H. pylori infection is declining in the industrialized world and emerging economies.
Simultaneously, as the world population moves to a “Western”
diet, obesity and gastroesophageal reflux disease are on the rise, and
the use of acid-suppressing drugs, particularly proton pump inhibitors
(PPIs) is becoming widespread.
In parallel with these changes, a major shift is occurring in gastric pathology.
Multifocal atrophic gastritis, once common, is now rare; reactive gastropathy
is the new normal; autoimmune gastritis, previously believed to be unusual,
now represents an increasing proportion of the atrophic gastritides seen
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