When a gastroscopy report says “erosive gastritis”, “mucosal erosions” or “erosive gastropathy”, it means that small, superficial losses of tissue (erosions) were seen on the inner surface of the stomach, together with redness and irritation.
Erosive gastritis is not cancer and is not the same thing as a stomach ulcer. But because erosions can sometimes lead to bleeding, the cause should be assessed.
What is an erosion?
The inner surface of the stomach is covered by a protective layer called the mucosa. Superficial damage to this layer is called an erosion. An erosion is shallower than an ulcer.
- Erosion → superficial damage
- Ulcer → a deeper loss of tissue
These two terms should not be used interchangeably.
What causes erosive gastritis?
Some of the most commonly encountered causes are:
- NSAID painkillers (such as ibuprofen, naproxen and diclofenac)
- Aspirin
- Alcohol
- Helicobacter pylori infection
- Bile reflux
- Mucosal damage developing during severe illness
- Other medicines or conditions affecting the stomach lining
More than one factor can be present together in one patient.
What symptoms can it cause?
Some patients have no symptoms at all. Others may have pain or burning in the stomach area, nausea, indigestion and discomfort in the upper abdomen.
If the erosions bleed, vomiting blood, vomiting that looks like coffee grounds, or black, tarry stools can appear.
Should Helicobacter pylori be looked for?
It may be, depending on the clinical picture. If H. pylori is found, eradication treatment is given in suitable patients.
But seeing erosive gastritis does not necessarily mean H. pylori is present.
Is a biopsy needed?
A biopsy does not have to be taken from every erosion. Depending on the endoscopic appearance and the patient’s features, the doctor may take a biopsy to assess H. pylori, gastritis or other changes in the lining.
A biopsy being taken does not mean cancer was suspected.
How is erosive gastritis treated?
Treatment varies with the cause. The painkillers and other medicines being taken are reviewed, H. pylori is treated if present, and acid-suppressing medicines may be used in patients who need them.
Do not stop a blood thinner on your own
Prescribed aspirin or blood-thinning medicines should not be stopped without speaking to your doctor.
Does erosive gastritis turn into cancer?
Erosive gastritis is not regarded on its own as a pre-cancerous condition. But if the patient also has H. pylori, atrophic gastritis or intestinal metaplasia, those are assessed separately.
When should you see a doctor without delay?
These can suggest gastrointestinal bleeding
Vomiting blood, vomiting that looks like coffee grounds, black tarry stools, fainting or marked weakness should be assessed without delay.
Unexplained anaemia, unintended weight loss, persistent vomiting or worsening symptoms should also be investigated.
Remember
- Erosive gastritis There is superficial damage to the surface of the stomach.
- An erosion Can sometimes bleed.
- Painkillers Are one of the important causes.
- H. pylori Can accompany it in some patients.
- An erosion Is not an ulcer.
- Erosive gastritis Is not cancer.
This is not enough to make a diagnosis
When erosive gastritis is found at endoscopy, how widespread the erosions are, whether there is bleeding, the medicines being taken, H. pylori status and the patient’s symptoms all have to be weighed together.
Sources
- Prof. Ali Tüzün İnce, MD