Treatment Options for Chronic Gastritis with Intestinal Metaplasia

Chronic gastritis with intestinal metaplasia occurs when the lining of the stomach undergoes changes due to long-term inflammation. In this condition, the normal stomach lining is replaced by cells similar to those found in the small or large intestine. While intestinal metaplasia itself may not be immediately dangerous, it is considered a precancerous condition and should be monitored closely.

One of the most effective ways to treat this condition is by eliminating Helicobacter pylori (H. pylori), a bacterium commonly associated with chronic gastritis. Research shows that eradicating H. pylori can slow or even reverse the progression of intestinal metaplasia in some cases.

The standard treatment for H. pylori involves a 10- to 14-day course of quadruple therapy. This includes:
- A proton pump inhibitor (PPI) such as omeprazole, rabeprazole, or esomeprazole to reduce stomach acid.
- Two antibiotics like amoxicillin, clarithromycin, tetracycline, or levofloxacin to kill the bacteria.
- A bismuth-based medication such as bismuth subsalicylate to protect the stomach lining and enhance bacterial eradication.

Successful eradication of H. pylori significantly reduces the risk of further complications and helps restore normal gastric function.

In addition to medical treatment, lifestyle and dietary modifications play a crucial role in managing chronic gastritis and intestinal metaplasia. Patients are advised to avoid irritants such as spicy foods, alcohol, and tobacco. Adopting a balanced diet rich in fruits, vegetables, and whole grains may also support healing of the gastric mucosa.

Regular follow-up with a gastroenterologist is essential to monitor any changes in the stomach lining and assess the effectiveness of treatment. Endoscopic surveillance may be recommended, especially for patients with more advanced forms of intestinal metaplasia.

In summary, treating chronic gastritis with intestinal metaplasia involves a comprehensive approach that includes bacterial eradication, lifestyle adjustments, and ongoing medical evaluation to prevent disease progression.