Diagnosis of chronic gastritis

The making of diagnosis of chronic gastritis should be started out be examining the clinical picture, and figuring out what additional methods should be used:

1. First the doctor should study the patient’s anamnesis; nearly all patients with chronic gastritis suffer from a long period of dyspepsia.
2. All symptoms mentioned above should be carefully noted.
3. The content of the stomach should be examined at different intervals after having a meal. Normally, the stomach should already empty after a couple of hours after a meal. However, as a result of chronic gastritis, the undigested food can remain in the stomach for as much as 6-7 hours.
   
   
   
   

Additional methods for diagnosing chronic gastritis include

• Esophagogastroduodenoscopy (EGD) – during this procedure an endoscope is used to determine the state of the stomach’s inner lining. EGD should always be combined with biopsy, in order to determine if there are any precancerous alterations to the cell structure of the gastric mucosa. Biopsy samples can also be used to determine if the patient is infected with Helicobacer pylori.

• Laboratory diagnostics –
  • Cellular evaluation of the blood, which includes:
    • full blood count – the number of red blood cells per liter (could be decreased due to blood loss);
    • hematocrit and mean corpuscular volume – the volume percentage of red blood cells in the blood (could be decreased due to blood loss);
    • erythrocyte sedimentation rate – how fast the red blood cells sediment (increased ESR points to inflammation);
     

   

  • Biochemical analysis of the blood – includes a number of tests that detect various electrolytes, glucose, creatinine, cholesterol, etc.
  • Clinical urine analysis – is a test used to quantify the amount of various cells within the urine, while determining other properties, including specific gravity.
  • Testing of stool for hidden blood – this test is conducted to find out if there is any occult blood present in the feces. If there is, steps should be taken to stop the bleeding to prevent further blood loss.
  • Determining if the patient is infected with Helicobacter pylori – usually a breath urea test is used to determine if the patient is infected with Helicobacter pylori or not. Biopsy samples taken during fibrogastroduodenoscopy can also be used to determine the presence of Helicobacter pylori.
• Ultrasound scans of the liver, pancreas, and gull bladder, in order to exclude their role in the development of chronic gastritis.
• Intragastric pH-metry – allows determining if the parietal cells of the stomach are functioning properly. This test can easily determine the state of acid secretion before, during, and after meals, which is very important for making a diagnosis and choosing the right treatment.
• Electrogastroenterogram – is a method similar in principle to electrocardiogram. It allows registering muscle contractions of the stomach and intestine. It can be used to determine if the patient is suffering from duodenogastric reflux. It can also show the motor function of the stomach and small intestine.
• Manometry of the proximal parts of the gastrointestinal tract – allows to determine the presence of duodenogastric reflux (people with duodenogastric reflux have a pressure in their duodenum that is twice as high as in a healthy person).