What is the role of biopsy in the diagnosis of chronic gastritis?

Updated: Jun 07, 2019
  • Author: Akiva J Marcus, MD, PhD; Chief Editor: BS Anand, MD  more...
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The standard method of determining whether H pylori is the underlying cause of gastritis is histologic identification of the organism. Histologic examination is also used to evaluate the degree and distribution of gastritis. Obtain at least 2 biopsies from the gastric antrum, 2 from the corpus, and 1 from the incisura.

Special stains to identify H pylori (eg, Warthin-Starry, Giemsa, or Genta) or immunohistochemistry may be necessary when the organisms are not observed and chronic gastritis is obvious.

At late stages of infection with extensive atrophic gastritis, the numbers of H pylori organisms are markedly decreased because intestinal metaplasia creates an unfavorable environment for H pylori. In these cases, other tests (eg, the urea breath test) and serologic indicators of infection may provide evidence for H pylori infection.

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