Severe atrophic gastritis with intestinal metaplasia usually does not affect life expectancy, and with active treatment, a normal life expectancy can be achieved; however, if not actively treated, life expectancy may be affected. Severe atrophic gastritis, indicating that there may be a whole stomach atrophy, must actively cooperate with the doctor for treatment, otherwise it is prone to serious complications, such as gastric cancer, and once transformed into gastric cancer, it may have an impact on life expectancy. Severe atrophic gastritis with intestinal metaplasia, first of all, pay attention to dietary adjustments, do not eat spicy and stimulating food, light and easy to digest food, and eradicate Helicobacter pylori, the main four combination therapy, that is, a proton pump inhibitor, a bismuth and two antibiotic drugs, such as omeprazole, colloidal bismuth pectin, roxithromycin, amoxicillin, and so on. The above drugs are administered with care, and are forbidden to be taken by those who are allergic to the components of the drugs. Severe atrophic gastritis with intestinal metaplasia should be timely consultation, with the doctor’s medication to avoid aggravation of the condition. Drugs need to be under the guidance of a doctor.