How to treat chronic atrophic gastritis with intestinal metaplasia?

Written by Si Li Li

Gastroenterology

Updated on January 23, 2025

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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.

Other Voices

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Written by Jiang Guo Ming

Gastroenterology

1min 6sec

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What medicine should be taken for atrophic gastritis with erosion?

Chronic atrophic gastritis with erosion requires drug treatment based on the specific symptoms of the patient and whether there is a Helicobacter pylori infection. The infection rate of Helicobacter pylori is very high, often exceeding 50%, so it is also necessary to check for Helicobacter pylori infection in cases of chronic atrophic gastritis. If there is a Helicobacter pylori infection, antibacterial treatment is needed, typically employing a quadruple therapy. If there is no Helicobacter pylori infection, symptomatic treatment is generally used. Common treatments include protecting the gastric mucosa, suppressing gastric acid, and enhancing gastric motility, among others. Additionally, it is important to pay attention to daily diet and lifestyle habits, focusing on light and easy-to-digest foods, and avoiding raw, greasy, spicy, and irritating foods; quitting smoking and drinking can also be helpful. (Specific medication usage should be conducted under the guidance of a doctor.)

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Written by Si Li Li

Gastroenterology

1min 9sec

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Is atrophic gastritis easy to treat?

Atrophic gastritis is a type of chronic gastritis characterized by the atrophy of gastric mucosal glands. It carries a certain risk of becoming cancerous. The main symptoms include upper abdominal pain, postprandial fullness, heartburn, indigestion, belching, and acid reflux. Gastroscope examination reveals atrophy of the gastric glands, and a biopsy is needed for a pathological examination to confirm the diagnosis of chronic atrophic gastritis. In terms of treatment, the first step is to eradicate Helicobacter pylori, which includes a regimen of one proton pump inhibitor, two antibiotics, and one bismuth agent, lasting for 14 days. This is followed by acid suppression and mucosal repair treatments. Additionally, the treatment with traditional Chinese medicine plays a significant role in managing atrophic gastritis. This condition is challenging to treat, has poor outcomes, is prone to relapse, and carries a risk of cancer transformation.

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Written by Wu Hai Wu

Gastroenterology

49sec

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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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Written by Ren Zheng Xin

Gastroenterology

45sec

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What are the symptoms of atrophic gastritis?

Atrophic gastritis, also known as body-type gastritis, is mainly caused by Helicobacter pylori infection leading to atrophy of the gastric mucosa. Under microscopy, twisted blood vessels and alternating red and white mucosa can be seen. The main symptoms include nausea, vomiting, and decreased appetite. A reduction in parietal cells can lead to decreased secretion of intrinsic factor, thereby causing anemia with red blood cells. If atrophic gastritis is accompanied by ulcers, it can cause severe abdominal pain and bloody stools. It is important to adjust the diet, eat more soft and easily digestible foods, and consume fewer raw, cold, and spicy foods.

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Written by Feng Ying Shuai

Traditional Chinese Medicine

1min 7sec

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Where to apply moxibustion for atrophic gastritis?

For some symptoms of atrophic gastritis, moxibustion can be applied, such as on the Zhongwan acupoint located on the Ren meridian, as well as the Xiawan and Liangqiu acupoints. Moxibustion can also be done on the Zusanli acupoint along the stomach meridian, as well as on Neiguan and Gongsun acupoints, which are intersections of the eight meridians and can regulate atrophic gastritis. However, there is a particular method to follow during moxibustion; generally, acupoints on the upper body are treated first, followed by those on the lower body. For instance, start with the acupoints on the abdomen such as Zhongwan, Xiawan, and Liangqiu, followed by Zusanli, and then Gongsun. During moxibustion, the amount of moxa used should increase gradually, and the duration of treatment should extend from short to longer periods, indicating that the treatment period for atrophic gastritis might be longer.