisms are responsible for this process: reflux of bile, which is characteristic of such an operation, damages the gastric mucosa; the removal of the gastrin-producing antral section reduces the excitation of parietal and pepsin cells, causing atrophy; and also vagotomy, which contributes to the loss of the trophic effect of the vagus nerve.
Symptoms of postgastrectomy gastritis
Specific symptoms of postgastrectomy gastritis are absent. Postgastrectomy gastritis often progresses with the development of severe atrophy and achlorhydria. Production may be disrupted with the development of intrinsic factor deficiency of vitamin B 12 (deficiency can be exacerbated by the proliferation of bacteria in the resulting loop). The relative risk of gastric adenocarcinoma increases 15-20 years after partial gastrectomy; however, given the low incidence of cancer after gastrectomy, conventional endoscopic observation is inexpedient in terms of costs, but signs of bleeding from the upper gastrointestinal tract or anemia in such patients require the performance of endoscopy.