Can Helicobacter pylori positivity lead to gastric mucosal atrophy?

helicobacter pylori positivity may lead to gastric mucosal atrophy, but not all infected individuals will experience this condition. Helicobacter pylori infection is one of the main causes of chronic gastritis and gastric ulcers. Long term untreated treatment may lead to gastric mucosal atrophy and even intestinal metaplasia. Helicobacter pylori disrupts the gastric mucosal barrier by secreting substances such as urease and cytotoxin related proteins, continuously stimulating gastric epithelial cells. This chronic inflammatory response can lead to structural changes in the gastric gland, with some glands gradually disappearing and being replaced by fibrous tissue, resulting in gastric mucosal atrophy. Patients may experience symptoms such as upper abdominal pain, postprandial fullness, decreased appetite, and some cases may be accompanied by anemia or weight loss. Gastroscopy examination shows characteristic features such as pale mucosa and vascular transparency, while pathological biopsy can clarify the degree of atrophy. A small number of infected individuals may only present with mild superficial gastritis and not progress to atrophy due to weak virulence of the strain or strong host immunity. The probability of gastric mucosal atrophy is relatively lower in adolescent infected individuals, and the risk is higher in middle-aged and elderly populations. Combining high salt diets and long-term use of nonsteroidal anti-inflammatory drugs can accelerate the process of atrophy. Diagnosis can be confirmed through methods such as carbon-13/14 breath test and gastroscopy biopsy, and eradication therapy can effectively block the progression of lesions. After being diagnosed as positive for Helicobacter pylori, standardized quadruple therapy treatment should be carried out, commonly including proton pump inhibitors combined with two antibiotics and bismuth agents. After treatment, a follow-up examination is needed to confirm the eradication effect. It is necessary to avoid sharing utensils and pay attention to food hygiene in daily life. Patients with gastric mucosal atrophy should undergo regular follow-up gastroscopy to monitor changes in the lesions and, if necessary, undergo histopathological evaluation.