The diagnosis of chronic atrophic gastritis

September 10, 2009 · Posted in Symptoms of chronic gastritis 

Of chronic atrophic gastritis in the clinical performance of non-specific, so diagnosis of chronic atrophic gastritis associated with clinical manifestations of the need auxiliary examination, especially endoscopy and gastric biopsy. The following systematic introduction to the diagnosis of chronic atrophic gastritis based on:

 (1) Clinical Performance:

 Mainly loss of appetite, nausea, belching, upper abdominal fullness or dull pain, a small number of patients can occur upper gastrointestinal bleeding, weight loss, anemia, brittle A, glossitis, or tongue papilla atrophy.

 (2) laboratory tests

 ① gastric analysis: A type CAG in patients with multi-acid-free or low-acid, B-type CAG patients may be normal or low-acid.

 ② pepsinogen measurement: originally the main cells in pepsin secretion, chronic atrophic gastritis, the blood and urine pepsinogen content decreases.

 Determination of serum gastrin ③: gastric antrum G-cells to secrete gastrin. A-CAG patients, often significantly higher serum gastrin; B-type gastric mucosal atrophy in patients with CAG, directly affect the function of G cells to secrete gastrin, serum gastrin than normal.

 ④ Immunological tests: Parietal cell antibodies (PCA), intrinsic factor antibodies (IFA), gastrin-secreting cell antibodies (GCA) measurement can be used as chronic atrophic gastritis and its sub-type diagnosis.

 (3) X-ray examination:

 X-gastric barium meal examination in most patients with atrophic gastritis, no abnormality was found. Air-barium double contrast can show the body of stomach mucosal folds flat, thinning, greater curvature of gastric body mucosal folds of the serrated thinning or disappearance of fundus smooth, part of the gastric mucosal inflammation may be serrated or rough mucosa manifestations of disorder.

 (4), endoscopy and biopsy:

 Endoscopy and biopsy is the most reliable method of diagnosis. Endoscopic diagnosis should include lesions, atrophy, intestinal metaplasia and dysplasia degree. Eyes look directly observed atrophic gastritis mucosa Duocheng pale or gray, thinning, or folds flat. Mucosa can be red and white performance in serious cases, there are scattered white plaques. Submucosal blood vessels exposed to the characteristics of atrophic gastritis, can see the red mesh of small arteries or capillaries, severe atrophic gastritis, epithelial cell hyperplasia seen with the formation of fine particles or larger nodules. Also mucosal erosion, bleeding. Gastric biopsy varying degrees of gland atrophy mostly disappeared, replaced by pyloric gland metaplasia or intestinal gland metaplasia, interstitial inflammatory infiltration significantly.

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