Chronic atrophic gastritis is a common digestive system disease characterized by atrophy of the inherent glands of the gastric mucosa, accounting for 10 to 20% of chronic gastritis cases. The disease is more common in middle-aged and elderly people, and the incidence rate increases with age. Gastroscopy and gastric mucosal biopsy are the most reliable diagnostic methods.

Chronic atrophic gastritis refers to chronic gastritis in which the gastric mucosa has undergone atrophic changes. It can be divided into two categories: multifocal atrophic gastritis and autoimmune gastritis. The former atrophic changes show multifocal atrophy in the stomach, mainly in the gastric antrum, and are mostly developed from chronic non-atrophic gastritis caused by Helicobacter pylori infection. The latter atrophic changes are mainly in the gastric body and are mostly caused by autoimmune diseases. Caused by the development of gastritis in the body of the stomach.

Under gastroscopy, the normal gastric mucosal surface is smooth, covered with mucus, and has rich folds, which is generally pink. Endoscopy in patients with typical atrophic gastritis can reveal that the color of the gastric mucosa becomes lighter, the mucosa becomes thinner, the mucosal folds are reduced or disappeared, the submucosal blood vessels are transparent, and the surface is rough, granular or nodular.

Symptoms of chronic atrophic gastritis:

Some friends believe that atrophic gastritis is a serious stomach disease and will naturally cause obvious symptoms of discomfort. In fact, this is not the case. The symptoms of atrophic gastritis are non-specific, and some patients even have no obvious complaints. Common symptoms are mainly dull pain and indigestion, such as fullness, discomfort or pain in the upper abdomen, which is more obvious after meals, belching, acid reflux, nausea, vomiting, loss of appetite and other indigestion symptoms.

The diagnosis of chronic atrophic gastritis mainly relies on gastroscopy. Whether you have atrophic gastritis cannot be judged by symptoms. The patient's symptoms are not directly proportional to the gastroscopy findings and pathological results. In other words, patients with no obvious symptoms may suffer from more severe atrophic gastritis; conversely, patients with obvious symptoms of discomfort may not have gastric mucosal atrophy. Diseases are complex and require comprehensive diagnosis and treatment.

Chronic atrophic gastritis does not mean cancer

Chronic atrophic gastritis is a precancerous disease of gastric cancer. Chronic atrophic gastritis is a cancer if it is accompanied by intestinal metaplasia or dysplasia. Before lesions, the two concepts are different. Although atrophic lesions are common in the mucosa surrounding gastric cancer, there is no conclusion that chronic atrophic gastritis will inevitably develop into gastric cancer.

Whether chronic atrophic gastritis will develop into precancerous lesions or cancerous lesions in the future should be analyzed based on the degree of atrophy of the lesions and the specific situation, and cannot be generalized. The current common knowledge in the medical community is that although chronic atrophic gastritis can become cancerous, the canceration rate is very low (most studies have found that the canceration rate does not exceed 3), so it cannot be generally said that chronic atrophic gastritis is the precursor and prelude to gastric cancer. The two cannot be equated.

In recent years, domestic and foreign scholars have done a lot of research on the relationship between chronic atrophic gastritis, Helicobacter pylori, and gastric cancer. They found that among people in areas with a high incidence of gastric cancer, the incidence of atrophic gastritis is high, but it is also related to Helicobacter pylori. It is related to the high incidence of bacteria. People do not need to strictly distinguish whether it is Helicobacter pylori or atrophic gastritis that can easily cause gastric cancer. Both often coexist and jointly lead to dysplasia of the gastric mucosa. The treatment of Helicobacter pylori itself is also a treatment. Aspects of atrophic gastritis.

Chronic atrophic gastritis must be reviewed regularly

Although the cancer rate of chronic atrophic gastritis is very low, they are not unrelated. Gastric cancer is caused by intestinal metaplasia of atrophic gastritis. and dysplasia developed step by step. In order to minimize the possibility of cancer, standardized treatment and review are needed, so active prevention and treatment is still necessary and appropriate.

Patients with chronic atrophic gastritis accompanied by incomplete colonic intestinal metaplasia should pay attention and should take regular follow-up precautions. In order to monitor the dynamic changes of lesions, gastroscopy should be reviewed regularly. For general chronic atrophic gastritis (without significant intestinal metaplasia and atypical hyperplasia), reexamination should be performed once every 3 years; for incomplete colonic intestinal metaplasia with mild atypical hyperplasia, reexamination should be performed once a year; for patients with moderate atypical hyperplasia, reexamination should be Patients with atypical hyperplasia should be treated once every 3 months; patients with severe atypical hyperplasia should be regarded as cancerous, and local disease tissue resection or surgical resection can be considered to avoid future problems.

Treatment of chronic atrophic gastritis:

1. Anti-Helicobacter pylori treatment: Helicobacter pylori parasitizes in the gastric epithelium, secretes toxins, damages gastric epithelial cells, and a series of secondary effects. Ultimately leading to the occurrence of atrophic gastritis. A large part of atrophic gastritis in my country is aggravated or induced by Helicobacter pylori infection. Therefore, the treatment of atrophic gastritis should first carry out anti-Helicobacter pylori treatment. In addition, the radical cure of Helicobacter pylori is also helpful in preventing gastric cancer. positive effect.

2. General treatment: including quitting smoking, avoiding alcohol, avoiding salty, spicy, overheated, strong tea, coffee, and eating more fresh vegetables and fruits. Prevent and treat Helicobacter pylori infection, standardize antibacterial treatment, and review. Establish good hygiene habits, share meals, disinfect tableware, and treat family members together, etc.

3. Standardized treatment of chronic atrophic gastritis: Some people think that atrophic gastritis is stubborn and difficult to cure. In fact, poor curative effect depends on whether the treatment is standardized. Blind treatment: There are two types of chronic atrophic gastritis, one is related to autoimmunity, and the other is related to Helicobacter pylori infection, tobacco and alcohol stimulation, reflux gastritis, etc. If the cause is not identified, the treatment will lack pertinence. , better therapeutic effect cannot be achieved. Failure to adhere to treatment: Some symptoms of atrophic gastritis are not obvious. After taking medicine, the symptoms are relieved, and the vigilance is relaxed mentally. The patient still smokes and drinks alcohol. As a result, the atrophic gastritis comes back, and even gradually worsens. Eventually, the gastritis remains unchanged every time the gastroscopy is reviewed. It's atrophic gastritis.

4. The earlier the treatment of chronic atrophic gastritis, the better: The sooner atrophic gastritis is discovered, the better the treatment effect. If you do not insist on treatment or review, you will have to wait until intestinal metaplasia and incontinence appear. Isn’t it deceiving oneself and others to only pay attention to typical hyperplasia? You must know that most mild and moderate atrophic gastritis are reversible after treatment, while the reversibility of severe atrophic gastritis is very small.

Not so. Most superficial gastritis can be fully recovered and will not develop into atrophic gastritis after treatment or nursing care with quadruple drugs and Vilexu. Individually, it is an early manifestation of atrophic gastritis. It is difficult to recover from atrophic gastritis, but it can be slowly recovered by taking Vexu. Therefore, superficial gastritis should be treated actively.

First of all, let me make it clear that I am not a traditional Chinese medicine practitioner, I am a traditional Chinese medicine enthusiast, and I only represent my personal views. Chronic gastritis refers to stomach yin deficiency and yang hyperactivity caused by various reasons (improper diet, emotional injury, invasion of external evils, etc.). Over a long period of time, the spleen and stomach cannot absorb rotten gas and transform it normally, and the stomach itself cannot receive normal support. The disease is atrophic gastritis.

If chronic gastritis cannot be treated promptly and correctly, chronic gastritis can persist. People with H.pylori-related antral gastritis are prone to duodenal ulcers, and patients with multifocal atrophy are prone to gastric ulcers. , People with atrophic gastritis accompanied by intestinal metaplasia or dysplasia have an increased risk of gastric cancer.

Guidance: Although the change of gastritis is relatively slow, if it is not treated, it is still very likely to develop in a bad direction. It is recommended to seek regular hospital treatment as soon as possible. Patients should develop good eating habits, eat small meals frequently, and avoid spicy and irritating foods. It is necessary to take medicine on time, seek medical advice promptly if adverse reactions occur, and engage in appropriate exercise, but overexertion should be avoided.

40-year-old Mr. Zhang usually loves to eat pickles and sauerkraut. Recently, he always felt uncomfortable in his stomach. He went to the hospital for a gastroscopy and found that he had "atrophic gastritis." Does "gastric atrophy" mean that the condition is serious? Mr. Zhang was very anxious about this.

Expert interpretation: Atrophic gastritis is a type of chronic gastritis and is also a common and frequently-occurring disease. After the gastric mucosa is damaged by various reasons, if it does not heal for a long time or has repeated attacks, it can evolve into chronic gastritis, and then atrophy and other changes may occur. When inflammation involves the glands deep in the mucosa and causes atrophy, sometimes accompanied by dysplasia, "gastric atrophy" truly occurs. This kind of gastric disease is closely related to bad living habits.

Five questions to the experts

1. What factors in life can cause "gastric atrophy"?

There are many causes of this disease, including Helicobacter pylori infection, gastric acid irritation, overeating of irritating foods or drugs, reflux of bile and duodenal fluid, immune disorders, gastric mucosal barrier changes and other factors. Overeating pickles is one of the important causes of atrophic gastritis. Of course, if you find stomach discomfort and treat it promptly, it will not cause the stomach to "atrophy".

2. What symptoms may warn of "gastric atrophy"?

Atrophic gastritis has many clinical symptoms, the main manifestations of which are loss of appetite, nausea, gas, upper abdominal fullness or dull pain. A few patients may develop upper gastrointestinal bleeding, weight loss, anemia, etc.

3. What kind of diet should be controlled to prevent "gastric atrophy"?

Avoid pickled, smoked, grilled, moldy foods and rough, raw, cold or overheated foods. Avoid spicy, sour, salty and other irritating foods that are too strong. If you are sick, the diet should be soft and easy to digest. Chew carefully and slowly.

4. Is there anything else that needs attention in daily life?

You should quit smoking and drinking, maintain an optimistic attitude, balance work and rest with work or study, and exercise more to enhance your physical fitness.

5. Is it easy for patients with atrophic gastritis to turn into cancer?

Suffering from atrophic gastritis does not necessarily lead to gastric cancer. Only a small number of people with chronic atrophic gastritis turn into gastric cancer. However, patients with chronic atrophic gastritis accompanied by dysplasia should be vigilant.

In the development process of chronic gastritis, various factors such as life, diet, work pressure, living environment, and drug treatment plans will have different development processes for chronic gastritis. If people are concerned about their own If the various influencing factors are well adjusted, the symptoms of chronic gastritis will improve or be effectively controlled. On the contrary, chronic gastritis may develop in an unfavorable direction. Therefore, each of us must have a certain standard in our life, diet, work, etc. Establishing good personal habits is a prerequisite for eliminating diseases.

Non-disease factors have been explained above. However, these factors may not seem to have much to do with the disease, but they can affect the course of the disease. We cannot ignore the existence of this problem.

Under normal gastroscopy, the gastric mucosa has a smooth surface, is covered with mucus, has abundant folds, and is mostly pink. Atrophic gastritis is just a branch of chronic gastritis that progresses in an unfavorable direction. Chronic gastritis is mainly characterized by congestion and edema on the surface of the gastric mucosa, while atrophic gastritis is mainly characterized by atrophy of the gastric mucosal glands (i.e., atrophy of the proper gastric glands), and the color of the gastric mucosa. The disease becomes lighter, thinner, the mucosal folds are reduced or even absent, and the surface is rough, unequal and irregular. This disease is more common in middle-aged and elderly people.

When we have chronic gastritis, there is a problem with the infectious bacteria or immune system in the body. At this time, the stomach is not affected by non-disease factors (life or work stress, age, diet, etc.) Under good control, the structure of the stomach will gradually change, affecting the physiological functions of the stomach, resulting in insufficient blood supply and nutrition, plus the invasion of Helicobacter pylori in the body or the immune system being on strike. Directions for a wasting disease. Authoritative interpretation of Yaoshi.com, no reproduction without authorization, plagiarism will be investigated.

Chronic non-atrophic gastritis may develop into chronic atrophic gastritis if not treated in time. Chronic atrophic gastritis mostly results from delayed or delayed treatment of chronic non-atrophic gastritis. In this case, you must follow the doctor's advice and start systematic and standardized treatment as soon as possible. Prevent further progression of the disease.

Why does chronic gastritis develop into atrophic gastritis?

If you think about it carefully, why do you need to change your toothbrush every few months? It’s not because we keep using it. The same is true for gastritis. Atrophic gastritis is a disease with multiple pathogenic factors, but To sum up the reasons, they are just these:

So in the final analysis, you still don’t take good care of your stomach enough. Now that it is clear why the disease occurs, the direction of treatment is also clear.

The above are my suggestions for patients with atrophic gastritis. They are also suggestions for friends who do not have gastritis. Take care of your stomach, okay?

Any inflammation that occurs in the human body without timely treatment and intervention and persists for a long time will stimulate irreversible pathological changes in tissues and organs, such as atrophy, proliferation, and even canceration. Non-atrophic gastritis is no exception, and changes such as atrophy or dysplasia are also inevitable results.

Chronic non-atrophic gastritis (erosive gastritis) is a chronic inflammation that occurs when Helicobacter pylori is not cleared in time or factors such as persistent bile reflux stimulate and damage the gastric mucosa for a long time, leading to atrophy of gastric mucosal glands. , continued development will cause gastric mucosal epithelial cells to undergo intestinal epithelial or pyloric gland epithelial metaplasia, dysplasia, intraepithelial neoplasia and other serious conditions.

Therefore, when chronic non-atrophic gastritis occurs, we should actively target Helicobacter pylori infection, bile reflux and other pathogenic factors, carry out treatment to kill Helicobacter pylori, control bile reflux, and On this basis, continue to take omeprazole acid suppressants, gastric mucosal protective agents such as bismuth pectin, potassium bismuth citrate, aluminum magnesium carbonate granules, and gastric motility drugs such as mosapride.

In addition, you should pay attention to avoid taking antipyretic analgesics, glucocorticoids and other drugs that damage the gastric mucosa in your daily diet and life, quit smoking and drinking, and eat less cold, spicy, and greasy foods. , can reduce the risk of long-term recurrence of non-atrophic gastritis turning into atrophic gastritis.

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The structure of the gastric wall from outside to inside is the mucosa layer, submucosa layer, muscular layer and serosal layer. The epithelial tissue of the gastric mucosa is composed of columnar epithelial cells. The epithelial tissue sinks deep into the mucosa to form a large number of secretory glands. Under normal circumstances, these glands secrete gastric acid, pepsinogen, mucus, bicarbonate, and intrinsic factor, which are important for entering the stomach. The food inside is digested to form chyme.

After chronic inflammation of the gastric mucosa, the epithelial tissue of the gastric mucosa will be damaged repeatedly over time under the long-term action of Helicobacter pylori, bile reflux, gastric acid and other irritating factors. The specific regeneration and repair ability of the mucosa leads to structural changes such as flattening or disappearance of gastric mucosal folds and thinning of the gastric mucosa, eventually leading to irreversible atrophy or even disappearance of the inherent glands of the gastric mucosa. This is how chronic non-atrophic rhinitis evolves into chronic atrophic rhinitis. The process of gastritis.

In general, chronic atrophic gastritis is caused by repeated attacks of non-atrophic gastritis caused by Helicobacter pylori infection, bile reflux, taking non-steroidal anti-inflammatory drugs and poor eating habits. Therefore, in the treatment of chronic non-atrophic gastritis, eliminating bad eating habits, killing pyloric helix, inhibiting bile reflux and other causes are the key to cure, and are also effective measures to prevent the development of atrophic gastritis.

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