Reactive gastropathy

Reactive gastropathy, chemical gastropathy also called gastritis of « C type » or "chemical gastritis"^[1] is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation.

Reactive gastropathy
Micrograph of a reactive gastropathy. H&E stain.
Specialty	Pathology, gastroenterology

Cause

Reactive gastropathy has a large number of causes, including:

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

Diagnosis

Reactive gastropathy, is characterized histologically by:^[2]
- Foveolar hyperplasia (black arrow), as a tortuosity in the "neck" region of the gastric glands.
- Scant or minimal inflammatory cells (white arrow), i.e. lack of large numbers of neutrophils and plasma cells..
- Smooth muscle hyperplasia in the lamina propria (in black oval).

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

• 
  Low mag.
• 
  High mag.

Relation to gastritis

Reactive gastropathy is morphologically distinct entity^[3][4] 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

• Gastritis