eMedicine Specialties > Gastroenterology > Stomach

Gastritis, Atrophic: Follow-up

Author: Antonia R Sepulveda, MD, PhD, Associate Professor of Pathology, University of Pennsylvania School of Medicine; Director of Surgical Pathology, Director of Surgical Pathology Fellowship, Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
Contributor Information and Disclosures

Updated: Mar 22, 2006

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

  • Epidemiological 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

 


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References
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References

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Further Reading

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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

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Contributor Information and Disclosures

Author

Antonia R Sepulveda, MD, PhD, Associate Professor of Pathology, University of Pennsylvania School of Medicine; Director of Surgical Pathology, Director of Surgical Pathology Fellowship, Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania
Antonia R Sepulveda, MD, PhD is a member of the following medical societies: American Association for Cancer Research, American Cancer Society, American Gastroenterological Association, American Society for Investigative Pathology, College of American Pathologists, and United States and Canadian Academy of Pathology
Disclosure: Nothing to disclose.

Medical Editor

Gregory William Rutecki, MD, Associate Professor, Program Director, Department of Internal Medicine, Feinberg School of Medicine, Northwestern University
Gregory William Rutecki, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Society of Nephrology, National Kidney Foundation, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Simmy Bank, MD, Chair, Professor, Department of Internal Medicine, Division of Gastroenterology, Long Island Jewish Hospital, Albert Einstein College of Medicine
Disclosure: Nothing to disclose.

CME Editor

Alex J Mechaber, MD, FACP, Assistant Dean for Medical Curriculum, Associate Professor of Medicine, Division of General Internal Medicine, University of Miami Miller School of Medicine
Alex J Mechaber, MD, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Chief Editor

Julian Katz, MD, Clinical Professor of Medicine, Drexel University College of Medicine; Consulting Staff, Department of Medicine, Section of Gastroenterology and Hepatology, Hospital of the Medical College of Pennsylvania
Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law Medicine and Ethics, American Trauma Society, Association of American Medical Colleges, and Physicians for Social Responsibility
Disclosure: Nothing to disclose.

 
 
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