More and more people find out they have chronic atrophic gastritis when going through health screenings. Doctors say that it can lead to gastric cancer, but it is still very important to understand the whole situation and think about what can be done to avoid it.
From a Normal Stomach to Atrophic Gastritis: The Journey
The stomach is generally exposed to various potential irritants like certain foods, alcohol, drugs, viruses, and bacteria, which may harm the gastric mucosa. As a result, the most common is gastritis, which may be one of the following types:
- Acute Gastritis: The stomach lining is highly capable of regeneration. When the trigger is swiftly removed, the inflammation disappears in a short time along with an immediate alleviation of the symptoms.
- Chronic Superficial Gastritis: Frequent damage eventually becomes repair-resistant, thus chronic gastritis develops, though the mucosa may still be able to recover if the cause is removed.
- Atrophic Gastritis:The situation of deeply penetrating damage to the stomach lining occurs when even the lower layers of the gastric mucosa become affected. To a large extent, the cells in the gastric glands are those that produce hydrochloric acid and enzymes. The mucosa thins and changes structurally, sometimes showing gland metaplasia or atypical cell changes.
Atrophic gastritis symptoms are dull upper abdominal pain, fullness, belching, loss of appetite or weight loss, and anemia, although these signs are not specific.
Intestinal Metaplasia: A Precancerous Change
Intestinal metaplasia is a pathological condition that is most often a finding in gastroscopies and represents a transformation of the gastric mucosa cells to cells with intestinal characteristics. The change is due to the presence of goblet cells and Paneth cells, which produce mucus and bactericidal substances, respectively.
It is not very worrying at the first instance, but extensive or severe intestinal metaplasia should be watched more closely. It can lead to intraepithelial neoplasia—a precancerous lesion with varying malignancy risk depending on the extent.
How Close Is Atrophic Gastritis to Gastric Cancer?
Chronic atrophic gastritis overall prognosis is mostly positive as per long-term investigations; however, the probability of developing cancer goes up with the illness intensity:
- Mild atypical hyperplasia: 3-5% 10-year cancer risk
- Moderate atypical hyperplasia: 4-35% 10-year cancer risk
- Severe atypical hyperplasia: 10-83% annual cancer risk
People suffering from severe atrophic gastritis, moderate to severe intestinal metaplasia or dysplasia, or elevated carcinoembryonic antigen should be under a doctor’s care regularly and undergo gastroscopies every 3-6 months.
Patients operated on for atrophic gastritis must keep away from bile reflux and alkaline stimulants if they want to lower the risk of cancer.
How to Manage and Treat Atrophic Gastritis
At the moment, there is no single medication that can directly stop cancer development from chronic atrophic gastritis. Nevertheless, treatment of the direct causes and the pathological changes will result in lesser progression of the disease:
- Timely Removal of High-Risk Lesions: Minimally invasive, endoscopic methods like Endoscopic Mucosal Resection (EMR) and Endoscopic Submucosal Dissection (ESD) are the best options for turning away the development of precancerous lesions.
- Eradication of Helicobacter pylori: Hp infection is a major factor leading to the inflammation of the stomach and then the risk of cancer. Therefore, getting rid of the bacterium can significantly improve precancerous lesions and help slow down the disease progression, especially in areas that are already at risk.
- Regular Gastroscopy Reviews: Surveillance cannot be skipped as it is very important and review frequency will be decided by severity of atrophy, metaplasia, and dysplasia:
- Mild cases without significant changes: every 1-2 years
- Moderate/severe atrophy or intestinal metaplasia: annually
- Mild dysplasia: every 6 months
- Severe dysplasia: immediate follow-up and possible treatment
- Mild cases without significant changes: every 1-2 years
Conclusion
Chronic atrophic gastritis is one of the most significant precancerous conditions that call for early detection and continuous monitoring. Knowledge of its development and following the doctor’s instructions concerning treatment and check-ups help to avoid gastric cancer, thus managing its prevalence and bettering patient survival.
The article serves as an instrument to make people aware of the risks and remedies related to atrophic gastritis and intestinal metaplasia in order to keep alert and active in self-care.
“Dr. Puneet Girdhar, currently serves as the Director of Orthopedic Spine Surgery at BLK Centre for Orthopaedics, Joint Reconstruction & Spine Surgery at BLK Super Speciality Hospital in New Delhi. With extensive experience, Best Orthopedic surgeon in Delhi, Dr. Girdhar specializes in microendodiscectomies, minimally invasive spinal decompressions and fusions, artificial disc replacements, and deformity correction in the cervical, thoracic, and lumbar spine. He expertly treats a broad range of spinal conditions, including congenital, degenerative, neoplastic, and traumatic.”
