eMedicine Specialties > Gastroenterology > Stomach
Gastritis, Atrophic: Follow-up
Updated: Jan 3, 2010
Follow-up
Further Outpatient Care
- Guidelines for follow-up care for cases of atrophic gastritis are not established.
- If the patient was treated for H pylori infection, confirm eradication. Perform evaluation of eradication at least 4 weeks after the end of treatment. Eradication may be assessed by noninvasive methods, such as the urea breath test.
- Follow-up care may be individualized depending on findings during endoscopy. For example, if dysplasia is found at endoscopy, increased surveillance is necessary.
Deterrence/Prevention
- Epidemiologic studies of H pylori- associated chronic gastritis show that acquisition of the infection is associated with large crowded households and lower socioeconomic status.
- Well-defined measures to prevent infection are not established.
Complications
- The multifocal atrophic gastritis that develops in some individuals with H pylori infection is associated with increased risk of the following:
- Gastric ulcers
- Gastric adenocarcinoma
- The corpus-restricted atrophic gastritis that develops in patients with autoimmune gastritis is associated with an increased risk of the following:
- Pernicious anemia
- Gastric polyps
- Gastric adenocarcinoma
Prognosis
- Atrophic gastritis is a progressive condition with increasing loss of gastric glands and replacement by foci of intestinal metaplasia over years.
- Results from studies evaluating the evolution of atrophic gastritis after eradication of H pylori have been conflicting. Follow-up for up to several years after H pylori eradication has not shown regression of gastric atrophy in most studies, while other studies report improvement in the extent of atrophy.
- Whether H pylori eradication in a patient with atrophic gastritis reduces the risk of development of gastric cancer is another important question.
- Available data are limited, but a prospective study in a Japanese population reported that H pylori eradication in patients with endoscopically-resected early gastric cancer resulted in decreased appearance of new early cancers, while intestinal-type gastric cancers developed in the control group without H pylori eradication.
- These findings support an interventional approach, with eradication of H pylori if the organisms are detected in patients with atrophic gastritis, aiming at prevention of development of gastric cancer.
Patient Education
- For excellent patient education resources, visit eMedicine's Esophagus, Stomach, and Intestine Center. Also, see eMedicine's patient education article Gastritis.
More on Gastritis, Atrophic |
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| Treatment & Medication: Gastritis, Atrophic |
Follow-up: Gastritis, Atrophic |
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References
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Further Reading
Related eMedicine Topics
- Achlorhydria
- Gastric Cancer [in the Oncology section]
- Gastritis, Acute
- Gastritis, Chronic
- Helicobacter pylori Infection
- Anti Free Radical & Anti Inflammatory Effect & Safety of Rebamipide in Chronic Gastritis
- Esomeprazole, Moxifloxacin and Amoxicilin for Rescue Therapy of Helicobacter Pylori Infection (ESAMOX)
- Study of the Chinese Prescription Weiqi Decoction on Chronic Atrophic Gastritis
- American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease. American Gastroenterological Association Institute - Medical Specialty Society. 2008 Oct. 14 pages. NGC:006759
- Management of helicobacter pylori infection. Gastroenterological Society of Singapore - Medical Specialty Society; Singapore Ministry of Health - National Government Agency [Non-U.S.]. 2004 Sep. 25 pages. NGC:003916
- Management of oesophageal and gastric cancer. A national clinical guideline. Scottish Intercollegiate Guidelines Network - National Government Agency [Non-U.S.]. 2006 Jun. 69 pages. NGC:005071
- Peptic ulcer disease. University of Michigan Health System - Academic Institution. 1996 Oct (revised 2005 May). 9 pages. NGC:004376
- Quality indicators for esophagogastroduodenoscopy. American College of Gastroenterology - Medical Specialty Society; American Society for Gastrointestinal Endoscopy - Medical Specialty Society. 2006 Apr. 6 pages. NGC:004966
Keywords
atrophic gastritis, chronic gastritis, autoimmune gastritis, Helicobacter pylori, H pylori, type A gastritis, diffuse corporal gastritis, pernicious anemia–associated gastritis, metaplastic gastritis, atrophic pangastritis, progressive intestinalizing pangastritis, environmental atrophic gastritis, multifocal atrophic gastritis, MAG
Follow-up: Gastritis, Atrophic