The Endoscopically Normal Stomach: Is It Worth a Biopsy?

In the absence of endoscopically visible lesions (such as tumors or ulcers), the gross appearance of the gastric mucosa is not believed by some gastroenterologists to be a reliable predictor of histopathologic findings. This is because in their experience, biopsies obtained from endoscopically abnormal-appearing areas with “erythema,” “inflammation,” or “atrophy,” often turn out to be histologically unremarkable. Using a kind of a fortiori reasoning, they assume that if endoscopically abnormal areas often reveal no histopathologic findings, then surely neither should endoscopically normal areas.

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