Non-atrophic gastritis with focal erosion treatment

Written by Si Li Li
Gastroenterology
Updated on February 18, 2025
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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 the cancerous transformation of atrophic gastritis related to the duration of the disease?

The carcinogenesis of atrophic gastritis does not have a significant relationship with the duration of the disease. The main cause of atrophic gastritis is Helicobacter pylori infection, with autoimmune abnormalities and genetic factors also playing a significant role in atrophic gastritis. Sometimes, patients with a short duration of atrophic gastritis may also develop cancer, while those who have had the disease for many years may not necessarily develop cancer. Therefore, once atrophic gastritis is diagnosed, it is important to regularly re-examine with gastroscopy to rule out the possibility of early malignancy.

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How to treat chronic non-atrophic gastritis with bile reflux?

For cases of chronic non-atrophic gastritis with bile reflux, it is first necessary to clarify whether there is a Helicobacter pylori infection, which can be determined by a breath test. Based on this, regular visits to the department of gastroenterology for diagnostics and treatment can be established. Firstly, it is important to take oral medication to protect the gastric mucosa and then to promote gastrointestinal motility. Regular follow-ups are very important. Generally, for patients with non-atrophic gastritis and bile reflux, it depends on whether the condition is high or low. For those in the high category, it is necessary to undergo a gastroscopy every six months.

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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.

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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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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.)