Overview
Chronic gastritis is a prevalent condition characterized by persistent inflammation of the gastric mucosa, often linked to Helicobacter pylori infection and potentially progressing to gastric cancer if untreated 1.Diagnosis
Histological Examination: Essential for diagnosing chronic gastritis, often revealing chronic inflammatory changes 1.
Helicobacter pylori Testing: Recommended through biopsy culture or rapid urease tests to identify H. pylori infection, correlating well with histological findings 2.
Endoscopic Assessment: Visual inspection for mucosal changes can support the diagnosis 1.Management
First-Line Treatment: Triple therapy including a proton pump inhibitor (PPI) combined with two antibiotics (e.g., amoxicillin, clarithromycin) for 7-14 days 1.
Adjunctive Treatments: Quadruple therapy may be considered in regions with high antibiotic resistance, adding a bismuth compound to the regimen 1.
Follow-Up: Post-treatment testing for H. pylori eradication (urea breath test or stool antigen test) is crucial to assess treatment efficacy 1.Special Populations
Pregnancy: Management should avoid certain antibiotics; consult specific guidelines for safe alternatives 1.
Elderly: Consider potential drug interactions and renal function when selecting PPIs and antibiotics 1.Key Recommendations
Standardize diagnosis and treatment protocols for chronic gastritis based on national conditions and international guidelines (Evidence: Strong 1).
Use biopsy culture and histological examination for accurate diagnosis and correlation with H. pylori infection (Evidence: Moderate 2).
Implement triple therapy as first-line treatment for H. pylori eradication, adjusting based on local resistance patterns (Evidence: Moderate 1).References
1 . Guidelines for diagnosis and treatment of chronic gastritis in China (2022, Shanghai). Journal of digestive diseases 2023. link
2 Mahmood K, Chowdhury MN, Ayoola EA, Mofleh IA, Rashed RS, Faleh FZ. Helicobacter pylori; histological and cultural correlation in chronic gastritis. Tropical gastroenterology : official journal of the Digestive Diseases Foundation 1991. link