Reactive gastropathy

Reactive gastropathy
Classification and external resources
Micrograph of a reactive gastropathy. H&E stain.
eMedicine	article/1962893

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

Diagnosis

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

It is characterized, histologically, by:^[1]

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.

Etiology

Reactive gastropathy has a large number of causes, including:

• Alcohol abuse.
• Bile reflux, such as may be seen post-Billroth II.
• NSAIDs.

Relation to gastritis

Reactive gastropathy is morphologically distinct entity^[2][3] 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. Etymologically, "gastritis", in this context, is a misnomer as the process is not predominantly inflammatory, i.e. the condition is not an -itis. This type of mislabeling is not uncommon in medicine. Steatohepatitis is another example of this; it is not a process with significant inflammation yet, confusingly, carries the -itis ending.

See also

• Gastritis

Additional images

• 

  Low mag.

• 

  High mag.

References

1. ^ Genta, RM. (Nov 2005). "Differential diagnosis of reactive gastropathy.". Semin Diagn Pathol 22 (4): 273–83. PMID 16939055. 
2. ^ Pashankar, DS.; Bishop, WP.; Mitros, FA. (Nov 2002). "Chemical gastropathy: a distinct histopathologic entity in children.". J Pediatr Gastroenterol Nutr 35 (5): 653–7. PMID 12454581. 
3. ^ Dixon, MF.; O'Connor, HJ.; Axon, AT.; King, RF.; Johnston, D. (May 1986). "Reflux gastritis: distinct histopathological entity?". J Clin Pathol 39 (5): 524–30. PMID 3722405. 

External links

• Reactive gastropathy - surgical pathology criteria (standford.edu).