Atrophic gastritis with atypical hyperplasia

The emergence of atypical hyperplasia in atrophic gastritis has always been a big problem that has troubled us. Although everyone's living standards are gradually improving, people are paying less and less attention to their physical health. Whether in daily work or life, they are madly consuming our bodies, which eventually leads to damage to the body little by little, causing unnecessary troubles and complications. We must have a correct understanding and choose appropriate methods of treatment.

Atrophic gastritis with atypical hyperplasia

Gastric disease has always been a major problem that has troubled us. With the improvement of living standards, people pay more and more attention to their physical health. However, many people do not have enough knowledge about stomach diseases, and there are still major misunderstandings in diagnosis, treatment, conditioning and prognosis, especially chronic atrophic gastritis, which causes unnecessary anxiety and fear.

Chronic atrophic gastritis is a common stomach disease. It is a disease in which the gastric mucosal epithelium is repeatedly damaged, leading to atrophy and disappearance of the mucosal glands. It is a type of chronic gastritis. There are many causes, mainly caused by Helicobacter pylori infection, long-term stomach-damaging drugs, chronic infection foci in the mouth, nasopharynx, excessive drinking, bile reflux, etc. Atrophic gastritis of the gastric body is related to autoimmune damage. Persistent inflammation can cause glandular atrophy and intestinal metaplasia. With the widespread development of gastroscopy, the detection rate of atrophic gastritis has greatly increased and increases with age. Atrophic gastritis is considered to be a precancerous lesion of gastric cancer. How to treat atrophic gastritis? Patients with chronic atrophic gastritis will have upper abdominal fullness, discomfort or pain, which is more obvious after meals, accompanied by other indigestion symptoms such as belching, acid reflux, nausea, vomiting, loss of appetite, etc. Gastroscopy and pathological examination can confirm the diagnosis, and pathological results are the gold standard for diagnosis. Western medicine has no specific treatment for this disease and mostly uses symptomatic treatment, but it cannot improve atrophic lesions. Traditional Chinese medicine is currently the most effective treatment for atrophic gastritis. It generally combines syndrome differentiation with disease differentiation and can achieve a reversal effect on some atrophic gastritis. Atrophic gastritis is one of the specialty diseases treated with traditional Chinese medicine in our department.

1. Correctly understand chronic atrophic gastritis

Chronic atrophic gastritis can be divided into three types based on pathology: glandular atrophy, intestinal metaplasia and atypical hyperplasia (abnormal hyperplasia). The severity of the disease can be divided into mild, moderate and severe. Most data show that mild and moderate atrophy is reversible, while severe atrophy is less reversible. What is intestinal metaplasia? Under normal circumstances, there is no intestinal epithelium in the gastric mucosal glands. The more severe the atrophy, the more intestinal metaplasia appears. It was previously believed that intestinal metaplasia was irreversible, but it has been found that intestinal metaplasia can disappear by removing the cause and treating it. So you don’t have to be too nervous if you have intestinal metaplasia. At the same time, I want to tell you that intestinal metaplasia is not a precancerous lesion. Some scholars followed up patients with gastric intestinal metaplasia for 10 years and found that the cancer rate was only 1.9%.

From a pathological point of view, cancerous cells are the gastric mucosal cells that evolve from normal-aging-hyperplasia-atypical hyperplasia-cancer, but this process is long and does not happen in one or two years. Therefore, if you have chronic atrophic gastritis, you should not be overly afraid and think that you are about to develop gastric cancer. Mild atrophic gastritis is common among the elderly and does not require daily medication. It is just a sign of aging, just like wrinkles on your face. The chance of developing cancer is also small, so elderly patients should live an optimistic life.

Gastric precancerous lesions are not scary, but it takes a long time for intestinal metaplasia and dysplasia to develop into gastric cancer. Approximately no more than 5% of patients will develop gastric cancer. 5% is a statistically low probability event and can be considered to be very unlikely. Therefore, we have reason to believe that as long as they are handled properly, intestinal metaplasia and dysplasia are safe and do not need to cause excessive anxiety and worry. Patients with atypical hyperplasia should be careful. First, ask the doctor to analyze whether there may be a lesion but it has not been biopsied (this is very common in clinical practice and is not the doctor's error). If so, a gastroscopy and biopsy are required. If a lesion is found but difficult to see clearly, staining + magnifying endoscopy is required. If cancer is suspected, an ultrasonic endoscopic examination is required first to determine the depth of the lesion and see if it can be treated under endoscopy.