Abstract

Reactive gastropathy, also chemical gastropathy, is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation.

Cause

Reactive gastropathy has a large number of causes, including:

- Alcohol abuse.

- Bile reflux, such as may be seen post-Billroth II.

- NSAIDs.

Diagnosis

The diagnosis is by examination of tissue, e.g. a stomach biopsy.

It is characterized, histologically, by:

1. foveolar hyperplasia with gland tortuosity and dilation,

2. smooth muscle hyperplasia in the lamina propria, and

3. scant or minimal inflammation, i.e. lack of large numbers of neutrophils and plasma cells.

Relation to gastritis

Reactive gastropathy is morphologically distinct entity that can be separated from gastritis, which by definition has a significant inflammatory component.

As a reactive gastropathy may mimic a (true) gastritis symptomatically and visually in an endoscopic examination, it may incorrectly be referred to as a gastritis. Even aware of the underlying etiology of the pathologic process, e.g. NSAID use, the label "chemical gastritis" is applied to a chemical gastropathy.