Chronic Gastritis Diagnosis

Chronic gastritis often presents with non-specific symptoms and few physical signs, making it difficult to diagnose based on clinical presentation alone. To accurately identify the condition and rule out other gastrointestinal disorders, a combination of laboratory tests and imaging studies is typically used, with the final diagnosis relying on endoscopic and histopathological evaluation of gastric tissue. Below are the key diagnostic procedures involved:

Laboratory Tests
(1) Helicobacter pylori testing – This can be performed using carbon-13 or carbon-14 breath tests, which are highly effective in detecting active infection.
(2) Gastric acid secretion analysis – This test helps assess the stomach's ability to produce acid and may provide insights into the type and severity of gastritis.

Imaging Techniques
(1) Endoscopy – This is the most direct method for examining the mucosal lining of the esophagus, stomach, and duodenum. During the procedure, multiple biopsies can be taken from different areas of the stomach for further histological analysis.
(2) Barium X-ray – While less invasive, this method is useful for ruling out conditions like peptic ulcers or gastric cancer. It is generally safe and well-tolerated, though not recommended for patients with acute respiratory infections or severe liver and kidney dysfunction.

Histopathological Evaluation
Biopsy of the gastric mucosa remains the gold standard for diagnosing chronic gastritis, especially the atrophic form. Microscopic examination of the tissue allows for accurate classification and staging of the disease.

Additional Assessments
In cases suspected of autoimmune or corpus-predominant atrophic gastritis, further blood tests may be necessary, including complete blood count, gastric fluid volume, serum gastrin levels, vitamin B12 concentration, and antibody tests for parietal cells and intrinsic factor. These help in identifying underlying causes and guiding appropriate treatment strategies.