People who suffer from chronic gastritis inevitably have doubts and worries about the possibility of developing gastric cancer. So, can gastritis progress to gastric cancer?
The development of gastric cancer is a complex, slow and gradual process in which many factors work together. Normal gastric mucosal cells become cancer cells may undergo the following process: normal mucosa → chronic non-atrophic gastritis → chronic atrophic gastritis → intestinal epithelial hyperplasia → gastric mucosal epithelial atypical hyperplasia → gastric cancer. Through gastroscopy and pathological diagnosis, chronic gastritis can be broadly classified into two categories: non-atrophic and atrophic, both of which are a part of the evolution of gastric cancer.
- Non-atrophic gastritis, also called chronic superficial gastritis, has little change in the gastric mucosa from the outside, and most patients with gastric distress will be diagnosed with chronic non-atrophic gastritis after undergoing gastroscopy. This type of gastritis is far from being cancerous and there is no need to be overly alarmed. Usually, asymptomatic patients do not need medication and can be cured through diet, physical and mental regimen, and lifestyle habits. For those with obvious symptoms, doctors may give appropriate medication based on the results of gastroscopy and pathological diagnosis, with the main goal of improving symptoms, removing the cause, protecting the gastric mucosa, and stopping the progression of non-atrophic gastritis as much as possible. The main therapeutic agents include gastrodynamic drugs, acid suppressants, gastric mucosal protectors, and usually Hp eradication therapy if H. pylori (Hp) infection is present.
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- Chronic atrophic gastritis evolves gradually from chronic non-atrophic gastritis and requires attention. Patients usually have no obvious symptoms, but may also experience vague abdominal pain, a feeling of fullness and indigestion, or burping, acid reflux, nausea, vomiting, and poor appetite. The thinning of gastric mucosa in chronic atrophic gastritis will, on the one hand, damage the gastric barrier and make it easier for carcinogens to destroy gastric mucosal cells and induce gastric cancer; on the other hand, it will induce gastric intestinal hyperplasia and atypical hyperplasia, which will light up the “warning light” of gastric cancer. The most important thing is that you can get a good idea of what you are getting into.
To summarize, chronic gastritis does not necessarily develop into gastric cancer, but if chronic non-atrophic gastritis is detected, it needs to be prevented from developing into chronic atrophic gastritis; if chronic atrophic gastritis is detected, more attention needs to be paid to reduce the intake of carcinogenic substances and to actively treat it to prevent the development of intestinal hyperplasia and moderate or severe atypical hyperplasia. For chronic atrophic gastritis, the most effective and direct method for early detection of gastric cancer is regular gastroscopy, usually every 3 years for chronic atrophic gastritis, and every year or every 6 months for patients with intestinal hyperplasia or atypical hyperplasia, depending on the situation. (Written by Jingxu Sun, Department of Gastrointestinal Oncology, The First Hospital of China Medical University)