Monitoring

Your Organisational Guidance

ebpracticenet urges you to prioritise the following organisational guidance:

MaagklachtenPublished by: NHGLast published: 2025

Guidelines recommend that whenever Helicobacter pylori infection is identified and treated, eradication testing should be offered to the patient.[3][100]​ Testing for eradication of H pylorimay be performed using urea breath test, fecal antigen test, or biopsy-based testing.[3]​ One study has demonstrated that serological biomarkers such as pepsinogens I and II, gastrin-17, and H pylori IgA/IgG antibodies (markers of gastric mucosal status) show a high degree of accuracy as a non-invasive method to diagnose corpus atrophy, a common occurrence in the general population, although the clinical role of these markers is unclear at present.[101][102]

Patients with non-steroidal anti-inflammatory drug (NSAID)/alcohol-associated erosive gastritis refractory to symptomatic therapy may require a follow-up endoscopy with biopsy.[43]

Patients with diffuse atrophic gastritis and vitamin B12 deficiency should have close follow-up with tests for serum vitamin B12 levels, methylmalonic acid levels, or homocysteine levels to determine response to treatment.[31] At present, there is no definitive treatment for atrophic gastritis; however, monitoring these patients for gastric intestinal metaplasia is important. Patients should be risk stratified to determine surveillance intervals, with recommendations stating that patients with advanced atrophic gastritis should undergo endoscopic surveillance every 3 years.​[103]

The risk of gastric adenocarcinoma and carcinoid tumours with atrophic gastritis and/or autoimmune gastritis is uncertain; however, atrophic pangastritis, severe intestinal metaplasia of the body of the stomach, and age >50 years all increase the risk for developing gastric neoplastic lesions in patients with atrophic gastritis.[104]​ One study examined 929 patients with chronic atrophic gastritis undergoing at least three screening upper endoscopies followed for 36-129 months. Low-grade intra-epitheial metaplasia developed in 75 (8.1%) patients, high-grade intra-epithelial neoplasia developed in eight (0.9%) patients, and gastric cancer developed in 14 (1.5%) patients.[105]

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