Monitoring

American College of Gastroenterology guidelines now recommend that whenever Helicobacter pylori infection is identified and treated, eradication testing is offered to the patient. Testing for eradication of H pylorimay be performed using urea breath test, fecal antigen test, or biopsy-based testing.[4] One study has demonstrated that serological biomarkers such as pepsinogens I and II, gastrin-17, and H pylori IgA/IgG antibodies (markers of gastric mucosal status) show a high degree of accuracy as a non-invasive method to diagnose corpus atrophy, a common occurrence in the general population, although the clinical role of these markers is unclear at present.[89][90]

Patients with non-steroidal anti-inflammatory drug (NSAID)/alcohol-associated erosive gastritis refractory to symptomatic therapy may require a follow-up endoscopy with biopsy.[35]

Patients with diffuse atrophic gastritis and vitamin B₁₂ deficiency should have close follow-up with tests for serum vitamin B₁₂ levels, methylmalonic acid levels, or homocysteine levels to determine response to treatment.[25]

The risk of gastric adenocarcinoma and carcinoid tumours with atrophic gastritis and/or autoimmune gastritis is uncertain; however, atrophic pangastritis, severe intestinal metaplasia of the body of the stomach, and age >50 years all increase the risk for developing gastric neoplastic lesions in patients with atrophic gastritis.[91]

Use of this content is subject to our disclaimer