From the Research
For asymptomatic patients with mild chronic gastritis, no specific treatment is generally recommended, but if Helicobacter pylori infection is detected, eradication therapy may be considered. This approach is based on the potential long-term risks associated with H. pylori infection, such as peptic ulcer disease and gastric cancer 1. The decision to treat asymptomatic patients with mild chronic gastritis should be made on a case-by-case basis, taking into account the patient's overall health, medical history, and the presence of any risk factors for complications. Some key points to consider in the management of asymptomatic patients with mild chronic gastritis include:
- Lifestyle modifications, such as avoiding potential gastric irritants like alcohol, tobacco, NSAIDs, and spicy foods, may be beneficial in reducing symptoms and preventing progression of the disease.
- If H. pylori infection is detected, eradication therapy may be considered, typically consisting of a proton pump inhibitor (such as omeprazole 20mg twice daily) plus two antibiotics (commonly amoxicillin 1g twice daily and clarithromycin 500mg twice daily) for 7-14 days 2.
- Regular follow-up with a healthcare provider is advisable to monitor for any development of symptoms or complications. The rationale for minimal intervention in asymptomatic cases is that chronic gastritis often follows a benign course without progression to significant disease, and unnecessary medication may introduce side effects without providing clinical benefit 3. However, the most recent and highest quality study 4 suggests that H. pylori eradication is still a crucial aspect of managing patients with chronic gastritis, even in the absence of symptoms, due to the potential long-term risks associated with the infection.