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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What is the cause of recurrent atrophic gastritis?

Recurrent atrophic gastritis is likely caused by Helicobacter pylori infection. When atrophic gastritis recurs, a Carbon-13 urea breath test or Carbon-14 urea breath test should be conducted to detect whether there is an infection of Helicobacter pylori. If the test is positive, a two-week quadruple therapy containing a bismuth agent should be used to eradicate Helicobacter pylori. Consider using a proton pump inhibitor, such as omeprazole or lansoprazole, combined with two of the antibiotics amoxicillin, clarithromycin, metronidazole, and furazolidone, as well as bismuth citrate, to form the quadruple therapy. (Please use medication under the guidance of a doctor.)

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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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Written by Wu Peng
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Chronic atrophic gastritis is what kind of condition?

Chronic atrophic gastritis is a digestive system disease characterized by atrophy of the intrinsic gastric glands. It is commonly seen in middle-aged and elderly people. Clinically, it mainly manifests as loss of appetite, nausea, belching, heartburn, and continuous or intermittent bloating and dull pain in the upper abdomen. A minority of patients may experience upper gastrointestinal bleeding, weight loss, anemia, and malnutrition, with incidence rates increasing significantly with age. Chronic atrophic gastritis can be divided into autoimmune gastritis and multifocal atrophic gastritis, also referred to as Type A gastritis and Type B gastritis, respectively. Gastric mucosal biopsy is a reliable method for its diagnosis.

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Chronic non-atrophic gastritis with bile reflux treatment

Chronic non-atrophic gastritis with bile reflux is mainly characterized by symptoms such as upper abdominal distension, belching, acid reflux, nausea, vomiting, poor appetite, and indigestion. A diagnosis can be made if bile reflux into the stomach or bile patches on the stomach wall are observed during gastroscopy. A Carbon-14 breath test is also necessary to determine the presence of Helicobacter pylori infection. If the infection test is positive, a 14-day anti-Helicobacter pylori treatment is required. Additionally, treatment for chronic non-atrophic gastritis with bile reflux should include acid suppression, gastric protection, and promotion of gastric motility to protect the gastric mucosa, with a treatment duration of about four to six weeks. Bile reflux-associated chronic gastritis is primarily caused by poor gastric motility, thus increasing physical exercise is recommended as it can enhance gastric motility and improve the condition.

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Difference between atrophic gastritis and non-atrophic gastritis

Chronic gastritis includes two types: chronic non-atrophic gastritis and chronic atrophic gastritis. The symptoms of both can be similar, such as upper abdominal pain, bloating, nausea, vomiting, acid reflux, and heartburn. Chronic atrophic gastritis tends to be more severe than non-atrophic gastritis. Over the long term, atrophic gastritis may lead to symptoms like fatigue, weight loss, loss of appetite, and even anemia. The main differentiation still requires gastroscopy and pathological examination. Under gastroscopy, chronic superficial gastritis mainly shows mucosal congestion and edema. In atrophic gastritis, due to gland atrophy, the submucosal blood vessels may appear as a net-like or petal-like pattern, and sometimes the mucosa may become granular. Pathological examinations can further clarify the diagnosis.