Chronic gastritis in China: a national multi-center survey

Abstract

BackgroundChronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear.MethodsA multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded.ResultsTotally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis.ConclusionsThe present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.

Examining health disparities and characteristics in general practice utilization: based on outpatient data from 2014 - 2018 in Shanghai

“…The group aged 0-30 years was more likely to suffer from digestive diseases than other age groups. The high proportion of outpatient visits for digestive diseases may be due in large part to the irregular eating habits that form part of the fast-paced lifestyle in Shanghai [26,27]. However, digestive diseases have not received much attention in public health policies.…”

Chinese consensus on chronic gastritis (2017, Shanghai)

“…In a nationwide multicenter study of 8 892 patients with chronic gastritis, as described above in Statement 5 of the Epidemiology section, 13.1% of patients were asymptomatic, and those who were symptomatic had the following symptoms in descending order of frequency: epigastric pain (52.9%), abdominal bloating (48.7%), postprandial fullness (14.3%) and early satiety (12.7%). Nearly 1/3 of the patients presented at the same time two or more of the abovementioned symptoms, which are similar to the symptoms of dyspepsia.…”

“…The diagnosis of chronic atrophic gastritis includes both endoscopic and pathologic evaluations, while atrophy diagnosed under the white light endoscope has a low agreement with a pathologic diagnosis. The final diagnosis should be based on the pathologic diagnosis …”

The effect of the fortifying the spleen, clearing heat, activating blood method on chronic atrophic gastritis: a real-world study

“…Helicobacter pylori (HP) infection is the most important cause of CAG [1,2] , which is epidemiologically associated with the occurrence of gastric cancer (GC) [3,4] and an unhealthy lifestyle, including alcohol abuse, tobacco abuse, high intake of sodium, preserved and spicy food [5][6][7] . A national multicenter cross-sectional study [8] showed that 17.7% of the examined patients (1,573/ 8,892) was diagnosed with CAG at endoscopy. The annual incidence of GC for patients with CAG within 5 years of diagnosis was 0.1% [9] .…”

“…There are various treatments for CAG, including the eradication of HP, antacids, acupuncture, prokinetics and mucosal-protective agents [8,11] . For HP positive patients, eradication therapy is still the most basic and effective treatment for CAG [12] that strongly improves the quality of life [13] , and promotes the revitalization of the gastric mucosa [14] .…”