Patients with chronic epigastric pain or epigastric fullness and discomfort are often diagnosed with “chronic gastritis” at the time of consultation, but in fact these cases may be true chronic gastritis or functional dyspepsia, gastroesophageal reflux disease, chronic biliary and pancreatic disease, chronic cardiopulmonary disease or costochondritis, among which chronic gastritis and functional dyspepsia are the two Chronic gastritis and functional dyspepsia are the most difficult to distinguish. Chronic gastritis is an organic lesion of the stomach, which means that the stomach does have lesions, often manifesting as mucosal erosion or atrophy, and is diagnosed by gastroscopy as “chronic superficial gastritis”, “erosive gastritis” or “atrophic gastritis”. Gastroscopy is usually diagnosed as “chronic superficial gastritis”, “erosive gastritis” or “atrophic gastritis”, the cause of which is mostly due to Helicobacter pylori infection; while functional dyspepsia, in which the stomach is not really diseased, is often due to “gastric gas”, the gastroscopy is usually gastric mucosal congestion and edema, also mostly diagnosed as “chronic superficial gastritis “The cause is mostly related to abnormal gastric sensory function, gastric dysfunction, gastrointestinal reflux, psycho-spiritual factors, gastric mucosal inflammation, visceral allergy, and vagal hypotonia. Many patients go around to see a doctor, probably due to gastric discomfort caused by over-sensitivity. Clinical manifestations are different Chronic gastritis and functional dyspepsia can both manifest as vague pain and discomfort in the upper abdomen (at the heart fossa), burning sensation, early satiety or postprandial fullness, and often pressure pain at the heart fossa. It is difficult to distinguish the two from each other symptomatically. But gastroscopy and endoscopic pathological biopsy histological examination is different: functional dyspepsia generally only gastric mucosa congestion edema, pathological biopsy mucosa often only lymphocytic infiltration, manifesting as chronic inflammation of the gastric mucosa; while chronic gastritis gastroscopy often have erosive lesions, or mucosal thinning, nodular uneven, pathological biopsy mucosa often neutrophil infiltration, manifesting as chronic mucositis with acute inflammation or active inflammation The mucosa is often infiltrated with neutrophils and shows chronic mucositis with acute inflammation or active inflammation. Treatment differs The upper abdominal discomfort caused by functional dyspepsia, the stomach is not really sick, but the patient feels uncomfortable, hypersensitive or the stomach is too delicate, in fact, there is no obvious lesion on examination, so the treatment is symptomatic and individualized. Medication should be given on a case-by-case basis, and patients are mostly treated on an outpatient basis. Emphasis needs to be placed on explaining the condition to the patient to avoid aggravating the condition with tension and apprehension. It is recommended to avoid smoking, alcohol or spicy stimulating foods and to eat less and more often. Psychological and behavioral treatment can be given to those who have obvious mental factors. If you always suspect that you have a disease, you can also find an authoritative hospital and an authoritative physician to make a comprehensive judgment, and you should be assured that there is no serious problem, and you can work and live normally. It is also possible to reduce the patient’s concern about his or her symptoms by diverting attention. The purpose is to eliminate the causes of gastritis, enhance gastric mucosal defense, and control clinical symptoms. Since Helicobacter pylori is the main germ causing chronic gastritis, antibacterial therapy targeting this bacterium to eradicate H. pylori and prevent recurrence of the lesion, as well as drugs to protect the gastric mucosa, are needed. In cases of atrophic gastritis or intestinal epithelial hyperplasia, pathological histology is also performed to assess the cancer potential and determine the protocol for follow-up review.