Overview
Atrophic gastritis is a chronic condition characterized by the thinning and loss of gastric glandular cells, often associated with chronic Helicobacter pylori infection or autoimmune processes, leading to impaired gastric function and increased risk of gastric neoplasia 3.Diagnosis
Endoscopic evaluation: Identification of atrophy and intestinal metaplasia 3.
Biopsy analysis: Histopathological assessment for atrophy grading and presence of Helicobacter pylori 3.
Serological tests: For Helicobacter pylori infection 3.
Parietal cell antibodies: To differentiate autoimmune gastritis 3.
Gastric juice analysis: Measuring pepsinogen levels for diagnosing atrophic gastritis 3.Management
Antibiotic therapy for H. pylori: Eradication treatment if H. pylori infection is present 3.
Traditional Chinese Patent Medicines (TCPM): Used adjunctively with conventional treatments; Wei... (specific TCPM not fully detailed) 1.
Symptomatic relief: Medications like Weierkang pills for symptom improvement (e.g., reducing Kyoto risk score and atrophy score) 2.
Nutritional support: Supplementation with vitamin B-12 in patients with hypochlorhydria due to atrophic gastritis 4.Special Populations
Elderly: Increased risk of vitamin B-12 deficiency due to hypochlorhydria; fortified foods may be beneficial 4.Key Recommendations
Diagnose atrophic gastritis using endoscopic findings and biopsy analysis to assess atrophy and metaplasia (Evidence: Strong 3).
Consider Helicobacter pylori eradication therapy in patients with H. pylori infection to halt progression 3.
Monitor and supplement vitamin B-12 in elderly patients with atrophic gastritis to prevent deficiency 4.
Evaluate adjunctive use of Traditional Chinese Patent Medicines in combination with conventional treatments for symptom management and efficacy (Evidence: Moderate 12).References
1 Ren B, Zhong M, Yu C, Xiong M, Zhou S, Gao Q et al.. Unveiling the therapeutic effects of traditional Chinese patent medicines: A network meta-analysis on chronic atrophic gastritis. Medicine 2025. link
2 Chen X, Shen K, Deng Y, Mo J, Ni J, Hendi M et al.. A Randomized Double-blind Clinical Trial of Weierkang Pills for the Treatment of Chronic Atrophic Gastritis. Journal of clinical gastroenterology 2023. link
3 Shah SC, Piazuelo MB, Kuipers EJ, Li D. AGA Clinical Practice Update on the Diagnosis and Management of Atrophic Gastritis: Expert Review. Gastroenterology 2021. link
4 Porter KM, Hoey L, Hughes CF, Ward M, Clements M, Strain J et al.. Associations of atrophic gastritis and proton-pump inhibitor drug use with vitamin B-12 status, and the impact of fortified foods, in older adults. The American journal of clinical nutrition 2021. link