Gastric Biopsy in Clinical Practice

Whenever Gastric Biopsies are Taken for Any Reason

Whenever gastric biopsies are taken for any reason, I take two biopsies from the distal antrum and two from the mid-body greater curve to size up the terrain (Lunn and Weinstein, 2000). This provides a quick sampling of the two main gland zones of the stomach and potential information regarding two important clinical implications. One is whether there is concomitant H. pylori infection. Apart from other issues related to H. pylori eradication, it does makes some hyperplastic polyps disappear or diminish in size (this is discussed subsequently). Secondly mid-body greater curve biopsies determine whether there is concomitant atrophic gastritis, not uncommonly associated with hyperplastic polyps and adenomas of the stomach. Its finding should prompt the obtaining of serum B12 levels at the time and, if necessary, periodically in the future to watch for the development of pernicious anemia (PA).

Biopsy Mapping of the Stomach

In some instances, biopsy mapping of the stomach is worthwhile. The technique I use is to divide the stomach into five zones, including the fundus body-lesser and greater curves, respectively, and the antrum greater and lesser curves respectively. I generally take two biopsies from the fundus. Then for each zone equidistant biopsies "by eye", I take four from the antrum greater curve, two or three from the antrum lesser curve, four from the body lesser curve and five to six from the body greater curve. In taking random biopsy samples from the stomach and presupposing that target lesions have had samples taken first, one can speed up the process. It is best accomplished by taking the samples by estimated site and not bother getting up close and cleaning each site of blood, mucous, bile, etc. There are other ways that one can speed up biopsy surveillance that are beyond the scope of this topic (Weinstein, 2000).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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