Atrophic gastritis


Is atrophic gastritis of the gastric antrum serious?
Atrophic gastritis is a chronic gastric disease characterized by repeated damage to the gastric mucosal epithelium, leading to the atrophy of the intrinsic glands, with or without intestinal metaplasia or pseudopyloric gland metaplasia. The main cause of this disease is infection by Helicobacter pylori. Symptoms primarily include upper abdominal distension, belching, acid reflux, early satiety, nausea, etc. Some patients may experience symptoms such as weight loss, fatigue, memory loss, anxiety, and depression. The main treatment involves eradicating Helicobacter pylori, suppressing acid production, and using gastric mucosal protectants and prokinetic agents. The majority of patients have Helicobacter pylori-related gastritis, which after chronic inflammation (chronic non-atrophic gastritis) can lead to atrophic gastritis, followed by intestinal metaplasia or dysplasia, and eventually may progress to gastric cancer.


Will atrophic gastritis and esophagitis cause significant weight loss?
Patients with atrophic gastritis and esophagitis may experience weight loss, as those with atrophic gastritis can have upper abdominal pain, distension pain, and burning pain, accompanied by a feeling of bloating and belching. Severe cases can lead to anemia and weight loss. The main cause of atrophic gastritis is infection by Helicobacter pylori. Of course, immune factors and dietary habits also play significant roles in the development of atrophic gastritis. Once atrophic gastritis is definitively diagnosed, it is crucial to actively eradicate Helicobacter pylori, as well as to quit smoking and drinking, and avoid using medications and consuming foods that may damage the gastric mucosa.


How to treat chronic atrophic gastritis with intestinal metaplasia?
The treatment of chronic atrophic gastritis with intestinal metaplasia mainly includes the following aspects: The first is general treatment. Firstly, the diet should be light and easily digestible, avoiding spicy, stimulating, fried, grilled, cold, and sweet foods. It is important to exercise regularly and avoid emotions such as anxiety and depression. The second is the treatment against Helicobacter pylori, including a proton pump inhibitor plus two antibiotics, and a bismuth agent, with a treatment course of 14 days. Additionally, medications that promote gastric motility and protect the gastric mucosa are used. The fourth involves endoscopic treatments, including endoscopic APC treatment or endoscopic mucosal resection. The fifth, combining traditional Chinese medicine, differentiating syndrome treatments and oral herbal medicines, can also achieve good effects.


Chronic non-atrophic gastritis
Chronic non-atrophic gastritis is also known as chronic superficial gastritis. It is a classification of chronic gastritis, which also includes chronic atrophic gastritis and special types of gastritis as other classifications. Chronic non-atrophic gastritis refers to a condition where the glands in the gastric mucosa do not show atrophy, thus it is called chronic non-atrophic gastritis. Generally, the endoscopic appearance of the gastric mucosa being hyperemic, edematous, or eroded can lead to a diagnosis of chronic non-atrophic gastritis. Treatment mainly focuses on acid suppression, protecting the stomach, promoting gastric motility, and protecting the gastric mucosa. If there is a positive Helicobacter pylori infection, eradication treatment for Helicobacter pylori is required. Patients with chronic non-atrophic gastritis should primarily consume a light and easy-to-digest diet.


Is atrophic gastritis negative a problem?
Atrophic gastritis negative generally means there's no major issue. A negative result for atrophic gastritis indicates that the patient is unlikely to have atrophic gastritis. In such cases, it may be considered that there is chronic superficial gastritis. If the patient has symptoms such as acid reflux, belching, heartburn, nausea, vomiting, etc., the use of proton pump inhibitors can be considered to suppress the secretion of stomach acid, and products such as aluminum magnesium carbonate and sucralfate to protect the gastric mucosa. Treatment to promote gastric motility such as Itopride or Mosapride can also be considered. Additionally, it is necessary to conduct a Carbon-13 urea breath test or Carbon-14 urea breath test to check for Helicobacter pylori infection.


What are the symptoms before atrophic gastritis turns cancerous?
Patients with atrophic gastritis primarily exhibit symptoms such as dull pain, bloating, and burning pain in the upper abdomen, along with belching, acid reflux, weight loss, anemia, and more. If the pain from atrophic gastritis does not follow a clear pattern and is accompanied by progressive weight loss and refractory anemia, the possibility of cancerous changes in atrophic gastritis should be considered. It is advisable to promptly complete an endoscopy to confirm the diagnosis and rule out malignancy, and, if necessary, undertake a biopsy. In terms of treatment, it is first essential to test for Helicobacter pylori infection and then use medications to protect the gastric mucosa.


Are atrophic gastritis and atrophic gastric erosion the same?
Atrophic gastritis and atrophic gastric erosion do not mean the same thing; atrophic gastric erosion refers to the presence of gastric mucosal erosion based on atrophic gastritis. When atrophic gastritis is accompanied by gastric erosion, it is crucial to actively check for Helicobacter pylori infection. If the Helicobacter pylori infection tests positive, the treatment involves a two-week quadruple therapy that includes bismuth to eradicate Helicobacter pylori, along with medications to protect the gastric mucosa, such as magnesium carbonate, sucralfate, etc., and also some digestive aids. (Please take medication under the guidance of a doctor.)


Does chronic atrophic gastritis require lifelong medication?
If the patient has lifelong atrophic gastritis, they may need to follow a doctor's advice and take medications that increase mucosal nutrition for life, such as sucralfate, live gastric ketone, prostaglandin E1, etc. The main causes of atrophic gastritis are Helicobacter pylori infection, as well as other factors such as autoimmune mechanisms, genetic factors, and decreased gastric mucosal barrier function. The main symptoms of atrophic gastritis include obscure pain in the upper abdomen, distension, burning pain, along with accompanying symptoms like weight loss and anemia. Treatment for atrophic gastritis involves eradicating Helicobacter pylori and using medications that protect the gastric mucosa.


Can people with atrophic gastritis drink honey water?
Patients with atrophic gastritis can drink honey water. Patients with atrophic gastritis need to be careful with their diet by avoiding spicy, irritating foods, as well as overly sour, overly spicy, overly salty foods, and coarse foods. For patients with atrophic gastritis, it is important to eat regularly and in moderate amounts, opting for smaller, more frequent meals, and avoiding binge eating. Since honey water does not fall into the above categories of foods and is not considered spicy, patients with atrophic gastritis can drink honey water. However, it is also important to avoid drinking too much at once; drinking a moderate amount is fine.


Can atrophic gastritis turn into cancer?
Chronic atrophic gastritis has a certain chance of cancerous transformation, with an annual cancer transformation rate of between 0.5% and 1%. It is a type of chronic gastritis. During gastroscopy, the atrophy of the inherent glands of the gastric mucosa can be observed. A definitive diagnosis of chronic atrophic gastritis can be made through biopsy and pathological examination. In terms of treatment, the first step is the treatment against Helicobacter pylori, which includes a proton pump inhibitor, two antibiotics, and a bismuth agent, with a treatment course of 14 days. Additionally, treatments include acid suppression, stomach protection, promoting gastric motility, and protecting the gastric mucosa. Furthermore, oral traditional Chinese medicine plays a significant role in the treatment of atrophic gastritis. Therefore, it is suggested that patients with atrophic gastritis consider integrated traditional Chinese and Western medicine treatment, which can yield good results.