Final answer:
When EGD shows gastritis not controlled with medical therapy, alternative treatment options include different antibiotic regimens, discontinuation of NSAIDs with PPIs or H2 blockers, endoscopic procedures like APC, or surgical interventions such as partial gastrectomy, along with lifestyle modifications.
Step-by-step explanation:
When an EGD shows gastritis that is not controlled with medical therapy, treatment may escalate to interventional therapies or surgical options. Management of refractory gastritis depends on the underlying cause. For instance, if H. pylori infection is present and has failed conventional antibiotic therapy, a different regimen with a higher potency or different combination of antibiotics might be considered. If the gastritis is due to non-steroidal anti-inflammatory drug (NSAID) use, discontinuation of the offending agent along with the use of proton pump inhibitors (PPIs) or histamine 2 receptor antagonists (H2 blockers) may be necessary.
In cases where medical management fails and the patient's symptoms are severe, therapeutic endoscopic procedures such as argon plasma coagulation (APC) or surgical interventions like partial gastrectomy may become necessary. Besides, optimal management of any identified stress factors, smoking cessation, and avoidance of alcohol may contribute to the treatment. It is crucial that a thorough evaluation by a gastroenterologist is done to tailor the treatment plan to the specific needs of the patient.