How to Treat Erosive Gastritis

Erosive gastritis is caused by erosive lesions of the gastric mucosa and represents one of the major causes of upper gastrointestinal (UGI) bleeding. Clinically, patients commonly present with symptoms including dull epigastric pain, acid reflux, hematemesis, melena, syncope, or shock. This condition not only impairs appetite and causes abdominal discomfort but—particularly in severe cases—may lead to ulcer formation and subsequent bleeding. It frequently co-occurs with peptic ulcers and UGI bleeding.

How Is Erosive Gastritis Treated?

Diagnostic evaluation typically includes endoscopy, Helicobacter pylori testing, barium contrast radiography of the upper GI tract, and angiography. The disease often has an acute onset, manifesting as sudden UGI bleeding during the course of an underlying illness. Clinical presentation includes hematemesis and melena; isolated melena is uncommon. Bleeding tends to be intermittent; massive hemorrhage may result in syncope, shock, or anemia. Epigastric discomfort or tenderness may accompany active bleeding. Symptoms are often nonspecific and consistent with dyspepsia, such as dull epigastric pain, acid reflux, postprandial fullness, and decreased appetite.

Pharmacologic treatment may include acid-suppressing agents, gastric mucosal protectants, and hemostatic agents, along with supportive management of bleeding and shock as needed.

1. Conventional Western medications include intravenous or oral acid-suppressing agents (e.g., proton pump inhibitors or H₂-receptor antagonists) and gastric mucosal protectants. For substantial bleeding, oral thrombin may be administered.

2. Patients testing positive for H. pylori should receive eradication therapy.

3. In traditional Chinese medicine (TCM), treatment is individualized according to syndrome differentiation. For active bleeding, oral Yunnan Baiyao (a traditional hemostatic herbal preparation) may be prescribed.

Additionally, endoscopic interventions—including local application of hemostatic agents (e.g., thrombin) via the biopsy channel or electrocoagulation—can be performed under direct endoscopic visualization.

We hope the above information is helpful to you.