Verrucous Gastritis: How Often Should You Have a Follow-up Endoscopy?

If you've been diagnosed with verrucous gastritis, it's important to understand the appropriate timeline for follow-up endoscopies. Typically, patients are advised to have a repeat gastroscopy every 2-3 years. However, this recommendation can vary depending on the specific pathological findings and individual risk factors.

1. Intestinal Metaplasia Requires More Frequent Monitoring

If your biopsy results show signs of intestinal metaplasia—a condition where the stomach lining begins to resemble the intestine—you may need a follow-up endoscopy every 1.5 to 2 years. This is because intestinal metaplasia is considered a potential precursor to gastric cancer and requires closer monitoring.

2. Atrophic Gastritis Determines the Frequency of Surveillance

In cases where atrophy is present, the frequency of endoscopic follow-up depends largely on the extent and location of the atrophy:

If the atrophy is limited to the antrum or angularis, a repeat endoscopy after approximately 1.5 years is generally recommended.

If atrophy involves the corpus or the entire stomach (pan-gastric atrophy), annual follow-ups are usually advised due to the increased risk of malignancy.

For mild forms of gastritis—such as simple foveolar hyperplasia or benign epithelial hyperplasia—routine checks every 2 to 3 years may be sufficient.

3. No Atrophy or Metaplasia? A Longer Interval May Be Safe

Patients diagnosed with chronic non-atrophic gastritis or superficial gastritis without signs of intestinal metaplasia or glandular atrophy can often wait between 3 to 5 years before needing another endoscopic evaluation.

4. Family History Increases Risk—Monitor Closely

Having a family history of gastric cancer, especially in first-degree relatives such as parents or siblings, increases your personal risk. In such cases, more frequent endoscopic surveillance—especially after the age of 45—is strongly recommended.

Understanding the Link Between Verrucous Gastritis and Gastric Cancer

It's worth noting that most cases of intestinal-type gastric cancer develop in the context of chronic atrophic gastritis and intestinal metaplasia. If severe intestinal metaplasia is detected, special attention should be given during endoscopy. High-definition magnifying endoscopy can help assess the exact extent of metaplasia and detect any focal changes early.

Early detection of precancerous lesions allows for timely intervention through endoscopic techniques such as endoscopic mucosal resection (EMR) or radiofrequency ablation (RFA). These procedures can significantly reduce the risk of progression to cancer and, in many cases, lead to clinical remission.

Regular follow-up is key to preventing complications. By staying proactive and adhering to your doctor's recommendations, you can manage verrucous gastritis effectively and reduce long-term health risks.