“Erythema”, “hyperaemia”, “erythematous appearance” or “the mucosa is hyperaemic” are phrases often seen on gastroscopy reports. In general they describe a lining that looks redder than normal.
What do erythema and hyperaemia mean?
Erythema is a tissue looking red. Hyperaemia means an increase in the blood flow to an area.
Seeing redness on the inner surface of the stomach or oesophagus at endoscopy can suggest that there may be irritation or inflammation there.
But erythema and hyperaemia are not on their own a diagnosis.
What can cause it?
Erythema or hyperaemia in the stomach or oesophagus can be associated with:
- Gastritis
- Gastro-oesophageal reflux and oesophagitis
- Helicobacter pylori infection
- Some medicines, painkillers in particular
- Alcohol
- Bile reflux
- Various forms of irritation or inflammation
Sometimes mild redness is of limited clinical significance.
Does erythema or hyperaemia mean cancer?
No.
Seeing erythema or hyperaemia at endoscopy does not on its own mean cancer. These words only describe the appearance of the lining that the endoscopist saw.
If there is another suspicious finding, its features are noted separately in the report and a biopsy is taken where needed.
Is a biopsy needed?
A biopsy does not have to be taken from every area of erythema or hyperaemia. But where the doctor thinks it necessary, a biopsy may be taken to:
- Assess gastritis
- Look for H. pylori
- Examine changes such as atrophy or intestinal metaplasia
- Assess an area that looks suspicious
A biopsy having been taken does not mean cancer was found.
Is treatment needed?
Treatment is planned not from the words “there is erythema” but according to the cause.
If H. pylori is found, for instance, treatment for it may be needed; if there is reflux or acid-related disease, treatment appropriate to that. The medicines being taken may also be reviewed.
So the redness on an endoscopy report has to be weighed together with the patient’s symptoms and any biopsy result.
When should more care be taken?
Do not delay if these accompany it
Vomiting blood, black stools, unexplained anaemia, unintended weight loss, persistent vomiting or difficulty swallowing.
Remember
- Erythema Redness of the lining.
- Hyperaemia An increase in blood flow to the tissue.
- A biopsy Helps understand the cause where one is needed.
- Erythema / hyperaemia Are not on their own cancer.
This is not enough to make a diagnosis
“Erythema” or “hyperaemia” on an endoscopy report does not on its own make the diagnosis of any particular condition. The findings have to be weighed together with your symptoms, the medicines you take, your H. pylori status and, where needed, biopsy results.
Sources
- Prof. Ali Tüzün İnce, MD