How to Treat Chronic Atrophic Gastritis with Intestinal Metaplasia

Chronic atrophic gastritis with intestinal metaplasia is a condition that requires careful attention and appropriate medical intervention. Treatment options include Western medicine, traditional Chinese medicine (TCM), and proprietary Chinese medicines. In Western medicine, folic acid supplementation and selenium-containing compounds are commonly recommended. Clinical studies have shown that certain Chinese herbal formulations such as Weifuchun, Moluodan, and Tiedao Shihu may help in reversing gastric atrophy and intestinal metaplasia. Additionally, customized TCM decoctions can be prescribed based on individual syndrome differentiation.

This condition is primarily a histopathological diagnosis and does not present with specific clinical symptoms. Patients may experience symptoms like acid reflux, belching, heartburn, abdominal pain, bloating, or irregular bowel movements. However, upon undergoing a gastroscopy and biopsy, the pathology report may indicate chronic atrophic gastritis with intestinal metaplasia—findings that often cause concern. Gastric atrophy refers to the thinning of the gastric mucosa due to the loss of gastric glandular cells, and when intestinal metaplasia occurs, it means that these cells are being replaced by intestinal-type epithelial cells. This transformation is considered a precancerous change.

Historically, intestinal metaplasia was classified into complete and incomplete types, as well as colonic-type and small intestinal-type. While this classification system is becoming less distinct, incomplete small intestinal-type metaplasia has traditionally been associated with a higher risk of progressing to gastric cancer. Nevertheless, recent research suggests that the correlation between these subtypes and cancer risk may not be as clear-cut as once believed.

For patients diagnosed with this condition, regular endoscopic monitoring is advised to detect any early signs of dysplasia or malignancy. Lifestyle modifications, including a balanced diet rich in antioxidants, avoiding tobacco and excessive alcohol consumption, and managing stress, may also play a supportive role in slowing disease progression. Early detection and consistent follow-up are key components in managing chronic atrophic gastritis with intestinal metaplasia effectively.