Chronic atrophic gastritis: patient management
DOI: 10.32364/2587-6821-2021-5-6-427-432
M.A. Livzan, O.V. Gaus, S.I. Mozgovoi
Omsk State Medical University, Omsk, Russian Federation
Patient management in chronic atrophic gastritis (CAG) in real clinical practice is a difficult task for a clinician. It is mainly due to the lack of reliable clinical stigmas that allow suspecting the presence of gastric mucosal atrophy. The diagnosis of chronic atrophic gastritis is valid only after a morphological assessment of gastrobiopaths taken during an endoscopy. According to a contemporary view, regardless of the inflammatory process etiology, CAG can progress to stomach cancer. At the same time, the point of no-return (at which the risk of inflammatory changes progression in the gastric mucosa and carcinogenesis preserves) is the CAG formation with the presence of intestinal metaplasia, even after the etiological factor is eliminated. Patients of this group, depending on the severity of inflammatory changes and atrophy, require constant dynamic follow-up and timely implementation of necessary measures for cancer prevention. To inhibit the progression of gastric mucosal precancerous changes, it is necessary to include the regimen using gastroprotective drugs for patients with CAG. Patients with autoimmune gastritis (in addition to the gastroprotective drugs) need to conduct regimens of cyanocobalamin therapy to prevent hematological and neurological disease manifestations.
Keywords: chronic atrophic gastritis, intestinal metaplasia, gastric cancer, Helicobacter pylori, autoimmune gastritis, gastroprotection, carcinoprevention, eradication therapy, rebamipide.
For citation: Livzan M.A., Gaus O.V., Mozgovoi S.I. Chronic atrophic gastritis: patient management. Russian Medical Inquiry. 2021;5(6):427–432 (in Russ.). DOI: 10.32364/2587-6821-2021-5-6-427-432.
Aknowledgement
The technical edition is supported by PRO.MED.CS Praha a.s.
About the authors:
Maria A. Livzan — Dr. Sc. (Med.), Professor, Head of the Deparment of Faculty Therapy and Gastroenterology, Rector, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0002-6581-7017.
Olga V. Gaus — C. Sc. (Med.), Associate Professor of the Department of Faculty Therapy and Gastroenterology, Head of the Department for the Development of Regional Healthcare and Medical Activities, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0001-9370-4768.
Sergei I. Mozgovoi — Dr. Sc. (Med.), Associate Professor, Professor of the Department of Pathological Anatomy, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federaion; ORCID iD 0000-0001-7200-7082.
Contact information: Olga V. Gaus, e-mail: gaus_olga@bk.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 09.07.2021.
Revised 03.08.2021.
Accepted 26.08.2021.
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