Reactive gastropathy
| Reactive gastropathy |
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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]
- foveolar hyperplasia with gland tortuosity and dilation,
- smooth muscle hyperplasia in the lamina propria, and
- 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.
See also
Additional images
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References
- ^ Genta, RM. (Nov 2005). "Differential diagnosis of reactive gastropathy". Semin Diagn Pathol. 22 (4): 273–83. doi:10.1053/j.semdp.2006.04.001. PMID 16939055.
- ^ Pashankar, DS.; Bishop, WP.; Mitros, FA. (Nov 2002). "Chemical gastropathy: a distinct histopathologic entity in children". J Pediatr Gastroenterol Nutr. 35 (5): 653–7. doi:10.1097/00005176-200211000-00012. PMID 12454581.
- ^ 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. doi:10.1136/jcp.39.5.524. PMC 499914. PMID 3722405.