Why is gastritis biopsied

Keywords: Chronic superficial gastritis, Giemsa stain, H. Year : Volume : 7 Issue : 4 Page : Evaluation of gastric biopsies in chronic gastritis: Grading of inflammation by Visual Analogue Scale.

Figure 1: a H. Unidentified curve bacilli on gastric epithelium in active chronic gastritis. Lancet ; Classification and grading of gastritis. The Updated Sydney System. International Workshop on the histopathology of gastritis, Houston Am J Surg Pathol ; Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer cases with chronic gastritis cases. World J Gastroenterol ; Goldstein NS.

Am J Clin Pathol ; Helicobacter pylori infection and chronological extension of atrophic gastritis. Eur J Gastroenterol Hepatol ; Epidemiology of Helicobacter pylori in an asymptomatic population in the United States: Effect of age, race, and socioeconomic status. Gastroenterology ; It is recommended that the additional biopsies in all segments of the colon should be made to assess the presence and degree of inflammation. The observance of this technique is associated with a detection rate of dysplasia 3 times greater than that described for the protocol of random biopsies.

However, in the majority of centers, the protocol of random biopsies remains as the endoscopic approach. In the case of pancolitis, it is recommended biopsies of the four quadrants each 10 cm from the cecum to the rectum, with a minimum number of 33 biopsies. Patients with symptoms of pouchitis after proctocolecomy should be submitted to endoscopy with multiple biopsies of the ileo-anal pouch and afferent loop.

In the presence of macroscopic changes on the afferent loop, the possibility of a Crohn's disease should be considered, and the diagnosis can be confirmed by histology. Most colo-rectal cancers, regardless of its etiology, come from adenomatous polyps, of which only a minority become malignant As a general rule, polypoid lesions are excised and not submitted to biopsy. Small lesions mm can be removed with a forceps biopsy or through polypectomy.

Lesions of larger dimensions can be removed by polypectomy or mucosectomy, if technically possible. Biopsies in lesions with a high probability of being subsequently submitted to endoscopic resection can promote the development of submucosal fibrosis and fix lesions previously deployable. In addition, it should always be considered the potential variability of biopsies that may not be able to identify foci of adenocarcinoma in lesions of large dimensions. In these cases it should be considered the primary excision of the lesions.

The ideal endoscopic approach is not defined. Rectum and distal colon are the sites with the highest sensitivity, even in patients with symptoms suggestive of involvement of the upper digestive tract.

If the sigmoidoscopy is not diagnostic, it is suggested to perform an upper endoscopy with four or more biopsies in the gastric antrum and body and duodenum, and may also be considered the distal esophagus.

This review seeks to condense the existing evidence concerning the performing of biopsies in gastrointestinal endoscopy, focusing on the precise diagnosis of the most common gastrointestinal diseases that motivate endoscopic examinations through the rational use of resources, without compromising the proper follow-up of patients.

In addition, it also describes situations in which the histopathological evaluation may not be justifiable by its low sensitivity and specificity, in addition to possibly unnecessary costs. The development of policies together with the pathologic department it is fundamental to the effective establishment of these practices. The authors declare that no experiments were performed on humans or animals for this study.

The authors declare that no patient data appear in this article. The authors have no conflicts of interest to declare. ISSN: Descargar PDF. Armando Peixoto. Autor para correspondencia. Under a Creative Commons license. Table 1. Summary of recommendations for biopsies in upper endoscopy..

Table 2. Summary of recommendations for biopsies in lower endoscopy.. In this review we describe the available evidence in the literature, including the more recent published guidelines, on when or not to perform endoscopic biopsies in upper and lower endoscopy, focusing on the precise diagnosis of the most common gastrointestinal diseases that motivate endoscopic examinations and on the rational use of available resources without compromising proper management of patients.

Texto completo. Shepherd, R. The effective use of gastrointestinal histopathology: guidance for endoscopic biopsy in the gastrointestinal tract. Frontline Gastroenterol, 5 , pp. Sharaf, A. Shergill, R. Odze, M. Krinsky, N. Fukami, R. Jain, et al. Gastrointest Endosc, 78 , pp. Dinis-Ribeiro, M. Areia, A. Marcos-Pinto, M.

Monteiro-Soares, A. Endoscopy, 44 , pp. Loughrey, B. Guidance on the effective use of upper gastrointestinal histopathology. Clinical practice: gastroesophageal reflux disease. N Engl J Med, , pp. Microscopic esophageal mucosal injury in nonerosive reflux disease.

Clin Gastroenterol Hepatol, 5 , pp. Riddell, R. Definition of Barrett's esophagus: time for a rethink—is intestinal metaplasia dead. Am J Gastroenterol, , pp. McClave, H. Boyce Jr. Early diagnosis of columnar-lined esophagus: a new endoscopic diagnostic criterion. Gastrointest Endosc, 33 , pp. Sharma, J. Dent, D. Armstrong, J. Bergman, L.

Gossner, Y. Hoshihara, et al. Gastroenterology, , pp. Levine, P. Blount, R. Rudolph, B. Safety of a systematic endoscopic biopsy protocol in patients with Barrett's esophagus. Am J Gastroenterol, 95 , pp. Furuta, C. Liacouras, M. Collins, S. Gupta, C. Justinich, P. Putnam, et al.

Eosinophilic esophagitis in children and adults: a systematic review and consensus recommendations for diagnosis and treatment. Deficiency of vitamin B12 eventually leads to a condition called pernicious anemia. The patient presents with:. When acute gastritis symptoms are bad enough to warrant contacting a doctor, a diagnosis is usually able to be made based simply on the story.

However, a direct look at the stomach lining via an upper endoscopy examination —also known as an EGD or EsophagoGastroDuodenoscopy — may be necessary when the problem persists, or bleeding occurs. The inflammatory changes are usually confined to the stomach rather than the first part of the small intestine, referred to as the duodenum. Other tests, such as blood tests, X-rays and scans are usually not necessary for diagnosis unless an alternative condition is suspected during investigation.

Chronic gastritis is diagnosed by examining a specimen biopsy of the stomach mucosa. This is typically taken during an upper endoscopy examination.

Additional blood tests and tests for Helicobacter pylori may be required. The most important part of acute gastritis treatment obviously is to remove the irritant when found.

Anti-nausea medications may be needed. Consultation with a physician for further investigations and more sophisticated treatments will be necessary if symptoms do not settle quickly, or if any vomit contains blood.

When H. Most cases settle quickly unless the irritant or infection is not removed. Eliminating any causative infection usually H. Vitamin B12 deficiency is treated by intermittent injections. Patients with severe changes to the mucosa i. Digestive Disease Center. Digestive Diseases. Small Intestine. It is done with a flexible tube with a small camera flexible endoscope at the end.

The scope is inserted down the throat into the stomach. The health care provider sends the tissue sample to a laboratory where it is examined for signs of cancer, certain infections, or other problems. Follow instructions on how to prepare for the procedure. You will likely be asked not to eat or drink anything for 6 to 12 hours before the procedure. This test may be done to diagnose a stomach ulcer or the cause of other stomach symptoms.

These symptoms may include:. A gastric tissue biopsy is normal if it does not show cancer, other damage to the lining of the stomach, or signs of organisms that cause infection. A gastric tissue culture may be considered normal if it does not show certain bacteria. Stomach acids normally prevent too much bacteria from growing.