How many years does it take for chronic atrophic gastritis to develop into gastric cancer? The answer is different from what you think!

Author: Wang Huahong, Chief Physician, Peking University First Hospital

Reviewer: Shang Zhanmin, Chief Physician, Beijing Chaoyang Hospital (West Campus), Capital Medical University

In the minds of most of us, chronic gastritis is very common and is not a serious chronic disease, while chronic atrophic gastritis sounds scary and feels like a very serious disease.

In fact, chronic atrophic gastritis is a type of chronic gastritis, and it is not as terrible as we imagine.

1. What is atrophic gastritis?

Simply put, atrophic gastritis is somewhat similar to human aging, just like wrinkles on the faces of elderly people. As people age, the gastric mucosa will gradually atrophy.

For people over 45 years old, gastroscopy may reveal gastric mucosal atrophy. For people over 70 years old, almost everyone will have gastric mucosal atrophy.

Of course, for many people, atrophic gastritis is just an endoscopic manifestation and does not cause any discomfort. Therefore, if atrophic gastritis is found, there is no need to be too nervous.

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However, for some people, atrophic gastritis may develop into gastric cancer. However, this is a relatively long process, which takes at least 5-10 years.

2. Which patients with atrophic gastritis should be alert to gastric cancer?

First, people with a family history of gastric cancer, if they find that they have atrophic gastritis, especially active atrophic gastritis, need to be alert to the possibility of developing gastric cancer.

Second, patients with atrophic gastritis who are infected with Helicobacter pylori should also pay attention. However, there is no need to worry too much. As long as the eradication treatment of Helicobacter pylori is actively carried out, there will basically be no major problems. Regular gastroscopy will be done to monitor the changes in the gastric mucosa.

Third, if patients with atrophic gastritis are found to have some proliferative changes, intestinal metaplasia, or even atypical hyperplasia or dysplasia during gastroscopy, they should be highly vigilant about whether it is a precancerous lesion.

If so, some endoscopic treatment may be needed, such as directly cutting off the dysplastic epithelium. After the cutting, there will be no risk of developing gastric cancer.

3. Is there any treatment for atrophic gastritis?

Atrophic gastritis without symptoms does not require treatment.

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Because although there are currently drugs that can treat atrophic gastritis, long-term clinical observations have shown that no drug can truly cure atrophic gastritis.

Moreover, all medicines are poisonous to some extent. Some health supplements that people may think of may actually harm the stomach.

When patients with atrophic gastritis experience nausea, vomiting, abdominal pain, bloating, and abdominal discomfort, they need to actively receive symptomatic treatment. For example, patients with bloating can take drugs that aid digestion and promote gastric motility.

4. What should patients with atrophic gastritis pay attention to in their daily lives?

For patients with atrophic gastritis, the most important thing to note is this sentence: relax and live a good life. If you worry about atrophic gastritis every day, do not get enough rest, and are in a bad mood, it will also cause poor stomach function.

We call the gastrointestinal tract the second brain. What is the second brain?

The first brain is the one that thinks about things every day, while the stomach and intestines are called the second brain. The second brain can control the first brain. Why? For example, when you are hungry, you want to eat a certain food, especially some people say that they are greedy and want to eat meat. In fact, it is not the brain that wants to eat meat, but the stomach and intestines that want to eat meat.

So the gastrointestinal tract also has memory, and we cannot always let it be in an anxious state, otherwise the gastrointestinal function will be poor and gastritis may progress. Therefore, the most important thing is to relax.

Some other so-called irritating foods, such as chili peppers, are eaten by people from Sichuan and Hunan, and no increase in atrophic gastritis has been found. Capsaicin may also have a certain protective effect on the gastric mucosa and intestinal mucosa.

Of course, some people feel stomach discomfort after eating peppers, onions, ginger, garlic and other foods, so they should not eat them. In terms of diet, there are no special taboo foods.

5. How often should patients with atrophic gastritis undergo gastroscopy examinations?

When atrophic gastritis is discovered, there is no need to perform repeated gastroscopy unless the doctor indicates the need for frequent gastroscopy for monitoring and the patient does not show any signs of discomfort.

Some patients with atrophic gastritis are very nervous and can do gastroscopy five or six times a year. In fact, during the gastroscopy, there will be some irritation to the gastric mucosa, so this is not necessary.

For the general population, it is sufficient to have a gastroscopy every three to five years to see if chronic gastritis has changed, worsened, or if other new gastric lesions have appeared. However, repeated gastroscopy is not very meaningful and may cause damage to the gastric mucosa and function.