There are many patients with gastric disease who have regular gastroscopy to understand their condition, but when they get the gastroscopy report, they are rather confused. The gastroscopy report will have this diagnosis: chronic superficial gastritis or chronic atrophic gastritis. If you are sloppy, you may only focus on the last two words “gastritis”. This issue of “Stomach Warfare” will specifically discuss gastritis with you, so that you can have a more correct understanding of gastritis. Acute gastritis is an acute inflammation of the gastric mucosa caused by a variety of etiologies, often manifested as acute upper abdominal discomfort, vague pain and other symptoms. Chronic gastritis is a chronic inflammatory or atrophic lesion of the gastric mucosa caused by various etiologies and is very common clinically, accounting for about 80% to 90% of patients undergoing gastroscopy. Today, we are discussing two types of chronic gastritis: chronic superficial gastritis and chronic atrophic gastritis. What are the differences? Atrophic gastritis has a deviated prognosis Chronic superficial gastritis is a chronic superficial inflammation of the gastric mucosa, which is a common disease of the digestive system and is one of the chronic gastritis. Patients may have varying degrees of dyspeptic symptoms, such as epigastric discomfort and vague pain after eating, accompanied by belching, nausea, acidity, and occasionally vomiting. Gastroscopy is the main method to diagnose chronic superficial gastritis. Most chronic superficial gastritis can be completely recovered after several months of treatment. Chronic atrophic gastritis is a chronic digestive disease characterized by atrophy and reduction in the number of epithelium and glands of the gastric mucosa, thinning of the gastric mucosa, thickening of the mucosal base, or with pyloric glandular hyperplasia and intestinal glandular hyperplasia, or with atypical hyperplasia. Atrophic gastritis is far more severe than superficial gastritis in terms of damage and pathological changes, but it is possible that the clinical manifestations of atrophic gastritis are not particularly severe. Some patients may have symptoms such as burning pain, distension, dull pain or fullness in the upper abdomen, constipation or diarrhea. Without gastroscopy and gastric mucosal biopsy, chronic atrophic gastritis is instead easily missed. Compared with superficial gastritis, the prognosis of atrophic gastritis is relatively deviant. Currently, we have good results in reversing atrophy and intestinal epithelial metaplasia in atrophic gastritis with Chinese medicine. How to differentiate? Early detection by biopsy pathology The incidence of atrophic lesions gradually increases with age. It should be reminded that the clinical presentation of atrophic gastritis not only lacks specificity but is not entirely consistent with the extent of the lesion. There is no shortage of such cases in the clinic. The patient’s stomach symptoms are not obvious, slightly uncomfortable and solved by conventional gastric medicine, but a chance gastroscopy, the pathology report shows moderately severe atrophy, moderately severe enterosis with atypical hyperplasia, glandular hyperplasia, etc. To put it nicely, it is atrophic gastritis, but to put it nicely, it is precancerous gastric change. Such a result can be more or less frightening. It is worth emphasizing that the only criterion to distinguish superficial and atrophic gastritis is the biopsy pathology of gastroscopy. On the flip side: after all the hard work of a gastroscopy, if a biopsy is not done, its diagnostic value is greatly diminished. Therefore, we should pay attention to this disease, have various uncomfortable symptoms, gastroscopy and pathological biopsy when conditions allow, in order to early detection and early treatment. Can “atrophy” be reversed? The majority of patients can recover the gastric mucosa Gastritis is not terrible, the terrible thing is the delay in treatment. As a superficial gastritis, purely Western medicine has a relatively good effect, but for atrophic gastritis, Western medicine does not have a particularly good treatment. Some doctors will tell patients that the gastric mucosa is like hair, can it grow back when the hair is lost in old age? In fact, this view is worthy of speculation. This is confirmed by the “gold standard” of biopsy.