Why are the gastroscopy results and pathology results different, and what should I do?

Under normal circumstances, discrepancies between gastroscopy results and pathological findings may be related to factors such as sampling limitations, evaluation bias, disease progression, inflammatory bowel disease, or early gastric cancer. It is recommended to seek medical attention promptly and receive appropriate treatments—such as general management and medication—under a doctor’s guidance. Specific explanations are as follows:

1. Sampling Limitations

During gastroscopy, doctors must comprehensively examine the gastric mucosa within a short time and select appropriate sites for biopsy. However, due to the diverse morphology of the gastric mucosa and uneven distribution of lesions, sampling may be limited. In such cases, doctors may need to perform another gastroscopy to ensure accurate and adequate tissue sampling.

2. Evaluation Bias

Gastroscopy primarily relies on visual observation by the physician to make an initial assessment of whether a lesion is benign or malignant, whereas pathological examination determines the nature of the lesion by observing cellular morphology under a microscope. Differences in evaluation methods and focus may lead to inconsistent results. When evaluation bias occurs, patients are advised to undergo repeat gastroscopy with biopsy or consult pathology experts for further diagnosis.

3. Disease Progression

In some diseases, pathological characteristics may change over time, leading to inconsistencies between gastroscopy and pathology results. In such situations, physicians should adjust treatment plans based on the latest pathological diagnosis to control disease progression.

4. Inflammatory Bowel Disease

Inflammatory bowel disease is an idiopathic chronic inflammatory disorder of the intestine. During gastroscopy, findings such as redness and ulcers may be observed, but pathological examination can reveal inflammation and fibrosis extending into the submucosal and even muscular layers. It is typically accompanied by symptoms such as abdominal pain, diarrhea, and weight loss. Treatment involves medications prescribed by a physician, including mesalazine enteric-coated tablets, sulfasalazine enteric-coated tablets, and azathioprine tablets.

5. Early Gastric Cancer

Lesions associated with early gastric cancer may be very small, confined only to the mucosal layer, and show minimal visible changes, making them difficult to detect during gastroscopy. Pathological examination, however, can accurately identify abnormal cells through tissue analysis. Symptoms often include indigestion and loss of appetite. Medications such as omeprazole sodium enteric-coated tablets, sodium bicarbonate tablets, and huachansu tablets may be used under medical advice.

It is recommended to consume light, easily digestible foods in daily life, avoiding spicy, greasy, and irritating foods, and to quit smoking and alcohol consumption. Additionally, maintaining a positive mindset and minimizing stress can contribute to overall health.