Why is a biopsy necessary for atrophic gastritis?

Written by Zhu Dan Hua
Gastroenterology
Updated on September 06, 2024
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Atrophic gastritis is generally treated with biopsy, which is the standard for diagnosing atrophic gastritis, so biopsy is typically conducted when considering atrophic gastritis. Atrophic gastritis is increasingly common in clinical settings, especially among middle-aged and elderly patients. It begins with symptoms of chronic gastritis, such as abdominal pain, bloating, nausea, and belching, and sometimes may include changes in appetite. Patients usually undergo gastroscopy, which shows atrophy of the gastric mucosa, alterations in red and white patches, or white-like mucosa. Histopathological examination can further support the atrophic changes. In clinical settings, when considering atrophic gastritis, treatment focuses on protecting the stomach and screening for Helicobacter pylori. If Helicobacter pylori is positive, treatment targeting Helicobacter pylori is recommended. Regular gastroscopic examinations are necessary, typically every six months to a year.

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Non-atrophic gastritis with focal erosion treatment

Non-atrophic gastritis with erosive lesions, primarily diagnosed through gastroscopic examination that revealed erosive and other changes in the gastric mucosa. If erosion is detected, doctors generally perform a biopsy under gastroscopy to ascertain the nature of the erosion. If the erosion is inflammatory, it can be treated with oral medications, including acid-suppressing and stomach-protective drugs, promoting gastric motility, and protecting the gastric mucosa. If the erosion involves intestinal metaplasia or atypical hyperplasia, it requires endoscopic APC treatment or endoscopic submucosal dissection (ESD) to eliminate the erosive areas, thereby addressing the erosion fundamentally. Additionally, attention should be paid to a light and easily digestible diet.

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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.

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Written by Wu Hai Wu
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What should I do if atrophic gastritis causes severe weight loss?

Patients with atrophic gastritis should be highly attentive if they experience significant weight loss and should receive standardized traditional treatments. Additionally, dietary habits also require careful attention; it is important to quit smoking and drinking alcohol, and to avoid using medications that damage the gastric mucosa, such as nonsteroidal anti-inflammatory drugs and steroids. Furthermore, eating habits should be regular, avoiding binge eating and foods that are too salty, spicy, or that are fried or deep-fried. Active treatment should also be directed against Helicobacter pylori, utilizing medications that protect the gastric mucosa, enhance its resistance to gastric acid, and improve the regenerative ability of gastric mucosal cells. Medications that inhibit bile reflux and improve gastric motility can also be employed.

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Written by Li Ying
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Can chronic atrophic gastritis be cured?

Chronic atrophic gastritis is primarily a chronic digestive system disease caused by atypical hyperplasia. It is mainly characterized by upper abdominal dull pain, bloating, loss of appetite, weight loss, anemia, etc., and lacks specificity. It is a disease caused by multiple pathogenic factors and is a precancerous lesion. There are many causes, including Helicobacter pylori infection and dietary factors, among others. Moreover, treatment for atrophic gastritis can be targeted based on the specific condition, clinical symptoms, and auxiliary examinations.

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Is atrophic gastritis serious?

Chronic atrophic gastritis, compared to chronic non-atrophic gastritis, is relatively more severe. It is usually due to the atrophy of the gastric mucosal glands that this condition occurs. Under gastroscopy, the gastric mucosa can be seen to become pale, and the submucosal blood vessels are easily exposed. Sometimes, the gastric mucosal cells are replaced by intestinal epithelial cells, which is what we refer to as intestinal metaplasia. Some believe that this condition is a precancerous lesion, so it must be given sufficient attention. Firstly, it is necessary to check for Helicobacter pylori infection; if present, comprehensive antibiotic treatment is required. Some believe that if Helicobacter pylori is completely eradicated, partial reversal of gastric mucosal atrophy can happen, and in some cases, it may even return to normal, making the eradication of Helicobacter pylori particularly important. If there is no Helicobacter pylori infection, symptomatic treatment is advocated, such as protecting the gastric mucosa, etc. Additionally, traditional Chinese medicine has relatively better effects in treating atrophic gastritis compared to Western medicine, and further diagnosis and treatment in a traditional Chinese medicine department can be considered. (Note: The use of medications should be under the guidance of a professional doctor.)