Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2023; 29(23): 3733-3747
Published online Jun 21, 2023. doi: 10.3748/wjg.v29.i23.3733
Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis: Insights into mechanisms, pathophysiology, and treatment options
Roberta Elisa Rossi, Alessandra Elvevi, Valentina Sciola, Francesco Vito Mandarino, Silvio Danese, Pietro Invernizzi, Sara Massironi
Roberta Elisa Rossi, Gastroenterology and Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano 20089, Milan, Italy
Alessandra Elvevi, Pietro Invernizzi, Sara Massironi, Gastroenterology Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy and Department of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy
Valentina Sciola, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano 20100, Italy
Francesco Vito Mandarino, Silvio Danese, Department of Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan 20132, Italy
Silvio Danese, School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy
Author contributions: Massironi S conceived the idea for the review; Rossi RE, Elvevi A, Sciola V, and Mandarino FV conducted the literature search; Rossi RE, Elvevi A, and Sciola V screened the articles for inclusion and exclusion criteria; Rossi RE, Sciola V, and Elvevi A wrote the initial draft of the manuscript; Massironi S, Mandarino FV, Danese S, and Invernizzi P contributed to revising the manuscript critically for important intellectual content and finally all authors approved the final version for submission.
Conflict-of-interest statement: All the authors declare no conflict of interests for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Sara Massironi, MD, PhD, Chief Physician, Doctor, Medical Assistant, Research Scientist, Division of Gastroenterology, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi, 33, Monza 20900, Italy.
Received: March 21, 2023
Peer-review started: March 21, 2023
First decision: April 12, 2023
Revised: April 23, 2023
Accepted: May 6, 2023
Article in press: May 6, 2023
Published online: June 21, 2023
Core Tip

Core Tip: The management of dyspepsia in patients with autoimmune gastritis (AIG), a chronic, immune-mediated disease, remains a challenge, as it can overlap with functional dyspepsia and gastroesophageal reflux disease. Currently, there are no specific therapies. A tailored treatment approach based on a better understanding of putative pathogenic mechanisms underlying symptoms is needed. Prokinetic agents, antidepressant drugs, and non-pharmacological treatments may be helpful, although not adequately evidence-based supported. As a future perspective, targeting dyspepsia in AIG based on changes in the microbiota and advanced endoscopic techniques to treat severe dyspeptic symptoms might be an area of ongoing research.