Atrophic Gastritis: Reversible after Treatment?

ABSTRACT

Chronic atrophic gastritis is a result of chronic inflammation characterized by the replacement of oxyntic and antral gastric glandular structures by connective tissue or by glandular structures inappropriate for location such as metaplastic atrophy. Chronic atrophic gastritis is considered as one of the major risk factors for noncardiac gastric cancer or mucosa associated lymphoid tissue lymphoma. Since chronic inflammation is generally considered to be triggered by Helicobacter pylori infection, many studies have evaluated whether H. pylori eradication therapy could make histologic improvement or reversal. However, it is controversial whether eradication of H. pylori improves atrophy or metaplasia. There has been a lot of conflict, but many previous studies including meta-analyses tend to demonstrate that it is possible that gastric atrophy could be improved after H. pylori eradication in the corpus but not in the antrum. Also, intestinal metaplasia seems to be irreversible even after H. pylori eradication.