Endoscopic and Histological Gastritis: Less Than Meets the Eye

Aims Gastritis is a histological diagnosis of inflammation of the gastric mucosa¹. When referred for endoscopy it is often reported at time of gastroscopy, prior to confirmation on biopsy. We aimed to assess endoscopic versus histological diagnosis of gastritis.

Methods We performed a single centre retrospective analysis over a two-year period. Endoscopic electronic results were compared to histopathology reports [1].

Results Two thousand three hundred and thirty patients were diagnosed with Gastritis at endoscopy. Sixty seven percent of patients (n=1558) had gastric biopsies taken at time of procedure. Eight occurred in the presence of a new diagnosis of cancer and were excluded. Of the remaining population fourty three percent (n=674) had gastritis on biopsy. Fifty seven percent (n=876) of endoscopic diagnoses of gastritis were not confirmed histologically. Although trainees performed more biopsies than consultants (69% versus 59%) there was no discrepancy between rates of histology confirmation (41% versus 43%). One hundred and seven patients with histological gastritis also had Intestinal Metaplasia, fifty three percent of which had biopsies taken from more than one site. Of the nine patients with dysplasia -8 low grade and 1 high grade-only two patients did not have a clinical suspicion documented at time of endoscopy. It is unclear why thirty three percent of patients did not have biopsies, but it was not dependent on patient age, gender or seniority of endoscopist ([Fig. 1]).

Fig. 1

Conclusions These findings suggest clinical practice is extremely varied and recommendations are required for biopsies in patients with suspected gastritis.

Gastritis Flowchart

Publication History

Article published online:
14 April 2023

• 1 Ehrenpreis E.. Best Practice Guidelines Gastritis. British Medical Journal. 2022